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目的分析塞拉利昂埃博拉病毒病(Ebola virus disease,EVD)疫情流行特征,总结该国疫情未能及时控制原因,为今后我国新发和输入性传染病防控工作提供借鉴。方法收集世界卫生组织和塞拉利昂卫生部官方网站公布的疫情资料,采用描述性流行病学方法进行分析。结果至2015年3月1日,塞拉利昂共报告EVD病例11 446例,死亡3546人,发病率为180.6/10万,死亡率为55.9/10万。塞拉利昂疫情时间分布可分为五个阶段:悄然而缓慢传播阶段、暴发阶段、快速上升阶段、快速下降阶段、波动式缓慢下降阶段。疫情首发地区为西南部的凯拉洪,之后输入至西北部的坡特洛科,继而蔓延至全国。有登记信息的病例(10 903例)数据显示,女性发病率高于男性(P=0.01),年龄越大发病率越高(χ~2=2136.07,P<0.001)。医务人员发病率高于全国,有统计学意义(P<0.001)。结论塞拉利昂疫情未能及时控制的原因主要有:经济水平落后、文化习俗、防控资源不足、早期防控措施落实不到位等。该国疫情应对经验对我国今后新发和输入性传染病防控有重要的借鉴意义。
Objective To analyze the epidemiological characteristics of Ebola virus disease (EVD) in Sierra Leone, summarize the reasons for the failure to control the epidemic situation in the country in time, and provide reference for the prevention and control of emerging and imported sexually transmitted diseases in our country in the future. Methods Epidemic data released by WHO and the official website of Sierra Leone Ministry of Health were collected and analyzed by descriptive epidemiological method. Results As of March 1, 2015, a total of 11 446 EVD cases were reported in Sierra Leone, with 3,546 deaths. The incidence rate was 180.6 / 100,000 and the death rate was 55.9 / 100,000. The time distribution of the outbreak in Sierra Leone can be divided into five stages: quietly and slowly transmitting stage, outbreak stage, rapid rising stage, rapid descending stage and fluctuating slowly descending stage. The onset of the outbreak was Kailahun in the southwest, and then to Potrodoc in the northwest, before spreading to the entire country. The data of 10 903 cases with registration information showed that the incidence of women was higher than that of men (P = 0.01). The older the incidence was (χ ~ 2 = 2136.07, P <0.001). The incidence of medical staff was higher than that of the whole country, with statistical significance (P <0.001). Conclusions The main reasons for the failure to control the outbreak in Sierra Leone are: backward economy, cultural practices, inadequate resources for prevention and control, and inadequate implementation of early prevention and control measures. The response to the outbreak in the country is of great reference significance for the future prevention and control of imported infectious diseases in our country.