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目的分析江西省疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)的发生特征,评价监测系统运转情况,探讨提高监测系统敏感性的措施。方法对扩大免疫规划(Expanded Program onImmunization,EPI)Date数据库和免疫规划监测信息管理系统收集的江西省2005～2008年AEFI个案数据,采用描述性方法进行流行病学分析。结果有52.52%的县(市、区,下同)在4年内向监测系统报告了168例AEFI;乡级医疗机构及县级疾病预防控制中心(CDC)报告的占报告总数的86.90%;24h内报告的占48.21%,接到报告后48h内调查的占78.57%。168例AEFI中,男、女性别比为2∶1,国家免疫规划疫苗占71.43%,接种后<24h、24h～<48h、2～7d发生的分别占51.79%、16.07%、17.26%;临床损害为硬结、肿痛、脓肿的占1/3以上。报告AEFI病例居前三位的疫苗依次为:百日咳-白喉-破伤风联合疫苗(Diphtheria,Tetanus and Pertussis CombinedVaccine,DPT)、乙型肝炎疫苗、卡介苗(Bacille Calmette-Guerin,BCG);估计报告发生率居前三位的疫苗依次为:DPT、BCG、白喉-破伤风联合疫苗。结论江西省AEFI监测系统敏感性、报告及时性需进一步提高,建立AEFI补偿机制,将AEFI系统建成公众亦能报告的开放系统,有助于提高监测系统的敏感性。
Objective To analyze the occurrence characteristics of Adverse Events Following Immunization (AEFI) in Jiangxi Province, evaluate the operation of monitoring system and explore the measures to improve the sensitivity of monitoring system. Methods The data of AEFI cases from 2005 to 2008 in Jiangxi Province collected from the Expanded Program on Immunization (EPI) Date database and the immunization program monitoring information management system were used to carry out epidemiological analysis by descriptive method. Results 52.52% of the counties (cities, districts, the same below) reported 168 cases of AEFI to the monitoring system within 4 years; 86.90% of the total reports were reported by township medical institutions and county CDCs; 24h Accounting for 48.21% within the report, and 78.57% within 48 hours after receiving the report. 168 cases of AEFI, male and female ratio was 2: 1, the national immunization vaccine accounted for 71.43%, after vaccination <24h, 24h ~ <48h, 2 ~ 7d occurred accounted for 51.79%, 16.07%, 17.26% Damage to induration, swelling and pain, abscess accounted for more than 1/3. The top three vaccines reported in the AEFI cases were: Diphtheria, Tetanus and Pertussis Combined Vaccine (DPT), Hepatitis B vaccine, Bacille Calmette-Guerin (BCG); Estimated report rate The top three vaccines are: DPT, BCG, diphtheria-tetanus combination vaccine. Conclusion The sensitivity and reporting timeliness of AEFI monitoring system in Jiangxi Province need to be further improved. Establishing AEFI compensation mechanism and building an open system that AEFI system can report to public also help to improve the sensitivity of monitoring system.