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目的及时了解、掌握伤寒高发区流行情况。方法在广西河池市的金城江辖区内的金城江镇、东江镇建立以人口为基数的监测系统开展伤寒监测,监测内容包括对发热疑似病人进行病原学、血清学检测;对就诊发热病例进行登记。监测区内的各级医疗机构及大部分的个体诊所均作为监测点。以病原学为确诊依据,肥达试验作为辅助诊断依据。结果监测区内4年的伤寒副伤寒发病数为99例,年均年龄段发病率为20.6/10万。病原学监测9049份标本,分离出伤寒、副伤寒菌99株,其中甲型副伤寒沙门氏菌占70.1%,伤寒沙门氏菌仅占29.9%;伤寒副伤寒症状相似,以发热头痛为主要症状。结论监测区内以散发病例为主要流行趋势,监测的发病率低于以往的常规疫情报告,甲型副伤寒沙门菌是优势菌型;肥达试验在常规监测中的诊断意义较差,确诊伤寒、副伤寒病例的肥达试验诊断符合率低。
Purpose To keep abreast of and understand the prevalence of high incidence of typhoid fever. Methods To establish a population-based monitoring system for typhoid fever in Jinchengjiang and Dongjiang townships in Hecheng City, Hechi City, Guangxi. The surveillance includes etiological and serological tests on suspected feverish patients and registration of fever cases . The medical institutions at various levels and most individual clinics in the monitoring area serve as monitoring points. The etiology as the basis for diagnosis, as the basis for assisting the diagnosis of fat. Results The incidence of typhoid and paratyphoid fever in 4 years in the monitoring area was 99 cases, with an average annual incidence of 20.6 / 100000. Ninety ninety-nine specimens were isolated from the etiology. Ninety isolates of typhoid and paratyphoid fever were isolated, of which Salmonella paratyphi A accounted for 70.1% and Salmonella typhi accounted for only 29.9%. Symptoms of typhoid and paratyphoid fever were similar with fever headache as the main symptom. Conclusions The prevalence of sporadic cases in monitoring area is the main epidemic trend, the incidence of surveillance is lower than the previous reports of routine epidemic situation, Salmonella paratyphi A is the predominant bacterium, and the diagnostic significance of routine testing is poor. The diagnosis of typhoid fever , Cases of paratyphoid fever test consistent with the low rate of diagnosis.