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为了解海口市1997~2000年新生儿破伤风(NT)的发病情况,利用该市法定传染病报告系统对4年来3个区的 NT病例进行分析。1997~2000年共有19例 NT发生,年发病率在 0.36‰至0.75‰(活产儿)之间波动,其中死亡 2例,病死率10.5%。秀英区是海口市经济较为滞后的地区,也是NT的高发地区,例如1998、1999、2000年发病率分别为1.79‰、2.64‰、1.11‰),均超过国家小于1‰的规定。19例NT中,流动人口17例(占89.4%),常住人口2例(占10.6%)。无证私人诊所接生16例(占84.2%),家中不洁接生3例(占15.8%)。19例NT中均无一例母亲接种过破伤风类毒素及知道NT为何病。结果提示经济较为落后的地区是本病的高发区,流动人口儿童是本病发生的主要人群,无证私人诊所接生是滋生本病的温床。因此,加强流动人口管理,尤其对育龄妇女进行破伤风类毒素接种是控制NT发生的有效手段。
To understand the incidence of neonatal tetanus (NT) from 1997 to 2000 in Haikou City, NT cases of 3 districts in 4 years were analyzed by using the reporting system of legal infectious diseases in this city. A total of 19 NT occurred between 1997 and 2000, with an annual incidence fluctuating between 0.36 ‰ and 0.75 ‰ (live births), of which 2 died and the case fatality rate was 10.5%. Xiuying District is a relatively laggard economy in Haikou City and also a high incidence area of NT. For example, the incidence rates in 1998, 1999 and 2000 were 1.79 ‰, 2.64 ‰ and 1.11 ‰ respectively, all exceeding the national requirements of less than 1 ‰. Of the 19 NT cases, 17 were migrants (89.4%) and 2 were residents (10.6%). 16 cases (84.2%) were admitted to a private clinic without a license and 3 cases (15.8%) were admitted to the household with unclean births. None of the 19 NT patients had their mother vaccinated with tetanus toxoid and knew why NT was sick. The results suggest that the economy is more backward areas is the high incidence of this disease, the floating population of children is the main population of this disease, the birth of a private clinic without permits is a breeding ground for this disease. Therefore, to strengthen the management of floating population, especially tetanus toxoid inoculation of women of childbearing age is an effective means to control the occurrence of NT.