筛查和行为干预在梅毒控制中的作用  

Effect of syphilis control based on STI screening and behavioral intervention at sentinel surveillance points

作　　者：叶兴东[1,2] 何婉苹[1,2] 黄雪梅[1,2] 汤少开[1,2] 刘颖[1,2] 朱慧兰[1,2] 张锡宝[1,2] 

机构地区：[1]广州市皮肤病防治所 [2]广州市性病防治监测中心,广州510095

出　　处：《中国艾滋病性病》2013年第1期53-55,共3页Chinese Journal of Aids & STD

基　　金：广东省科技计划(编号2012B031800014);广州市医药卫生重大科技项目(编号20121A031001)~~

摘　　要：目的探讨性病哨点机构(包括哨点医院和专科哨点机构)开展梅毒筛查和行为干预,在梅毒控制中的作用。方法按照哨点医院和专科哨点机构分层抽样,选取广州市15个性病监测哨点,统计2005-2010年各机构梅毒快速血浆反应素试验(RPR)筛查量,分析两类哨点梅毒筛查的人次及阳性率变化趋势,以及同期因卖淫嫖娼被治安收容人群的梅毒感染率趋势。同时,统计同期哨点机构开展的行为干预的工作量。结果 6年间,累计筛查39.8万人次,发现RPR阳性1.41万人次,阳性率3.54%;哨点机构初诊RPR筛查人次年均递增22.00%,RPR阳性率由4.06%下降至2.83%。按照不同哨点机构来源分析,性病专科哨点机构RPR阳性率分别从7.81%上升到12.19%,而哨点医院RPR阳性率则从3.79%下降到2.56%。卖淫嫖娼人群的RPR和梅毒螺旋体明胶凝集试验双阳性率,由2005年的5.85%下降到2011年的4.03%。结论广州市性病哨点医院普通人群梅毒筛查量逐年增加,结合性病哨点专科机构对高危人群的梅毒筛查及行为干预,在广州市梅毒控制中有重要作用。Objective To investigate the effectiveness of syphilis control based on screening and behavioral intervention at sexually transmitted infection （STI） sentinel surveillance points in Guangzhou. Methods Fifteen STI sentinel points including 11 sentinel hospitals and 4 STI sentinel institutions were enrolled by means of group-sampling. Data of behavioral intervention and rapid plasma reagent （RPR） screening from 15 STI sentinel points were annually collected during 2005-2010. The data of syphilis screening and the trend of RPR positive rate collected from the two types of sentinel points, as well as syphilis infection trend among those detained for commercial sexual behaviors during the same period were analyzed. Meanwhile, the workload of behavioral intervention including distribution of health materials and condoms delivered at the sentinel institutions were also calculated. Results A total of 398 000 persons/times were screened for syphilis in the 6 year span and 14 000 persons/times were detected as RPR positive,with a RPR incidence of 3.5%. RPR incidence decreased from 4.06% in 2005 to 2.83% in 2010 and the an- nual person/times of RPR screening increased by 22.00% on average at the sentinel sites in Guangzhou. RPR positive rate decreased from 3.79% to 2.63% in sentinel hospitals, but increased from 7.81% to 12.19% in STI sentinel institutions. RPR and TPPA incidence among female sex workers （FSW） and their clients decreased from 5.24% in 2005 to 4.03% in 2011. Conclusion The number and magnitude of mass syphilis screening for the general population in STI sentinel hospitals in Guangzhou increases year by year. It will be more effective if syphilis screening at the sentinel hospitals is combined with behavioral interventions to the high risk group at STI sentinel in stitutions.

关 键 词：性传播感染 筛查 梅毒 行为干预 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]