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目的继续保持德江县无脊髓灰质炎(脊灰)状态,为该县消灭脊灰工作提供科学依据。方法对德江县2004—2012年急性迟缓性麻痹(AFP)监测系统进行分析和评价。结果德江县2004—2012年共报告27例AFP病例,平均年报告率为2.62/10万。病例分布在全县12个乡镇,占总乡镇数的60%。AFP病例中男女性别比为2∶1;男性发病率3.36/10万,女性发病率1.82/10万,男女发病率比为1.68∶1,男女发病率差异无统计学意义(χ2=2.35,P﹥0.05)。德江县1～7岁AFP儿童发病占总病例数62.96%,27例AFP经60 d随访有16例恢复,11例未恢复,残留麻痹率为40.74%(其中3例死亡)。全程免疫残留麻痹率为37.5%,未全程免疫残留麻痹率为66.67%,差异无统计学意义(χ2=0.94,P﹥0.05)。0～7岁组发病率为3.28/10万(17/517 937),8～14岁组发病率为1.95/10万(10/513 251),差异无统计学意义(χ2=2.35,P﹥0.05)。当地报告病例9例,占33.33%;外县报告18例,占66.67%。结论该县AFP病例监测系统运转良好。做好常规免疫和强化免疫、查漏补种和AFP合格标本的采集工作,强化医务人员对AFP报告意识,提高首诊报告率,是有效维持无脊灰状态的重要工作。加强相关单位AFP病例诊断水平,防止漏诊、漏报、误诊,提高AFP合格标本采集率;提高监测敏感力度是今后该县工作的重点。
Objective To continue to maintain the state of poliomyelitis-free (poliomyelitis) in Dejiang County and provide a scientific basis for the eradication of polio in this county. Methods The AFP monitoring system in Dejiang County from 2004 to 2012 was analyzed and evaluated. Results A total of 27 cases of AFP were reported in Dejiang County from 2004 to 2012, with an average annual rate of 2.62 / 100,000. Cases distributed in the county 12 townships, accounting for 60% of the total number of towns. AFP cases male to female ratio was 2: 1; male incidence of 3.36 / 100000, the incidence of 1.82 / 100000 women, male to female incidence ratio was 1.68: 1, male and female incidence was no significant difference (χ2 = 2.35, P > 0.05). The incidence of AFP children aged 1 ~ 7 years old in Dejiang County accounted for 62.96% of the total number of cases. In the 27 cases of AFP, 16 cases recovered after 60 days, 11 cases did not recover, and the residual paralysis rate was 40.74% (3 of them died). The whole immune residual paralysis rate was 37.5%, incomplete immune residual paralysis rate was 66.67%, the difference was not statistically significant (χ2 = 0.94, P> 0.05). The incidence of 0 to 7 years old group was 3.28 / 10 million (17/517 937), and the incidence rate was 1.95 / 100000 (10/513 251) in 8 to 14 years old group, with no significant difference (χ2 = 2.35, P> 0.05). Nine cases were reported locally, accounting for 33.33%; 18 cases were reported by other counties, accounting for 66.67%. Conclusion The county AFP case monitoring system is working well. Good routine immunization and immunization, leak detection and replantation of AFP qualified collection of samples, strengthen medical staff awareness of AFP reporting, improve the first report rate is an important polio effectively maintain the status quo. Strengthen the relevant units of AFP case diagnosis, to prevent misdiagnosis, omission, misdiagnosis and improve the AFP qualified sample collection rate; improve surveillance sensitivity is the focus of the county’s work in the future.