中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2011年
1期
38-41
,共4页
仇小强%董柏青%杨进业%林玫%谭毅%吴兴华%李艺星%Stephen Hadler
仇小彊%董柏青%楊進業%林玫%譚毅%吳興華%李藝星%Stephen Hadler
구소강%동백청%양진업%림매%담의%오흥화%리예성%Stephen Hadler
流行性乙型脑炎%急性脑炎症候群%现场评估
流行性乙型腦炎%急性腦炎癥候群%現場評估
류행성을형뇌염%급성뇌염증후군%현장평고
Japanese encephalitis%Acute encephalitis syndrome%On-site assessment
目的 应用症候群监测资料评估WHO发布的流行性乙型脑炎(乙脑)监测手册(手册)中疑似病例定义和分类方法,为该手册提供现场依据和修订建议.方法 基于急性脑炎脑膜炎症候群监测项目,获取乙脑实验室确诊病例和急性脑炎症候群(AES)病例,利用队列研究中相对危险度(RR)和人群归因危险度百分比(AR%)评估AES与乙脑病例是否存在统计学关联及其强度大小和AES对人群中乙脑病例的覆盖范围.结果 研究期间共评估病例1424例,确诊乙脑103例.AES对人群中乙脑病例,RR=4.62,95%CI:2.80～7.63;AR%=78.35%,95%CI:64.25%～86.89%;筛检敏感度为81%(95%CI:79%～83%),特异度为53%(95%CI:50%～55%),约登指数为0.33,Kappa值为0.10,阳性、阴性预测值分别为13%和97%."AES+抽搐"病例定义对人群中乙脑病例,RR=9.84,AR%=89.83%.结论 AES病例定义对人群中乙脑病例有统计学意义上的筛检作用,AES与乙脑病例间存在较强程度的关联."抽搐"定义具有良好的乙脑病例筛检价值,建议在新版手册中予以采用.
目的 應用癥候群鑑測資料評估WHO髮佈的流行性乙型腦炎(乙腦)鑑測手冊(手冊)中疑似病例定義和分類方法,為該手冊提供現場依據和脩訂建議.方法 基于急性腦炎腦膜炎癥候群鑑測項目,穫取乙腦實驗室確診病例和急性腦炎癥候群(AES)病例,利用隊列研究中相對危險度(RR)和人群歸因危險度百分比(AR%)評估AES與乙腦病例是否存在統計學關聯及其彊度大小和AES對人群中乙腦病例的覆蓋範圍.結果 研究期間共評估病例1424例,確診乙腦103例.AES對人群中乙腦病例,RR=4.62,95%CI:2.80～7.63;AR%=78.35%,95%CI:64.25%～86.89%;篩檢敏感度為81%(95%CI:79%～83%),特異度為53%(95%CI:50%～55%),約登指數為0.33,Kappa值為0.10,暘性、陰性預測值分彆為13%和97%."AES+抽搐"病例定義對人群中乙腦病例,RR=9.84,AR%=89.83%.結論 AES病例定義對人群中乙腦病例有統計學意義上的篩檢作用,AES與乙腦病例間存在較彊程度的關聯."抽搐"定義具有良好的乙腦病例篩檢價值,建議在新版手冊中予以採用.
목적 응용증후군감측자료평고WHO발포적류행성을형뇌염(을뇌)감측수책(수책)중의사병례정의화분류방법,위해수책제공현장의거화수정건의.방법 기우급성뇌염뇌막염증후군감측항목,획취을뇌실험실학진병례화급성뇌염증후군(AES)병례,이용대렬연구중상대위험도(RR)화인군귀인위험도백분비(AR%)평고AES여을뇌병례시부존재통계학관련급기강도대소화AES대인군중을뇌병례적복개범위.결과 연구기간공평고병례1424례,학진을뇌103례.AES대인군중을뇌병례,RR=4.62,95%CI:2.80～7.63;AR%=78.35%,95%CI:64.25%～86.89%;사검민감도위81%(95%CI:79%～83%),특이도위53%(95%CI:50%～55%),약등지수위0.33,Kappa치위0.10,양성、음성예측치분별위13%화97%."AES+추휵"병례정의대인군중을뇌병례,RR=9.84,AR%=89.83%.결론 AES병례정의대인군중을뇌병례유통계학의의상적사검작용,AES여을뇌병례간존재교강정도적관련."추휵"정의구유량호적을뇌병례사검개치,건의재신판수책중여이채용.
Objective To assess the new edition of WHO Japanese Encephalitis (JE) Surveillance Standards (WHO Standards) based on syndrome surveillance data and to provide field evidence regarding the standards. Methods Based on syndrome surveillance data, acute encephalitis syndrome (AES) case was categorized, according to the WHO Standards. A cohort study was applied to estimate the AES definition set in the Standard and relative risk was computed to estimate the existence and intensity of statistical correlation between AES and JE cases. Percentage of attributable risk was counted to describe the coverage of AES for JE cases in the studied population. Sensitivity,specificity, Youden index and positive predictive value of AES components were calculated for the purpose of identifying the clinical values under the screening program. Results 1424 suspected cases were evaluated in the surveillance program and 1396 cases with ELISA result, of which 109 positive cases were detected. According to the "standardized" classification, a total of 706 cases in line with AES case deftuition, were categorized into 83 cases of JE, 425 cases of AES unknown and 198 cases of AES other agent. In the cohort study,a relative risk of 4.62 (95% CI:2.80-7.63 ) and the percentage of attributable risk as 78.35% (95% CI: 64.25% -86.89% ) were observed. Conclusion The AES definition for JE was significantly effecting on the screening programs and a strong correlation strength was observed in the study. AES syndrome could cover most of the JE cases. "Convulsions",with appreciative screening value, was recommended to be involved into the new version of the WHO Standards.
