马鞍山市5种常见传染病暴发流行早期自动预警阈值优选研究  

Study on the preferential selection of early automatic warning thresholds for outbreak epidemics of five common infectious diseases in Ma'anshan City

作　　者：查兵[1] 杨锟[1] 吴起乐 姚为玲[1] 赵志荣[1] 陈健 ZHA Bing;YANG Kun;WU Qile;YAO Weiling;ZHAO Zhirong;CHEN Jian(Ma'anshan Center for Disease Control and Prevention,Ma'anshan,Anhui 243011,China)

机构地区：[1]马鞍山市疾病预防控制中心,安徽马鞍山243011

出　　处：《医学动物防制》2023年第8期765-769,共5页Journal of Medical Pest Control

基　　金：2021年中央补助重大传染病防控项目(皖卫财秘[2021]246号);马鞍山市科技计划项目(2019-06)。

摘　　要：目的优选马鞍山市手足口病、流行性感冒、流行性腮腺炎、其他感染性腹泻病和水痘5种常见传染病暴发流行早期的预警阈值,以提高传染病自动预警效能。方法采用移动百分位数法分别建立上述5种常见传染病的暴发流行早期自动预警模型,通过计算其灵敏度、特异度、阳性和阴性预测值、约登指数及绘制受试者操作特征(receiver operating characteristic,ROC)曲线,筛选出适合马鞍山市的传染病流行早期最优预警阈值。结果马鞍山市手足口病、流行性感冒、流行性腮腺炎、其他感染性腹泻病和水痘的最优预警阈值分别为P_(90)、P_(90)、P_(85)、P_(70)~P_(75)、P_(95),该预警阈值的灵敏度分别为100.0%、91.3%、87.5%、100.0%和91.2%,特异度分别为91.8%、96.6%、80.6%、79.6%和66.7%,阳性预测值分别为42.9%、95.5%、66.7%、23.1%和83.8%,阴性预测值分别为100.0%、93.3%、93.5%、100.0%和80.0%,约登指数分别为0.918、0.879、0.681、0.796和0.579,ROC曲线显示各预警阈值均为最靠近坐标图左上方的点。结论马鞍山市流行性感冒、流行性腮腺炎的预警阈值可适当调高,其他感染性腹泻病的预警阈值可适当调低,以提高传染病疫情监测的预警效能。Objective To optimize the warning thresholds of early outbreak epidemics for five common infectious diseases,namely hand foot and mouth disease(HFMD),influenza,mumps,other infectious diarrhea and chickenpox in Ma'anshan City,and improve the efficacy of automatic warning of infectious diseases.Methods An early automatic warning model for outbreak epidemics was set up for 5 common infectious diseases by using the moving percentile method.By calculating the sensitivity,specificity,positive predictive value,negative predictive value,Youden's index and the receiver operating characteristic(ROC)curve,the optimum early warning threshold values of epidemics in Ma'anshan City were selected.Results The best early warning threshold of HFMD,influenza,numps,other infectious diarrhea and chickenpox in Ma'anshan City were P_(90),P_(90),P_(85),P_(70)-P_(75)and P_(95)respectively.The early warning sensitivities of the best early warning threshold were 100.0%,91.3%,87.5%,100.0%and 91.2%,the specificities were 91.8%,96.6%,80.6%,79.6%and 66.7%respectively.The positive predictive values were 42.9%,95.5%,66.7%,23.1%and 83.8%,the negative predictive values were 100.0%,93.3%,93.5%,100.0%and 80.0%,and the Youden's indexes were 0.918,0.879,0.681,0.796 and 0.579 respectively.Receiver operating characteristic curve showed that each early warning threshold was the point closest to the upper left of the coordinate diagram.Conclusion The early warning thresholds for influenza and mumps in Ma'anshan City may be raised appropriately,and those for other infectious diarrhea may be reduced slightly to improve the early warning effectiveness of the epidemic surveillance of infectious disease.

关 键 词：传染病 移动百分位数法 预警阈值 暴发 

分 类 号：R181.8[医药卫生—流行病学]