林玫, 王鸣柳, 董柏青, 唐振柱, 李翠云, 方锦嵩, 权怡, 张杰. 广西壮族自治区霍乱监测系统的建立与效果评价[J]. 疾病监测, 2008, 23(7): 404-408. DOI: 10.3784/j.issn.1003-9961.2008.7.404
引用本文: 林玫, 王鸣柳, 董柏青, 唐振柱, 李翠云, 方锦嵩, 权怡, 张杰. 广西壮族自治区霍乱监测系统的建立与效果评价[J]. 疾病监测, 2008, 23(7): 404-408. DOI: 10.3784/j.issn.1003-9961.2008.7.404
LIN Mei, WANG Ming liu, DONG Bai qing, TANG Zhen zu, . Establishment and evaluation of cholera surveillance system in Guangxi[J]. Disease Surveillance, 2008, 23(7): 404-408. DOI: 10.3784/j.issn.1003-9961.2008.7.404
Citation: LIN Mei, WANG Ming liu, DONG Bai qing, TANG Zhen zu, . Establishment and evaluation of cholera surveillance system in Guangxi[J]. Disease Surveillance, 2008, 23(7): 404-408. DOI: 10.3784/j.issn.1003-9961.2008.7.404

广西壮族自治区霍乱监测系统的建立与效果评价

Establishment and evaluation of cholera surveillance system in Guangxi

  • 摘要: 目的 通过在广西壮族自治区境内建立霍乱监测系统,及时发现疫源,控制霍乱发生和流行。 方法 选择30个监测点并进行分类管理,确定监测内容和任务量,并组织实施;统计分析8年监测结果并评价效果。 结果 8年间共检索标本561 147份,总检出率为0.051%,腹泻病例及疑似病例、重点人群、水体、食品及其他外环境标本检出阳性率分别为0.061%、0.032%、0.099%、0.055%和0.115%;1999-2001年疫情期间分离菌株均为流行株或产毒株,2002-2006年无疫情期间菌株均从外环境检出,92.31%为非流行株或非产毒株;三类地区检索总阳性率分别为0.061%、0.043%和0.134%;3个有疫情年份的首例病例均是通过监测系统的腹泻病门诊发现,8年间通过腹泻病门诊发现了93.23%的霍乱病例;阳性标本多出现在疫区,疫区检出阳性率0.378%高于非疫区0.005%,总阳性率与流行强度呈正相关关系,与流行情况相符。 结论 腹泻病门诊提高了发现病例的敏感性,监测系统掌握的数据真实反映了流行情况,能有效指导预防控制措施的制定;亟待制定针对不同地区各级医疗机构的腹泻病门诊设置和工作规范。

     

    Abstract: Objective The study was conducted to early detect natural focus and to control the incidence and spread ofcholera by establishing a surveillance system in Guangxi. Methods Thirty selected areas were classified and managed, and theobjects and tasks were confirmed and implemented; the surveillance results of 8 years were analyzed and evaluated. Results Atotal of 561 147 samples were tested during 8 years; the total detection rate of cholera was 0.051%, and the culture positiverates in patients with diarrhea, suspected cases, high risk population, water, food and other environmental samples were respectively 0.061%, 0.032%, 0.099%, 0.055% and 0.115%. All Vibrio cholera isolated between 1999 and 2001 were epidemic strains or toxic strains, while between 2002 and 2006 all the Vibrio cholera strains were only isolated from environmental samples and 92.31% of them were non epidemic or non toxic strains. For the samples collected in the three types of areas, the culture positive rates were respectively 0.061%, 0.043% and 0.134%. All the first reported cases in the three years when epidemics occurred were detected by the surveillance system, and 93.23% cases of vibrio cholera were detected at the diarrhea clinics. The majority of positive cases of Vibrio cholera were found in epidemic areas, where the culture positive rate (0.378%) was higher than that in non epidemic areas (0.005%). The overall positive rate was positively correlative with the epidemic intensity, which was consistent with the epidemic situation. Conclusion The sensitivity of case detection at diarrhea clinics has been improved. The data collected through the surveillance system reflected the true prevalence and provided effective directions to control policy making. It is urgently necessary to establish more diarrhea clinics and to make proper guidelines for implementing the surveillance in medical institutions at all levels.

     

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