CAJ | 학술논문

目的评估云南省玉溪市红塔区2008年5月1日至2009年4月30日甲型副伤寒的流行病学负担.方法在建立基于全人群的发热症状监测系统基础上,分别调查和测算红塔区发热病例的就诊率,就诊病例采样率,样本检测率,检测方法灵敏度和实验室确诊病例报告率等,根据食源型疾病的疾病负担金字塔模型对当地伤寒、副伤寒的实际发病数进行估算和分析.结果发热症状监测系统一年内共监测红塔区发热病例6642例,采样并检测6570例,采样率为98.92%,检测率为100%.确诊居住在红塔区的甲型副伤寒阳性病例354例.调查发现发热病例就诊率为73.53%,其中10岁以下儿童就诊率为100%.依据参考文献假定血培养法检测甲型副伤寒的灵敏度为70%,病例网络报告率为90%,经倍数校正后估算红塔区甲型副伤寒年发病数为965例(95%CI:745～2284),年发病率为220.33/10万(95%CI:170.1～521.4),其中发病率最高的年龄组为15～44岁组(318.27/10万).结论玉溪市红塔区甲型副伤寒处于高流行状态,15～44岁组为高发人群,应采取有针对性的防治措施以减缓甲型副伤寒的高发态势.
목적 평고운남성옥계시홍탑구2008년5월1일지2009년4월30일갑형부상한적류행병학부담.방법 재건립기우전인군적발열증상감측계통기출상,분별조사화측산홍탑구발열병례적취진솔,취진병례채양솔,양본검측솔,검측방법령민도화실험실학진병례보고솔등,근거식원형질병적질병부담금자탑모형대당지상한、부상한적실제발병수진행고산화분석.결과 발열증상감측계통일년내공감측홍탑구발열병례6642례,채양병검측6570례,채양솔위98.92%,검측솔위100%.학진거주재홍탑구적갑형부상한양성병례354례.조사발현발열병례취진솔위73.53%,기중10세이하인동취진솔위100%.의거삼고문헌가정혈배양법검측갑형부상한적령민도위70%,병례망락보고솔위90%,경배수교정후고산홍탑구갑형부상한년발병수위965례(95%CI:745～2284),년발병솔위220.33/10만(95%CI:170.1～521.4),기중발병솔최고적년령조위15～44세조(318.27/10만).결론 옥계시홍탑구갑형부상한처우고류행상태,15～44세조위고발인군,응채취유침대성적방치조시이감완갑형부상한적고발태세.
Objective To evaluate the burden of paratyphoid fever A in Hongta district, Yuxi city, Yunnan province from May 1, 2008 to April 30, 2009 so as to provide information for the development of comprehensive intervention measures. Methods Based on the Fever Syndromic Surveillance System, information as attendance rate of patients with fever, rate of patients being sampled, laboratory testing rate, sensitivity on the detection of blood culture and the rate of case reporting etc. were calculated. According to the pyramid model of food-borne disease on disease burden, the local actual incidence of paratyphoid fever A was estimated and analyzed. Results Under the Fever Syndromic Surveillance System, there were 6642 fever cases being detected, among whom 6570 cases were sampled and undergone testing, with the sampling rate as 98.92% and all the samples received laboratory testing. There were 354 positive cases of paratyphoid fever A reported,all from the Hongta district. Data showed that the attendance rate of the feverish patients was 73.53%,with the highest rate seen in whose under 10 years old (100%). Assumed that the sensitivity of paratyphoid fever blood culture was 70%, and the case reporting rate was 90%, we estimated that the annual incidence of paratyphoid fever A in Hongta was 220.33 (95% CI: 170.1-521.4) per 100 thousand, with 965 (95%CI: 745-2284) as new cases. Among all the age groups, the incidence in the age group from 15 to 44 years old was estimated to be at the highest (318.27 per 100 thousand).Conclusion Hongta seemed to be an endemic region for paratyphoid fever A, with the highest incidence occurred in the age group of between 15 and 44 years old. These findings highlighted the urgent need to carry out further investigation on the risk factors and to implement targeted effective prevention and control measures.