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目的分析高县流行性乙型脑炎(乙脑)流行特征,为预防和控制工作提供科学依据。方法用描述流行病学方法对高县1960-2013年乙脑疫情资料进行统计分析。结果 1960-2013年高县累计报告乙脑629例,死亡57例,总发病率和死亡率分别为2.70/10万和0.25/10万,1972-2013年各年发病率差异具有统计学意义(χ2=329.22,P<0.01)。疫苗使用前期,发生3次暴发流行,总发病率为5.56/10万,发病率呈现上升趋势(趋势χ2=77.22,P<0.01);疫苗使用初期,总发病率为2.23/10万,与疫苗使用前期相比,发病下降71.82%,总发病率呈现下降趋势(趋势χ2=14.82,P<0.01);计划免疫冷链运转期,总发病率为1.73/10万,1990-1994年与疫苗使用初期相比,发病率下降7.18%;规范门诊接种期,总发病率为1.04/10万,2004-2013年与冷链运转期相比,发病率下降20.44%。发病高峰在8-9月,占病例总数的75.83%。病例集中在7岁以下,占病例总数的64.39%。男女性别比为1.78∶1,差异具有统计学意义(χ2=49.80,P<0.01)。发病最多的是散居儿童,其次是托幼儿童和学生,共占病例总数的85.85%。结论高县乙脑发病率呈现逐年下降趋势,提示疫情得到较好控制。发病具有明显的季节性,男性发病高于女性,7岁以下散居儿童和托幼儿童是高危人群,应加强预防接种和防蚊灭蚊为主的综合防治措施。
Objective To analyze the epidemiological characteristics of Japanese encephalitis (JE) in high counties and provide a scientific basis for prevention and control. Methods Descriptive epidemiological methods were used to analyze the epidemic data of JE from 1960 to 2013 in Gao County. Results A total of 629 JE cases and 57 deaths were reported in Gaoxian County from 1960 to 2013. The overall incidence and mortality rates were 2.70 / lakh and 0.25 / lakh respectively. The difference in incidence between 1972 and 2013 was statistically significant ( χ2 = 329.22, P <0.01). In the early stage of vaccine use, the outbreak occurred 3 times with a total incidence of 5.56 / 100 000, the incidence showed an upward trend (trend χ2 = 77.22, P <0.01); the initial incidence of the vaccine was 2.23 per 100 000, Compared with the pre-treatment period, the incidence decreased 71.82%, the overall incidence showed a downward trend (trend χ2 = 14.82, P <0.01); immunization cold chain operation period, the overall incidence was 1.73 / 100000, 1990-1994 and vaccine use Compared with the beginning of cold chain operation, the incidence decreased by 7.18%. The outpatient coverage rate was 1.04 / 100000 during standard outpatient inoculation, and the incidence rate was decreased by 20.44% compared with that in cold chain during 2004-2013. The peak incidence in August-September, accounting for 75.83% of the total number of cases. Cases concentrated in the 7-year-old, accounting for 64.39% of the total number of cases. The ratio of male to female was 1.78:1, the difference was statistically significant (χ2 = 49.80, P <0.01). The most common diseases were scattered children, followed by kindergartens and children, accounting for 85.85% of the total cases. Conclusions The incidence of JE in Gao County shows a declining trend year by year, suggesting that the epidemic situation is well controlled. The onset is obviously seasonal. The incidence of male is higher than that of female. Diaspore children and kindergarten children under 7 years old are at high risk. Comprehensive prevention and control measures such as vaccination and mosquito control should be strengthened.