国家传染病自动预警系统探测范围对手足口病聚集性事件预警效果的影响  

Effect of narrowing scan area on performance of China Infectious Diseases Automated-alert and Response System on hand,foot and mouth disease cluster detection

作　　者：叶楚楚[1] 朱渭萍[1] 王远萍[1] 王静[1] 徐红梅 顾霍铮 孙乔 YE Chu-chu ZHU Wei-ping WANG Yuan-ping WANG Jing XU Hong- mei GU Huo-zheng SUN Qiao.(Research Base of State Key Laboratory for Communicable Disease Surveillance and Early Warning of Chinese Center for Disease Control and Prevention, Shanghai Pudong New District Center for Disease Control and Prevention, Pudong 200136 ,Shanghai,China)

机构地区：[1]传染病监测预警中国疾病预防控制中心重点实验室研究基地上海市浦东新区疾病预防控制中心,上海200136

出　　处：《疾病监测》2017年第9期725-730,共6页Disease Surveillance

基　　金：浦东新区卫生和计划生育委员会青年科技项目(No.PW2014B-3)~~

摘　　要：目的比较国家传染病自动预警系统(CIDARS)不同的探测范围对手足口病聚集性疫情的预警效果,为CIDARS的完善和改进提供依据。方法收集2014年1月1日至2016年12月31日CIDARS在上海市浦东新区发出的手足口病时间模型预警信号,以同期该区域发生的聚集性手足口病疫情作为评价标准,分析CIDARS的预警灵敏度、错误预警率;选择浦东新区3个街道/镇,缩小CIDARS预警探测范围,比较每个街道/镇不同探测范围的预警效果差异。结果2014 2016年,CIDARS在浦东新区共发出393个手足口病预警信号,成功预警了182起聚集性手足口病疫情;同期浦东新区发生手足口病聚集性疫情726起,CIDARS预警灵敏度为24.97%,错误预警率53.69%。对大、中、小3种规模的手足口病聚集性事件预警灵敏度分别为100.00%、45.30%和16.05%,差异有统计学意义。将CIDARS的探测范围从全区缩小为街道/镇后,3个街道/镇的预警灵敏度分别从原来的25.93%、13.04%和50.00%上升至88.89%、78.26%和100.00%,错误预警率有所上升,但无显著性变化。结论 CIDARS对浦东新区小规模手足口病聚集性事件的预警效果欠佳,模型探测范围从全区缩小至街道/镇后,对聚集性手足口病疫情的预警效果明显提高;CIDARS应进一步缩小预警模型的探测范围,以提高对聚集性疫情的预警效果。Objective To compare the performance of China Infectious Diseases Automated-alert and Response System（ CIDARS） for hand,foot and mouth disease（ HFMD） outbreak/cluster detection with different scan areas. Methods Information of all the signals generated by CIDARS from January 1,2014 to December 31,2016 in Pudong NewDistrict were collected and descriptively analyzed. Performance of CIDARS was evaluated,including sensitivity and false alert ratio,based on real HFM D clusters during the same period. The assessment of the early warning model currently used in CIDARS was conducted by using the time series data of daily reported HFM D cases in three selected communities,and outbreak detection performance with different scan area were compared in each community. Results From 2014 to 2016,a total of 393 signals of HFM D were generated by CIDARS in Pudong,and 182 HFM D clusters were successfully detected. During the same period,726 HFM D clusters occurred in Pudong. The sensitivity and false alert ratio of CIDAR was 24. 97% and 53. 69%.The sensitivities to detect large,medium and small clusters were 100. 00%,45. 30% and 16. 05% respectively. After adjusting the scan area of early warning model in CIDARS from district to community level,the HFM D cluster detection sensitivities in the three selected communities increased obviously from 25. 93%,13. 04% and 50. 00% to 88. 89%,78. 26%and 100. 00%,with a slight increase of false alert rate. Conclusions The HFM D cluster detection performance of CIDARS was unsatisfied and differed with cluster size and scan area. Cluster detection performance of CIDARS could be improved through method optimizing,such as narrowing scan area of early warning models.

关 键 词：手足口病 暴发疫情 预警系统 评价 

分 类 号：R181.8[医药卫生—流行病学] R512.5[医药卫生—公共卫生与预防医学]