CAJ | 학술논문

目的分析中国传染病自动预警系统(CIDARS)在广西壮族自治区(广西)传染病暴发早期探测中应用效果.方法对2009-2011年预警系统移动百分位数法的预警信号及其信号响应率、响应时间、信号核实方式及响应结果进行描述性分析,并比较2010年12月10日预警参数调整前后的预警效果.结果广西区域内CIDARS共发出16种传染病的29 788条预警信号,平均每县每周约产生预警信号1.7条.信号响应率为100％,平均响应时间为1.5h.其中624条信号(2.09％)经初步核实后被判断为疑似暴发事件,经过现场调查最终确认9种传染病的191起暴发.总体上预警灵敏度为89.25％,探测及时性为2.8d.与预警参数调整前比较,预警参数调整后每月预警信号数减少,各病种预警灵敏度上升；除流行性腮腺炎外,流感、风疹及其他感染性腹泻的预警及时性均有所提高.结论 CIDARS在广西区域内预警信号响应率和响应及时性较高,通过调整预警参数可进一步改进预警系统的应用效果,但目前假阳性信号所占比例仍较大,需根据不同疾病的特点改进预警方法.
목적 분석중국전염병자동예경계통(CIDARS)재엄서장족자치구(엄서)전염병폭발조기탐측중응용효과.방법 대2009-2011년예경계통이동백분위수법적예경신호급기신호향응솔、향응시간、신호핵실방식급향응결과진행묘술성분석,병비교2010년12월10일예경삼수조정전후적예경효과.결과 엄서구역내CIDARS공발출16충전염병적29 788조예경신호,평균매현매주약산생예경신호1.7조.신호향응솔위100％,평균향응시간위1.5h.기중624조신호(2.09％)경초보핵실후피판단위의사폭발사건,경과현장조사최종학인9충전염병적191기폭발.총체상예경령민도위89.25％,탐측급시성위2.8d.여예경삼수조정전비교,예경삼수조정후매월예경신호수감소,각병충예경령민도상승；제류행성시선염외,류감、풍진급기타감염성복사적예경급시성균유소제고.결론 CIDARS재엄서구역내예경신호향응솔화향응급시성교고,통과조정예경삼수가진일보개진예경계통적응용효과,단목전가양성신호소점비례잉교대,수근거불동질병적특점개진예경방법.
Objective To analyze and further improvement the application of the China Infectious Diseases Automated-alert and Response System (CIDARS) in Guangxi Zhuang Autonomous Region.Methods Resuts related to the amount of signal,proportion of signal responded,time to signal response,manner of signal verification and on each signal of Guangxi in CIDARS from 2009 to 2011 were described.Performance was compared between the periods of pre/ post the adjustment of parameters in CIDARS on December 10,2010.Results A total of 29 788 signals were generated on 16 infectious diseases in the system in Guangxi.100％ signals had been responded with the median time to response as 1.5 hours.The average amount of signal per county per week was 1.7; with 624 signals (2.09％) verified as suspected outbreaks preliminarily and 191 outbreaks of 9 diseases were finally confirmed by further field investigation.The sensitivity of CIDARS was 89.25％,and the timeliness of detection was 2.8 d.After adjusting the parameter of CIDARS,the number of signals reduced,and the sensitivity and timeliness of detection improved for most of the diseases.Conclusion The signals of CIDARS were responded timely,and the performance of CIDARS might be improved by adjusting the parameters of early-warning model,which helped enhance the ability of outbreaks-detection for local public health departments.However the current proportion of false positive signals still seemed to be high,suggesting that both the methods and parameters should be improved,according to the characteristics of different diseases.