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目的通过分析新疆喀什地区痢疾流行现状,发现高危因素,为今后采取针对性预防控制措施提供科学依据。方法资料来源于2005—2014年中国疾病监测信息报告管理系统,采用描述流行病学方法分析痢疾的三间分布特征。结果喀什地区2005—2014年累计报告痢疾17 860例,年平均报告发病率为45.57/10万,年平均报告死亡率0.01/10万,病死率为0.002%。发病人群以3岁以下儿童为主,男女之比1.11∶1。喀什地区痢疾发病有明显的季节性,5—9月份为发病高峰期。喀什噶尔河流域区域(伽师县、岳普湖县、疏附县、疏勒县、喀什市)的5个县市发病率明显高于叶尔羌河流域区域(英吉沙县、莎车县、泽普县、叶城县、麦盖提县、巴楚县)的6个县,二者相比差异有统计学意义(χ2=2 824.01,P<0.01)。流行菌株为福氏志贺菌。结论 2005—2014年痢疾发病率总体呈现下降趋势,可能与监测方式改变有关;发病以农民、散居儿童为主。喀什地区应针对重点人群、重点区域采取以管理好传染源、切断传播途径、健康教育、大搞爱国卫生、加强饮用水管理为主的综合预防措施,防止出现暴发流行,持续有效控制痢疾报告发病率。
Objective To analyze the status quo of dysentery in Kashgar region of Xinjiang and find out the risk factors to provide a scientific basis for the targeted prevention and control measures in the future. Methods Data were collected from China Disease Surveillance Information Reporting Management System from 2005 to 2014, and the epidemiological methods were used to analyze the three distribution characteristics of diarrhea. Results A total of 17 860 cases of dysentery were reported in Kashgar region from 2005 to 2014, with an average annual incidence of 45.57 / 100 000. The annual average reported mortality was 0.01 / 100,000 and the case fatality rate was 0.002%. The incidence of children under 3 years of age, male to female ratio of 1.11: 1. The incidence of dysentery in Kashgar region is obviously seasonal, the peak period of incidence is from May to September. The incidence rates of the five counties in the areas of Kashgar River Basin (Jiashi County, Yuepuhu County, Shufu County, Shule County and Kashgar City) were significantly higher than those in the Yarkand River Basin (Yingjisha County, Shache County, Zepu (Χ2 = 2 824.01, P <0.01) compared with the other six counties in the county, county, Yecheng, Maigeiti and Bachu. The popular strain is Shigella flexneri. Conclusion The overall incidence of dysentery in 2005-2014 shows a downward trend, which may be related to the change of monitoring methods. The incidence of dysentery is dominated by peasants and scattered children. Kashi Prefecture should focus on key populations and key areas to take integrated preventive measures to manage sources of infection, cut off the route of transmission, health education, vigorously patriotic health, strengthen drinking water management to prevent an outbreak and continue to effectively control the incidence of dysentery reports rate.