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目的探讨消除新生儿破伤风(Neonatal Tetanus,NT)的策略和措施。方法对上海市1995~2003年NT病例进行描述流行病学分析。结果上海市1995~2003年共报告NT 128例,死亡51例,病死率39.8%。全年发病无明显季节性,发病时间平均为出生后6.5d,男女性别之间差异有显著的统计学意义。1999~2003年作个案调查的74例NT中,仅1例的母亲有过1剂破伤风疫苗免疫史。128例NT中,126例(98.4%)在家中分娩,由未接受过培训的人员接生,其中123例(97.6%)使用的接生器械未经过消毒。结论要在流动人口集中的区域,加强宣传孕妇住院分娩、新法接生,减少或切断传染途径,消除流动人口中的NT。
Objective To explore the strategies and measures to eliminate neonatal tetanus (Neonatal Tetanus, NT). Methods Epidemiological analysis of NT cases from 1995 to 2003 in Shanghai was performed. Results A total of 128 NT cases were reported in Shanghai from 1995 to 2003, with 51 deaths and a mortality rate of 39.8%. The annual incidence of no significant seasonal onset time averaged 6.5d after birth, the difference between men and women was statistically significant. Of the 74 NT cases surveyed from 1999 to 2003, only 1 of the mothers had a history of tetanus immunization. Of the 128 NT cases, 126 (98.4%) were delivered at home and were delivered by untrained personnel, 123 of whom (97.6%) had not been sterilized. Conclusions In areas where the floating population is concentrated, it is necessary to step up hospitalization and delivery of pregnant women, take delivery of new drugs, reduce or cut off the route of transmission, and eliminate NT among floating population.