成都市霍乱预防控制策略框架构建与效果评价  

Strategic framework for cholera prevention and control in Chengdu： construction and effectiveness evaluation

作　　者：梁娴[1] 杜长慧[1] 杨兰[1] 马林[1] 黄中夯[1] 庹晓莉[1] 尹仲良[1] 

机构地区：[1]成都市疾病预防控制中心,610041

出　　处：《中华预防医学杂志》2011年第2期107-112,共6页Chinese Journal of Preventive Medicine

基　　金：成都市卫生局重大医学联合攻关项目（0611）

摘　　要：目的 构建适合成都市本地资源优势和社会发展形势、可操作性强的霍乱预防控制策略框架并评价其应用效果. 方法 （1）对成都市1994-2004年本地霍乱疫情资料分析,确定本市霍乱防治工作存在的主要问题和已采用措施的有效性和不足,形成基本策略框架;（2）邀请55名专家对策略框架进行初步评分后,提取72项具体措施形成措施条目库,再由17名核心专家对各项措施的重要性和可操作性进行评分;（3）从疫情控制、健康教育和病原学监测结果分析三方面对策略框架效果进行评价. 结果 （1）框架以政府主导为工作主线,以信息化为工作辅线,以改善社会环境、完善监测预警体系和机制、提高疾控队伍应急处置能力为三个工作重心,包括35项具体工作措施,其重要性总体评分（4.20±0.86）分,可操作性总体评分（4.09±0.87）分;（2）自2002年逐步开始实施策略框架后,成都市2005-2009年连续5年保持霍乱零发病,霍乱病原学监测检出阳性的19件样品均为海（水）产品,品种包括甲鱼、白鲢、牛蛙;针对基层干部、基层医务工作者、游厨培训覆盖率达98.14%（198 452/202 220）,培训合格率达98.17%（194 820/198 452）,针对食品从业人员培训合格率达96.00%（912 470/950 489）以上,农村居民、基层干部、基层医务工作者、游厨及帮工霍乱防治知识知晓率达93.87%（1653/1761）,良好卫生习惯养成率达70.58%（1243/1761）. 结论 本研究成功地构建了适合成都本地的霍乱预防控制策略框架,在周边地区霍乱疫情时有发生、进入成都市的海（水）产品霍乱弧菌持续存在等因素威胁不断的情况下连续5年保持霍乱零发病,证明其应用效果良好.Objective To construct an operable strategic framework for cholera prevention and control which mobilized the advantages of local resources and adapted to social developments in Chengdu,and to evaluate its application effects. Methods （1） After analyzing the local epidemic data of cholera in Chengdu from 1994 to 2004,we determined the main problems of cholera prevention and control works as well as the efficiency and deficiency of employed measures,and then formed a basic strategic framework.（2） After 55 invited experts preliminarily scored the strategic framework,we selected 72 specific measures to establish a measure entry database,and then the importance and operability of each measure were scored by 17 core experts.（3） Finally,the effectiveness of this strategic framework was evaluated according to the analyzing results of infection control,health education and etiological monitoring. Results （1） The framework took government leadership as main scenario and the informatization as subordination scenario.Meanwhile,it focused on three points：the improvement of social environment,the completion of system and mechanisms for monitoring and early warning,and the enhancement of CDC response to public health emergencies.Total importance score and operability score of 35 specific measures included in this framework was 4.20 ± 0.86 and 4.09 ± 0.87,respectively.（2） Chengdu had maintained zero cholera incidence for five consecutive years from 2005 to 2009 since it gradually began to implement the strategic framework in 2002.There were 19 positive cholera cases detected by etiological monitoring and all of them were seafood or fishery products including soft-shelled turtles,silver carps and bullfrogs.The coverage rate and qualification rate of the training for grassroots cadres,grassroots medical workers,mobile cooks and their assistants was 98.14% （198 452/202 220） and 98.17% （194 820/198 452） in average,respectively.The qualification rate of the training for employees in food industry was

关 键 词：霍乱 综合预防 策略 实验性 评价研究 

分 类 号：R183[医药卫生—流行病学]