CAJ | 학술논문

目的比较国家传染病自动预警系统(CIDARS)中移动百分位数法采用不同阈值对传染病预警效果的影响.方法分别采用P50、P60、P70、P80和P90 5个阈值作为移动百分位数法的候选预警阈值,对全国范围2008年7月至2010年6月期间报告的19种法定传染病病例数进行暴发探测和结果的比较.以暴发探测起数最多、暴发探测时间最短和预警信号数最少作为移动百分位数法最优阈值的筛选标准.结果细菌性和阿米巴性痢疾的最优阈值为P50,其他感染性腹泻和流行性腮腺炎的最优阈值为P60,甲型肝炎、流行性感冒和风疹的最优阈值为P70,流行性乙型脑炎的最优阈值为P80,猩红热、伤寒和副伤寒、戊型肝炎、急性出血性结膜炎、疟疾、流行性出血热、流行性脑脊髓膜炎、钩端螺旋体病、登革热、流行性和地方性斑疹伤寒、丙型肝炎和麻疹12种疾病的最优阈值为P90;对19种传染病分别采用最优剧值进行探测,与所有疾病均采用P50作为阈值相比,2年可减少64 840条(12.20%)预警信号,而暴发探测起数与暴发探测时间没有变化.结论不同传染病采用移动百分位数法进行暴发探测的最优阈值不同,CIDARS可进一步优化各病种的预警阈值,从而在确保暴发探测准确性和及时性的前提下,减少预警信号数量.
목적 비교국가전염병자동예경계통(CIDARS)중이동백분위수법채용불동역치대전염병예경효과적영향.방법 분별채용P50、P60、P70、P80화P90 5개역치작위이동백분위수법적후선예경역치,대전국범위2008년7월지2010년6월기간보고적19충법정전염병병례수진행폭발탐측화결과적비교.이폭발탐측기수최다、폭발탐측시간최단화예경신호수최소작위이동백분위수법최우역치적사선표준.결과 세균성화아미파성이질적최우역치위P50,기타감염성복사화류행성시선염적최우역치위P60,갑형간염、류행성감모화풍진적최우역치위P70,류행성을형뇌염적최우역치위P80,성홍열、상한화부상한、무형간염、급성출혈성결막염、학질、류행성출혈열、류행성뇌척수막염、구단라선체병、등혁열、류행성화지방성반진상한、병형간염화마진12충질병적최우역치위P90;대19충전염병분별채용최우극치진행탐측,여소유질병균채용P50작위역치상비,2년가감소64 840조(12.20%)예경신호,이폭발탐측기수여폭발탐측시간몰유변화.결론 불동전염병채용이동백분위수법진행폭발탐측적최우역치불동,CIDARS가진일보우화각병충적예경역치,종이재학보폭발탐측준학성화급시성적전제하,감소예경신호수량.
Objective To compare the different thresholds of 'moving percentile method' for outbreak detection in the China Infectious Diseases Automated-alert and Response System (CIDARS). Methods The thresholds of P50, P60, P70, P80 and P90 were respectively adopted as the candidates of early warning thresholds on the moving percentile method. Aberration was detected through the reported cases of 19 notifiable infectious diseases nationwide from July 1,2008 to June 30,2010. Number of outbreaks and time to detection were recorded and the amount of signals acted as the indicators for determining the optimal threshold of moving percentile method in CIDARS. Results The optimal threshold for bacillary and amebic dysentery was P50. For non-cholera infectious diarrhea,dysentery, typhoid and paratyphoid, and epidemic mumps, it was P60. As for hepatitis A, influenza and rubella, the threshold was P70, but for epidemic encephalitis B it was P80. For the following diseses as scarlet fever, typhoid and paratyphoid, hepatitis E, acute hemorrhagic conjunctivitis, malaria, epidemic hemorrhagic fever, meningococcal meningitis, leptospirosis, dengue fever, epidemic endemic typhus,hepatitis C and measles, it was P90. When adopting the adjusted optimal threshold for 19 infectious diseases respectively, 64 840(12.20%)signals had a decrease, comparing to the adoption of the former defaulted threshold(P50)during the 2 years. However, it did not reduce the number of outbreaks being detected as well as the time to detection, in the two year period. Conclusion The optimal thresholds of moving percentile method for different kinds of diseases were different.Adoption of the right optimal threshold for a specific disease could further optimize the performance of outbreak detection for CIDARS.