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摘要:
目的 了解浙江省台州市2012—2022年急性弛缓性麻痹(AFP)病例的流行特征,并评估AFP病例监测系统运行情况和监测质量。 方法 对台州市2012—2022年AFP监测病例资料进行整理,采用描述性流行病学方法分析其三间分布及监测敏感性、及时性。 结果 台州市2012—2022年共报告229例AFP病例,年均报告发病率为2.14/10万,所有AFP病例最终诊断分类均为脊髓灰质炎排除病例。 AFP发病无明显季节性,1~4岁组发病率较高(χ2=29.339,P<0.001),男性发病率高于女性(χ2=8.571,P=0.003)。 报告后48 h调查率为99.56%,14 d内双份粪便采集率为98.25%,合格粪便采集率、粪便标本7 d内送达率和75 d随访表及时送达率均为97.82%。 结论 台州市AFP病例主要集中在5岁以下,男性发病率高于女性,异地报告率高。 AFP监测系统处于稳定且较高的运行水平,达到国家各项监测指标要求,但仍需提高AFP病例监测敏感性。 Abstract:Objective To understand the epidemiological characteristics of acute flaccid paralysis (AFP) in Taizhou, Zhejiang province, from 2012 to 2022, and evaluate the performance and quality of the AFP surveillance system. Methods The surveillance data of AFP in Taizhou from 2012 to 2022 were collected, and the epidemiological characteristics and surveillance indicators of AFP cases in Taizhou were analyzed by descriptive epidemiological methods. Results A total of 229 AFP cases were reported in Taizhou from 2012 to 2022, with the average annual reported incidence rate of 2.14/100 000. All the AFP cases were finally diagnosed as polio-excluded cases. There was no obvious seasonality in the incidence of AFP. The incidence rate in age group 1−4 years was highest (χ2=29.339, P<0.001), and the incidence rate was higher in men than in women (χ2=8.571, P=0.003). The investigation rate within 48 hours after the reporting was 99.56%, and the double stool collection rate within 14 days was 98.25%. The adequate stool collection rate, the stool sample delivery rate within 7 days and the timely delivery rate of the 75−day follow-up form were all 97.82%. Conclusion AFP mainly occurred in children under 5 years old in Taizhou. The incidence rate was higher in men than in women, and the reporting rate from other places was high. The AFP surveillance system had a stable and good performance in Taizhou, meeting the national surveillance requirements. However, it is still necessary to improve the sensitivity of AFP surveillance. -
Key words:
- Acute flaccid paralysis /
- Poliomyelitis /
- Epidemiology /
- Surveillance
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表 1 2012-2022年台州市各年龄组人群急性弛缓性麻痹病例发病率
Table 1. Age specific incidence rate of acute flaccid paralysis in Taizhou, 2012−2022
年份 年龄组(岁)(/10万) χ2值 P值 <1 1~ 5~ 10~14 2012 0.00 4.26 1.14 0.71 9.403 0.018 2013 5.69 4.33 2.04 1.83 5.514 0.117 2014 3.64 3.85 1.53 1.45 5.108 0.138 2015 3.63 2.30 0.76 1.81 4.657 0.168 2016 2.83 3.94 2.09 1.12 4.611 0.178 2017 0.00 4.73 2.09 0.74 9.496 0.017 2018 0.00 3.09 1.54 2.55 3.045 0.344 2019 0.00 2.98 2.59 1.59 2.338 0.481 2020 0.00 3.16 1.71 1.28 3.153 0.333 2021 0.00 2.03 2.74 2.04 1.085 0.804 2022 1.80 2.85 2.44 1.75 0.920 0.862 合计 1.49 3.41 1.85 1.55 29.339 <0.001 表 2 2012-2022年台州市不同性别人群急性弛缓性麻痹病例发病率
