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目的比较国家传染病自动预警系统(CIDARS)不同的探测范围对手足口病聚集性疫情的预警效果,为CIDARS的完善和改进提供依据。方法收集2014年1月1日至2016年12月31日CIDARS在上海市浦东新区发出的手足口病时间模型预警信号,以同期该区域发生的聚集性手足口病疫情作为评价标准,分析CIDARS的预警灵敏度、错误预警率;选择浦东新区3个街道/镇,缩小CIDARS预警探测范围,比较每个街道/镇不同探测范围的预警效果差异。结果2014 2016年,CIDARS在浦东新区共发出393个手足口病预警信号,成功预警了182起聚集性手足口病疫情;同期浦东新区发生手足口病聚集性疫情726起,CIDARS预警灵敏度为24.97%,错误预警率53.69%。对大、中、小3种规模的手足口病聚集性事件预警灵敏度分别为100.00%、45.30%和16.05%,差异有统计学意义。将CIDARS的探测范围从全区缩小为街道/镇后,3个街道/镇的预警灵敏度分别从原来的25.93%、13.04%和50.00%上升至88.89%、78.26%和100.00%,错误预警率有所上升,但无显著性变化。结论 CIDARS对浦东新区小规模手足口病聚集性事件的预警效果欠佳,模型探测范围从全区缩小至街道/镇后,对聚集性手足口病疫情的预警效果明显提高;CIDARS应进一步缩小预警模型的探测范围,以提高对聚集性疫情的预警效果。
Objective To compare the warning effect of different detection ranges of CIDARS on the aggregation epidemic situation of hand foot and mouth disease and provide the basis for the improvement and improvement of CIDARS. Methods CIDARS time-model warning signals of hand-foot-mouth disease were collected from January 1, 2014 to December 31, 2016 in Shanghai Pudong New Area. Taking the aggregated hand-foot-and-mouth disease epidemic occurring in this area as the evaluation criteria, the CIDARS Early warning sensitivity and wrong warning rate. Choosing 3 streets / towns in Pudong, narrow CIDARS early warning detection range and compare the warning effect difference of different detection range of each street / town. Results 2014 In 2016, CIDARS issued a total of 393 hand-foot-mouth disease warning signals in Pudong New Area and successfully warned 182 cases of HFMD. In the same period, 726 HFMD outbreaks occurred in Pudong New Area. The CIDARS alert sensitivity was 24.97% , False alarm rate of 53.69%. The sensitivities of early, middle and small scale HFMH aggregation events were 100.00%, 45.30% and 16.05% respectively, with statistical significance. After narrowing the CIDARS detection range from the whole area to a street / town, the early-warning sensitivity of the three streets / townships increased from 25.93%, 13.04% and 50.00% to 88.89%, 78.26% and 100.00% respectively. The false alarm rate The increase, but no significant change. Conclusion CIDARS has a poor early warning effect on the small-scale HFMD aggregation event in Pudong New Area. The detection range of the model decreases from the whole area to the street / town, and the warning effect on the aggregation HFMD is obviously increased. CIDARS should further reduce the warning The detection range of the model to improve the warning effect of the cluster epidemic.