贵州省伤寒、副伤寒高发区发热症状监测分析  

Fever monitoring program in areas with high incidence of typhoid and paratyphoid fever in Guizhou province

作　　者：姚光海[1] 唐光鹏[1] 田克诚[1] 张静[2] 孙军玲[2] 王子军[2] 蒋有琴[3] 赵启良 陈学 陈少芬 刘明强[1] 卢荣 黎明[1] 王定明[1] 

机构地区：[1]贵州省疾病预防控制中心,贵阳550001 [2]中国疾病预防控制中心疾病控制与应急处理办公室 [3]安顺市疾病预防控制中心 [4]平坝县疾病预防控制中心 [5]开阳县疾病预防控制中心

出　　处：《中华流行病学杂志》2013年第3期254-258,共5页Chinese Journal of Epidemiology

基　　金：卫生部公益性行业科研专项（200802025）;贵州省“十一五”社会发展科技项目（黔科合s字[2007]1037）

摘　　要：目的了解贵州省伤寒、副伤寒高发区的发病水平，为综合干预及效果评价提供依据。方法选取安顺市平坝县6乡镇为干预区，贵阳市开阳县6乡镇为对照区，将示范区内各级各类医疗机构按照类别、实验室检测条件分为A、B、C三类监测点，开展以人群为基础，覆盖各级医疗卫生机构的发热症状监测进行伤寒、副伤寒的监测分析。结果对两县12944例不明原因发热者进行血培养，检出沙门菌200株（伤寒16株，甲型副伤寒184株），总检出率为1．55％，干预前检出率均高于干预后。A类点血培养2039例，分离沙门菌39株占19．50％（39／200），检出率为1．91％；B类点血培养4315例，分离沙门菌82株占41．00％（82／200），检出率为1．90％；C类点血培养6590例，分离沙门菌79株占39．50％（79／200），检出率为1．20％，C类点未使用抗生素者检出率明显高于使用者（P〈0．05）。春季和秋季为检出高峰，个别地方发生暴发或流行，农民和学生为高发人群，青壮年发病居多。伤寒、副伤寒症状不典型。结论覆盖基层医疗卫生机构的发热症状监测是伤寒高发区开展伤寒、副伤寒监测的可靠方法，能真实反映伤寒、副伤寒疾病负担。Objective To understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation. Methods Six townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control. All hospitals and clinics were classified into A, B and C types according to its level and the capacity of the blood culture. Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals, clinics and county CDCs among the patients with unknown fever. Results In the surveillance area in those two counties, there were 12 944 blood samples from patients with unknown fever which have been tested and cultured. Among them, 200 strains of Salmonella including 16 typhoid strains, 184 paratyphoid A strains were identified, with thetotal positive rate as 1.55%. The positive rate before the intervention program was higher than the after. The detection rate was 1.91% in the type A hospitals. 39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% （39/200） of the total strains. 4315 blood samples were cultured at the ＇Class B＇ sites which isolated 82 strains of Salmonella, accounting for 41.00% （82/200）, with a detection rate as 1.90%. 6590 samples were cultured at the ＇Class C＇ sites, which identified 79 strains of Salmonella, accounting for 39.50% （79/200）, with a detection rate as 1.20%. The detection rate was much higher before the use of antibiotics than after using them （P〈0.05）. The annual peak time of positive detection was in spring and fall. The outbreaks or epidemics often appeared in the same places, with farmers, students as the high-risk populations. Symptoms of both typhoid and paratyphoid fever were not typical. Conclusion Typhoid and paratyphoid monitoring programs which covered primary health care institutions in the high inci

关 键 词：伤寒 甲型副伤寒 发热症状监测 检出率 

分 类 号：R51[医药卫生—内科学]