CAJ | 학술논문

目的探讨2011年11月湖北省部分地区麻疹发病率突然升高的原因.方法选取2011年11月至2012年2月“湖北省麻疹监测信息报告管理系统”中报告麻疹发病率突然升高的W市和H市所有麻疹病例,通过查阅预防接种证了解病例麻疹疫苗接种史,并估算适龄儿童疫苗接种率.运用病例交叉研究,电话调查监护人,了解病例在麻疹发病前7 ～ 21 d(潜伏期内)和发病前37～51 d内就诊情况.结果调查两市共报告麻疹病例140例,其中＜8月龄和8～17月龄婴幼儿发病率较高(分别为69/10万和72/10万),其他年龄组发病率为0～5.8/10万.8～17月龄婴幼儿麻疹疫苗估算接种率＜75％,18月龄至3岁组接种率＜90％.58％的病例在发病前7～21d内有就医史,而发病前37～51 d内去医疗机构的病例占14％(RR=5.4,95％CI:2.1～14.0).结论在麻疹疫苗接种率不达标的情况下,儿童的医院暴露可增加麻疹发病风险.
목적 탐토2011년11월호북성부분지구마진발병솔돌연승고적원인.방법 선취2011년11월지2012년2월“호북성마진감측신식보고관리계통”중보고마진발병솔돌연승고적W시화H시소유마진병례,통과사열예방접충증료해병례마진역묘접충사,병고산괄령인동역묘접충솔.운용병례교차연구,전화조사감호인,료해병례재마진발병전7 ～ 21 d(잠복기내)화발병전37～51 d내취진정황.결과 조사량시공보고마진병례140례,기중＜8월령화8～17월령영유인발병솔교고(분별위69/10만화72/10만),기타년령조발병솔위0～5.8/10만.8～17월령영유인마진역묘고산접충솔＜75％,18월령지3세조접충솔＜90％.58％적병례재발병전7～21d내유취의사,이발병전37～51 d내거의료궤구적병례점14％(RR=5.4,95％CI:2.1～14.0).결론 재마진역묘접충솔불체표적정황하,인동적의원폭로가증가마진발병풍험.
Objective To identify the risk factors for reported sudden rise of measles incidence in November,2011,in some areas of Hubei province.Methods We analyzed all measles patients reported in the measles surveillance system from November 2011 to February 2012 in two prefectures with highest attack rates and their vaccination history by reviewing vaccination records.We interviewed patients' parents by telephone to obtain the history of visiting health care within 7 to 21 days before onset.We also used case-crossover study to estimate the relative risk (RR) of hospital acquired infection and to compare the exposure to health care between 7-21 days before onset to 37-51 days before onset among measles patients.Results Totally 140 patients were reported in the two prefectures.Reported measles incidence rates among the population aged ＜8 m (69/100 000) and 8 m to 17 m (72/100 000) were higher than other age groups (rang from 0 to 5.8 per 100 000).Among the population aged 8 m to 17 m,estimated vaccination coverage was lower than 75％,and it was lower than 90％ among those aged 18 m to 3 yrs.During 7-21 days before onset,58％(29/50) of the patients had an exposure to health care settings,compared to 14％ (7/50) of patients during 37 to 51 days before onset (MH RR=5.4,95％ confidence interval=2.1-14.0).Conclusion Under the condition of measles vaccination coverage lower than 95％,iatrogenic infection was a risk factor for measles in Hubei.