文章摘要
刘佳佳,朵林,陶晓燕,朱武洋.2016-2018年我国狂犬病流行特征分析[J].中华流行病学杂志,2021,42(1):131-136
2016-2018年我国狂犬病流行特征分析
Epidemiological characteristics of human rabies in China, 2016-2018
收稿日期:2020-01-16  出版日期:2021-01-22
DOI:10.3760/cma.j.cn112338-20200116-00037
中文关键词: 狂犬病;流行特征;监测
英文关键词: Rabies;Epidemiological features;Surveillance
基金项目:国家科技重大专项(2018ZX10713002,2018ZX10734404)
作者单位E-mail
刘佳佳 昆明医科大学阜外心血管病医院 650032
中国疾病预防控制中心病毒病预防控制所, 国家卫生健康委员会生物安全重点实验室, 北京 102206
中国科学院生物安全大科学研究中心, 武汉 430071 
 
朵林 昆明医科大学阜外心血管病医院 650032 duolin@hotmail.com 
陶晓燕 中国疾病预防控制中心病毒病预防控制所, 国家卫生健康委员会生物安全重点实验室, 北京 102206
中国科学院生物安全大科学研究中心, 武汉 430071 
txy212@126.com 
朱武洋 中国疾病预防控制中心病毒病预防控制所, 国家卫生健康委员会生物安全重点实验室, 北京 102206
中国科学院生物安全大科学研究中心, 武汉 430071 
 
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中文摘要:
      目的 分析2016-2018年我国狂犬病流行病学特征,掌握疫情变化规律,探讨相应的防控策略。方法 收集全国传染病报告信息管理系统2016-2018年狂犬病病例数据和11个国家监测点(湖南省、安徽省、贵州省、江苏省和山东省)以及国家统计局资料。采用描述性流行病学方法分析2016-2018年狂犬病疫情的分布特征,采用SPSS 25.0软件进行统计学分析。结果 2016-2018年狂犬病疫情主要分布于我国南部和中部地区。高发季节为夏秋季,病例以农民、学生和散居儿童为主。病例男女性别比为2.38:1(1 114:468)。各年龄组均有发病且发病曲线呈双峰型,中老年组发病高于青年组。狂犬病个案分析中,致伤动物以犬为主,占91.46%(439/480)。暴露程度以Ⅲ级暴露为主,占71.88%(345/480)。暴露后疫苗接种率仅为8.13%(39/480)。年龄、暴露程度、暴露部位、伤口处置、疫苗接种及被动免疫制剂注射可能是潜伏期的影响因素。结论 2016-2018年我国狂犬病疫情持续下降,且波及范围逐渐缩小,西北地区未出现传播病例。病例暴露后伤口处置率、疫苗接种率和被动免疫制剂注射率均有所提高,但暴露后伤口处置规范水平有待提高。应重视高发省份及周边省份的疫情监管,加强暴露后相关医疗机构专业化处置能力培训,强化犬只免疫及管理工作,努力实现"2030年人和犬间狂犬病零死亡"的目标。
英文摘要:
      Objective To analyze epidemiological characteristics and explore control and prevention measures based on the rabies surveillance data in China from 2016 to 2018. Methods The surveillance data of rabies in China from 2016-2018 were collected from the "Infectious Disease Surveillance Information Reporting Management System", eleven national surveillance sites in Hunan, Anhui, Guizhou, Jiangsu and Shandong provinces and National Bureau of Statistics. Descriptive epidemiological method was used to analyze the distributions of rabies outbreaks in China during this period, and univariate and multivariate analyses were conducted on the data using SPSS 25.0. Results Rabies epidemics were mainly found in southern and central areas in China. Rabies mainly occurred in summer and autumn, and the majority of patients were farmers, students and children outside child care settings. The male to female ratio of the cases was 2.38:1(1 114:468). The cases were reported in all age groups and the incidence curve was bimodal, and more cases occurred in middle aged and old adults than in youths. In the case analysis of rabies from 2016 to 2018, the majority of the animals biting human were dogs, accounting for 91.46%(439/480). And about 71.88% (345/480) of the exposures were degree Ⅲ. The vaccination rate after exposure was only 8.13%(39/480). Age, degree of exposure, site of exposure, wound management, vaccination and injection of passive immunization product might influence the incubation period. Conclusions The human rabies incidence in China declined consecutively from 2016 to 2018, and the affected areas decreased. No cases were reported in northwestern area. The rate of post exposure prophylaxis, vaccination and passive immunization product injection were all improved, but the level of standard wound management after exposure needs to be improved. Attention should be paid to epidemic surveillance in high-incidence provinces and neighboring provinces. It is necessary to strengthen professional treatment training in relevant medical institutions, strengthen immunization and management of dog to achieve the goal of "zero human rabies death by 2030".
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