中国2012~2014年麻疹监测系统运转情况分析

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目的评价中国(未包括香港、澳门特别行政区和台湾地区)2012~2014年麻疹监测系统(Measles Surveillance System,MSS)的运转状况,为加强麻疹监测、消除麻疹提供参考。方法分析31个省(自治区、直辖市,下同)2012~2014年通过MSS报告的疑似麻疹病例个案数据库,评价MSS的主要运转指标。结果全国2012年共报告疑似麻疹37 635例,其中6183例为麻疹(98.5%为实验室确诊病例),排除麻疹31 452例;2013年共报告疑似麻疹78 387例,其中27 646例为麻疹(96.3%为实验室确诊病例),排除麻疹50 741例;2014年共报告疑似麻疹127 522例,其中52 628例为麻疹(91.8%为实验室确诊病例),排除麻疹74 894例。2009年以来MSS各项运转指标逐年提高,2012~2014年,全国排除麻疹病例报告发病率分别为2.34/10万、3.74/10万、4.34/10万(2014年有24个省>2/10万),疑似麻疹病例48小时内个案调查率分别为98.3%、98.5%、98.3%(所有省均>80%),疑似麻疹病例血清学检测结果 <7天报告率分别为97.1%、97.5%、95.3%(2014年有29个省>80%),散发疑似麻疹病例血标本采集率分别为97.3%、97.5%、96.5%(2014年有30个省>80%)。2012~2014年,麻疹爆发疫情实验室确诊率均>90%,但麻疹爆发疫情病原学标本采集率仅从36.4%上升至78.3%。结论中国MSS运转良好,2009年以来各项监测指标均逐年提高。但各省MSS运转质量不均衡,需进一步提高MSS敏感性、特异性和及时性,以适应消除麻疹需要。 Objective To evaluate the operational status of Measles Surveillance System (MSS) in China (excluding Hong Kong, Macau Special Administrative Region and Taiwan) from 2012 to 2014 and provide a reference for strengthening measles surveillance and eliminating measles. Methods The case database of suspected cases of measles reported by MSS from 2012 to 2014 in 31 provinces (autonomous regions and municipalities directly under the Central Government) was analyzed to evaluate the main operational indicators of MSS. Results A total of 37,635 suspected measles cases were reported nationwide in 2012, of which 6,883 were measles (98.5% laboratory confirmed cases) and 31,482 measles cases were excluded. In 2013, a total of 78,387 measles cases were reported, of which 27,646 were measles 96.3% were laboratory confirmed cases) and 50 741 cases were excluded. A total of 127 522 measles cases were reported in 2014, of which 52 628 were measles (91.8% were laboratory confirmed cases) and 74 894 cases were excluded. The operating indicators of MSS have been increasing year by year since 2009, and the incidence of measles cases excluding measles nationwide was 2.34 / 100,000, 3.74 / 100,000 and 4.34 / 100,000 respectively from 2012 to 2014 (24 provinces> 2/10 in 2014 Cases of suspected measles cases were 98.3%, 98.5% and 98.3% within 48 hours respectively (all provinces> 80%). Serum test results of suspected measles cases were 97.1% and 97.5% respectively in 7 days. , 95.3% (80% of 29 provinces in 2014), and the blood samples collected from suspected cases of measles were collected at 97.3%, 97.5% and 96.5% respectively (2014: 30%> 80%). From 2012 to 2014, the diagnosis rate of measles outbreak laboratory was> 90%, but the collection rate of the etiological specimens of measles outbreak increased from 36.4% to 78.3%. Conclusion The MSS in China is in good condition. Various monitoring indicators have been increasing year by year since 2009. However, the quality of MSS operation in various provinces is not balanced, and the sensitivity, specificity and timeliness of MSS need to be further improved to meet the needs of eliminating measles.
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