Table 2. Gender specific incidence rate of acute flaccid paralysis in Taizhou, 2012−2022
年份 发病率(/10万) 男女
性别比χ2值 P值 男性 女性 2012 1.77 1.83 1.13∶1 0.006 0.940 2013 2.86 2.68 1.25∶1 0.029 0.864 2014 3.57 0.66 6.33∶1 9.233 0.002 2015 1.48 1.80 1.00∶1 0.159 0.690 2016 3.43 1.11 3.60∶1 5.534 0.019 2017 2.86 1.55 2.14∶1 1.837 0.175 2018 2.24 1.96 1.33∶1 0.094 0.760 2019 2.35 2.02 1.33∶1 0.111 0.738 2020 1.60 2.12 0.89∶1 0.335 0.563 2021 2.63 1.59 2.00∶1 1.205 0.272 2022 3.00 1.36 2.67∶1 2.871 0.090 合计 2.53 1.70 1.76∶1 8.571 0.003 表 3 2012-2022年台州市急性弛缓性麻痹病例的脊髓灰质炎疫苗免疫史分布
Table 3. Acute flaccid paralysis cases with different polio vaccination status in Taizhou, 2012−2022
年份 免疫次数(例) 0 1~3 ≥4 不详 2012 0 8 9 0 2013 0 12 14 1 2014 1 8 13 0 2015 0 8 8 0 2016 0 11 11 1 2017 0 13 9 0 2018 0 6 15 0 2019 0 4 17 0 2020 0 6 11 0 2021 1 4 16 0 2022 1 5 16 0 合计 3 85 139 2 表 4 2012-2022年台州市各县(市、区)急性弛缓性麻痹病例报告情况
Table 4. Reporting of acute flaccid paralysis cases by counties (district) in Taizhou, 2012−2022
年份 椒江区 黄岩区 路桥区 临海市 温岭市 玉环市 天台县 仙居县 三门县 总计 A B A B A B A B A B A B A B A B A B A B 2012 3 2.94 2 2.11 3 3.26 1 0.55 2 0.96 3 3.14 2 2.8 1 1.43 0 0.00 17 1.74 2013 3 2.95 1 1.06 2 2.18 8 4.43 6 2.88 1 1.05 3 4.21 1 1.44 2 3.35 27 2.77 2014 3 2.95 3 3.17 1 1.09 3 1.66 2 0.96 4 4.19 3 4.21 1 1.44 2 3.35 22 2.26 2015 1 0.98 1 1.06 1 1.09 3 1.66 4 1.92 1 1.05 3 4.21 1 1.44 1 1.67 16 1.64 2016 5 4.90 1 1.05 1 1.09 4 2.21 4 1.92 3 3.14 2 2.80 1 1.43 2 3.34 23 2.36 2017 2 1.96 1 1.06 3 3.26 6 3.32 3 1.44 3 3.15 2 2.80 1 1.44 1 1.67 22 2.26 2018 3 2.86 2 2.06 3 3.17 3 1.64 3 1.45 1 1.03 3 4.03 2 2.79 1 1.59 21 2.12 2019 3 2.86 3 3.08 1 1.06 3 1.64 3 1.45 3 3.15 2 2.69 1 1.39 2 3.18 21 2.12 2020 2 2.02 1 1.09 1 1.13 3 1.78 2 1.05 4 4.32 1 1.47 1 1.52 2 3.46 17 1.84 2021 1 0.82 1 1.02 2 2.26 5 2.89 2 1.10 4 4.35 3 3.85 1 1.32 2 3.11 21 2.16 2022 2 1.64 2 2.04 2 2.26 3 1.74 4 2.20 1 1.09 2 2.57 3 3.97 3 4.67 22 2.26 合计 28 2.40 18 1.71 20 1.99 42 2.14 35 1.58 28 2.69 26 3.27 14 1.85 18 2.58 229 2.14 注:A. 病例数(例);B. 发病率(/10万) 表 5 2012-2022年台州市急性弛缓性麻痹病例监测及时性
Table 5. Timeliness of acute flaccid paralysis surveillance in Taizhou, 2012−2022
年份 报告后48 h
调查率
(%)14 d内双份
粪便采集率
(%)合格粪便
采集率
(%)粪便标本
7 d内送达率
(%)75 d随访表
及时送达率
(%)2012 94.12 100.00 100.00 94.12 100.00 2013 100.00 92.59 92.59 96.15 85.19 2014 100.00 95.45 95.45 100.00 95.24 2015 100.00 100.00 100.00 100.00 100.00 2016 100.00 100.00 100.00 91.30 100.00 2017 100.00 95.45 95.45 95.24 100.00 2018 100.00 100.00 100.00 100.00 100.00 2019 100.00 100.00 95.24 100.00 100.00 2020 100.00 100.00 100.00 100.00 100.00 2021 100.00 100.00 100.00 100.00 100.00 2022 100.00 100.00 100.00 100.00 100.00 合计 99.56 98.25 97.82 97.82 97.82 -
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