CAJ | 학술논문

目的初步了解国家传染病自动预警系统(CIDARS)在基层传染病暴发早期探测中发挥的作用.方法在云南和湖南两省共选取4个市(县、区),对2008年7月1日至2010年6月30日预警相关病种的报告病例数、预警信号数、预警信号初步核实结果反馈时间间隔和初步核实方式、预警信号初步核实和现场调查结果进行分析.结果两省4个市(县、区)共报告了纳入预警系统的28种传染病病例12 346例,预警系统共发出2096条预警信号,共涉及19种疾病,平均每个市(县、区)每周预警信号数为4.94条.预警信号初步核实结果反馈时间间隔中位数为0.70 h(P25～P75为0.06-1.29h),预警信号初步核实的主要方式是监测数据分析(占63.07%).预警信号经过初步核实后,共有4种传染病的34条预警信号被判断为疑似事件信号,占总预警信号的1.62%;4个市(县、区)的疑似事件信号占预警信号的比例有较大差异,其中湖南省双峰县比例最高(4.71%)、昆明市西山区比例最低(0.58%),长沙市岳麓区为1.88%、云南省个旧市为0.95%.疑似事件经过进一步现场调查后确认了12起暴发,其中风疹事件5起,流行性腮腺炎4起,流行性感冒2起,伤寒1起.结论 CIDARS能够辅助基层疾病预防控制机构早期发现可能的传染病暴发,但不同地区、不同病种的预警效果存在差别.
목적 초보료해국가전염병자동예경계통(CIDARS)재기층전염병폭발조기탐측중발휘적작용.방법 재운남화호남량성공선취4개시(현、구),대2008년7월1일지2010년6월30일예경상관병충적보고병례수、예경신호수、예경신호초보핵실결과반궤시간간격화초보핵실방식、예경신호초보핵실화현장조사결과진행분석.결과 량성4개시(현、구)공보고료납입예경계통적28충전염병병례12 346례,예경계통공발출2096조예경신호,공섭급19충질병,평균매개시(현、구)매주예경신호수위4.94조.예경신호초보핵실결과반궤시간간격중위수위0.70 h(P25～P75위0.06-1.29h),예경신호초보핵실적주요방식시감측수거분석(점63.07%).예경신호경과초보핵실후,공유4충전염병적34조예경신호피판단위의사사건신호,점총예경신호적1.62%;4개시(현、구)적의사사건신호점예경신호적비례유교대차이,기중호남성쌍봉현비례최고(4.71%)、곤명시서산구비례최저(0.58%),장사시악록구위1.88%、운남성개구시위0.95%.의사사건경과진일보현장조사후학인료12기폭발,기중풍진사건5기,류행성시선염4기,류행성감모2기,상한1기.결론 CIDARS능구보조기층질병예방공제궤구조기발현가능적전염병폭발,단불동지구、불동병충적예경효과존재차별.
Objective To understand the effectiveness of China Infectious Disease Automated-alert and Response System(CIDARS)for outbreak detection at the regional level.Methods Two counties in Hunan province(Yuelu and Shuangfeng county)and two counties in Yunnan province(Xishan and Gejiu county)were chosen as the study areas. Data from CIDARS were analyzed on the following items: reported cases, warning signals, the time interval of signal response feedback, way of signal verification, outcome of signal verification and field investigation, from July 1,2008 to June 30,2010. Results In total, 12 346 cases from 28 kinds of diseases were reported,and 2096 signals of 19 diseases were generated by the system, with an average of 4.94 signals per county per week. The median of time interval on signal verification feedback was 0.70 hours(P25-P75:0.06-1.29 h)and the main way of signal preliminary verification was through the review of surveillance data(account for 63.07%). Among all the signals, 34 of them(1.62%)were considered to be related to suspected events via the preliminary verification at the local level. Big differences were found to have existed on the proportion of signals related to the suspected events of the total signals among the four counties, with Shuangfeng county as 4.71%, Yuelu county as 1.88%, Gejiu county as 0.95% and Xishan county as 0.58%. After an indepth study on the fields of suspected events, 12outbreaks were finally confirmed, including 5 on rubella, 4 on mumps, 2 on influenza and 1 on typhoid fever. Conclusion CIDARS could be used to assist the local public health institutions on early detection of possible outbreaks at the early stage. However, the effectiveness was different depending on the regions and diseases.