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目的分析、评价广州市近年来4次登革热疫情及其媒介防治的情况与效果。方法收集、分析本地病例的流行病学调查资料。采用布雷图指数、标准间指数、叮刺率等方法监测和调查白纹伊蚊密度。结果4次流行共发生2 286例本地病例,疫情最早首发于5月,最晚终止于12月,发病高峰在8~10月,共出现40个暴发疫点,累计流行614 d。经过积极的防治,白纹伊蚊幼虫密度呈下降趋势。布雷图指数从2002年的11.99降到2007年的4.64,标准间指数从2003年的4.45降到2007年的0.54。但在登革热高发季节,白纹伊蚊幼虫的密度指数仍处于危险的阈值范围。使用速杀型杀虫剂对疫点进行超低容量喷雾灭蚊,对成蚊的杀灭率达98.2%。对农村、城中村、社区等3种类型疫点的控制历时分别为10.3、49.4、56.6 d(P<0.01)。结论登革热疫情的控制,必须坚持以及时、快速、全面、反复地杀灭媒介伊蚊成蚊为主导,辅之以全面落实清除、控制孳生地的措施。要不断探索、完善对媒介伊蚊(尤其是成蚊)的监测方法和手段,以客观、科学地评估防治的效果。
Objective To analyze and evaluate the situation and effect of four dengue fever epidemic and its prevention and treatment in Guangzhou in recent years. Methods Collecting and analyzing the epidemiological survey data of local cases. The density of Aedes albopictus was monitored and investigated by means of the Brettizer index, standard index and tinker rate. Results A total of 2 286 cases of local epidemic occurred in 4 epidemics. The earliest outbreak was in May and the latest was in December. The peak incidence peak was in August to October. A total of 40 outbreaks were observed and the cumulative prevalence was 614 days. After positive control, Aedes albopictus larvae density showed a downward trend. The Bretton Woods index dropped from 11.99 in 2002 to 4.64 in 2007, while the benchmark index dropped from 4.45 in 2003 to 0.54 in 2007. However, in the season of dengue fever, the density index of Aedes albopictus larvae is still at a dangerous threshold. The use of instant kill type insecticide for the low-volume spray epidemic killing mosquitoes, the killing rate of adult mosquitoes reached 98.2%. The control over the three types of epidemic diseases in rural areas, villages in villages, and communities lasted for 10.3, 49.4 and 56.6 days respectively (P <0.01). Conclusion The control of dengue fever epidemic must be dominated by the timely, rapid, comprehensive and repeated killing of adult mosquitoes of Aedes albopictus, which is complemented by the full implementation of the measures of clearing and controlling breeding places. We should continue to explore and improve the methods and means of monitoring Aedes mosquitoes, especially adult mosquitoes, so as to objectively and scientifically evaluate the effects of prevention and treatment.