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目的研究广东省消除麻疹策略和实施效果。方法采用描述流行病学方法,研究2005-2013年期间不同免疫、监测和管理策略对广东省消除麻疹进程的影响。结果全省麻疹报告发病率2005-2007年持续升高,2008年开始下降,2011年达到历史最低水平,2012年起出现反弹,2013年麻疹报告发病率达到6.63/10万。近年麻疹发病年龄出现向两端移动。含麻疹成分疫苗第1剂估算接种率低于报告和调查接种率。补充免疫不仅可减少目标人群发病,而且显著减少其他人群发病。本土麻疹病毒流行尚未被阻断。产前最后1个月的孕妇、新生儿、3、6、8月龄婴儿的麻疹Ig G抗体阳性率分别为97.83%、97.83%、23.19%、12.32%和1.45%。8月龄-14岁麻疹病例中约有18.2%疑似麻疹疫苗相关病例。结论广东省消除麻疹取得重大进展,但离消除麻疹目标差距较大,需加大消除麻疹策略的落实力度,提高人群含麻疹成分疫苗接种率。
Objective To study the strategy of eliminating measles and its effect in Guangdong Province. Methods Descriptive epidemiological methods were used to study the impact of different immunization, surveillance and management strategies during 2005-2013 on measles elimination in Guangdong. Results The incidence of measles in the whole province kept increasing from 2005 to 2007, and began to decline in 2008, reaching the lowest level in history in 2011 and rebounding from 2012 onwards. The incidence of measles in 2013 reached 6.63 / 100,000. In recent years, the onset of measles appears to move to both ends. The estimated inoculation rate for the first dose of the measles-containing vaccine was lower than the reported and surveyed vaccination rates. Supplementary immunization not only reduces the incidence of the target population, but also significantly reduces the incidence of other populations. The local epidemic of measles virus has not been blocked. The positive rates of measles Ig G antibody in pregnant women, newborns, 3, 6, and 8 months olds in the last month of prenatal period were 97.83%, 97.83%, 23.19%, 12.32% and 1.45%, respectively. About 18.2% of measles-related cases of measles were found in measles cases between the ages of 8 months and 14 years. Conclusion Significant progress has been made in eradicating measles in Guangdong Province, but there is a big gap between the goal of eliminating measles and the need to step up efforts to eliminate measles and raise the population coverage of measles-containing vaccines.