2012-2019年南昌市急性弛缓性麻痹(AFP)病例流行病学分析及风险评估  

Epidemiological analysis and risk assessment of acute flaccid paralysis(AFP)cases in Nanchang City,2012-2019

作　　者：文海蓉[1] 许波[1] 彭时辉[1] 张艳霞[1] 廖征[1] WEN Hai-rong;XU Bo;PENG Shi-hui;ZHANG Yan-xia;LIAO Zheng(The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control,Nanchang Center for Disease Control and Prevention,Nanchang,Jiangxi 330038,China)

机构地区：[1]南昌市疾病预防控制中心,传染病预防控制国家重点实验室研究基地,江西330038

出　　处：《现代预防医学》2021年第1期14-18,共5页Modern Preventive Medicine

摘　　要：目的对南昌市急性迟缓性麻痹(Acute flaccid paralysis, AFP)病例流行病学特征及传播风险进行评估,以期发现工作中的薄弱环节,为进一步提高全市AFP监测工作质量,维持全市无脊灰状态提供策略。方法收集整理全市2012-2019年AFP病例流行病学调查及日常督导等资料,运用描述性流行病学方法进行统计分析。结果南昌市2012-2019年非脊灰AFP病例每个县区均有报告,各年报告发病率均超过1/10万;AFP病例呈散发状态,全市各县(区)均有AFP病例报告,各病例间无流行病学联系。季节性不明显,以10月报告病例最多;发病人群以0~4岁组为主,占58.62%。男性多于女性,男女发病比例为1.42∶1;AFP病例中累计服苗≥3次者占总病例数的91.72%,低年龄组、流动儿童脊灰疫苗接种率有待提高;各项监测指标达到要求,但是近两年采样合格率较往年偏低(<90%)。风险评估结果显示:青云谱区、高新区为高风险地区。结论南昌市要提高适龄儿童脊灰疫苗全程接种率,加强查漏补种、入托入学查验预防接种证工作及流动儿童的管理。加强对基层医院AFP病例诊断的专业培训,提高各级医院的诊断能力和报告率,进一步提高双份合格粪便采集率。加强对高风险地区的管理,避免薄弱环节,提高基础免疫接种率和采样率,进一步加强全市的AFP监测工作。Objective To find out the weak links in the work of control acute flaccid paralysis(AFP)casesin Nanchang City,and to provide strategies for further improving the quality of AFP monitoring and maintaining the polio-free status in Nanchang city.Methods The data of AFP cases epidemiological investigations and daily supervisions in 2012-2019 were collected and analyzed by descriptive epidemiological method.Results From 2012 to 2019,AFP cases of non-poliomyelitis had been reported in every county and district of Nanchang city.The incidence rate in each county was over 1/10 million.AFP cases were sporadic,and were reported in all counties(districts)of the city.There was no epidemiological link among the cases,and the epidemic characteristic of seasonality was not obvious.Most of the cases were reported in October.The majority of the patients was 0-4 years old,accounting for 58.62%.The proportion of male to female was 1.42:1.The proportion of AFP cases who had taken vaccine more than 3 times cumulatively accounted for 91.72%of the total cases.The polio vaccination rate of low age group and migrant children needed to be improved.All monitoring indicators met the requirements,but the qualification rate of sampling in recent two years was lower than that in previous years(<90%).The result of risk assessment showed that Qingyunpu district and Gaoxin district were high risk areas.Conclusion Nanchang city should improve the whole course coverage rate of polio vaccine for school-age children,strengthen the work of leak detection and re-inoculation and check of vaccination certificate in kindergarten and school and the management of migrant children.We should strengthen the professional training of AFP case diagnosis in primary hospitals,improve the diagnostic ability and reporting rate of hospitals at all levels,and further increasethe collection rate of double qualified feces.It is necessary to strengthen the management of high-risk areas,avoid weak links,improve the basic immunization coverage rate and sampling rate,and furt

关 键 词：急性迟缓性麻痹(AFP) 流行病学 风险评估 

分 类 号：R512.4[医药卫生—内科学] R181.3[医药卫生—流行病学]