绍兴市1999～2004年新生儿破伤风病例流行病学分析  

Epidemiological Analysis on Neonatal Tetanus Cases from 1999 through 2004 in Shaoxing City

作　　者：陈洁[1] 付利军[1] 吴建宏[1] 王吉玲[1] 

机构地区：[1]浙江省绍兴市疾病预防控制中心

出　　处：《疾病监测》2005年第6期309-310,308,共3页Disease Surveillance

摘　　要：目的了解绍兴市新生儿破伤风(NT)的流行病学特征,为控制和消除该病提供科学依据。方法用描述流行病学方法,对绍兴市1999～2004年NT专报系统的监测资料和个案调查材料进行统计分析。结果NT发病率波动在0.15‰～0.65‰之间,总体呈上升趋势,其中2004年有2个县(区)发病率≥1‰。NT病死率波动在11.11%～37.50%之间。病例主要集中在经济相对发达的越城区和绍兴县,发病无明显季节性。78例确诊病例中流动人口占89.74%,男性多于女性,男女性别比为2.12∶1,发病日龄集中在5～8d。在家分娩的占83.33%,接生员均未受过培训,所有母亲均无明确的破伤风类毒素(TT)接种史。结论旧法接生和产前未注射破伤风类毒素及人口流动是NT发病的主要因素。提高孕妇自我保健意识,推广住院分娩,对高危人群接种TT,加强新法接生培训,是消除NT的基本措施。Objective This analysis was conducted to better understand the epidemiological characteristics of neonatal tetanus(NT)in Shaoxing city in order to provide background information for the formulation of strategies to control and eradicate the disease. Methods Descriptive study was used to statistically analyze the data collected from the NT-specific reporting system and case study from 1999 to 2004. Results Statistics showed that the incidence of NT fluctuated between 0.15‰ and 0.65‰,exhibiting a general tendency of increasing. There were 2 counties (districts) where the incidence was equal to or more than 1‰. The mortality of NT ranged from 11.11% to 37.50%。It was observed that Yuecheng district and Shaoxing county where economics were relatively developed were dominated by the disease, with no seasonal. Of the 78 cases diagnosed, floating population accounted for 89.74% and males were more affected than females, with the ratio being 2.12:1. Most cases developed clinical manifestations 5-8 days after birth. 83.33% of the cases were infants delivered at home with the help of an untrained midwife. And all the mothers had no definite inoculation history of tetanus toxoid. Conclusion The dominant factors contributing to NT involve old midwifery, lack of tetanus toxoid injection before labor and delivery, and population floating. It is believed that eradication of NT can be achieved through improving self-care among pregnant women, promoting hospital delivery, inoculating high risk groups with TT and strengthening training of new midwifery.

关 键 词：新生儿破伤风 破伤风类毒素 流行病学分析 

分 类 号：R181.3[医药卫生—流行病学]