探讨症状监测在疾病暴发早期发现中的作用

吴生根; 翁育伟; 叶雯婧; 王灵岚; 严延生; 洪荣涛; 欧剑鸣; 陈武; 蔡少健

Abstract

吴生根,翁育伟,叶雯婧,王灵岚,严延生,洪荣涛,欧剑鸣,陈武,蔡少健.探讨症状监测在疾病暴发早期发现中的作用[J].Chinese journal of Epidemiology,2016,37(4):531-534

探讨症状监测在疾病暴发早期发现中的作用

Role of syndromic surveillance program in the practice of early detection on disease outbreak

Received:September 06, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.04.018

KeyWord: 登革热症状监测发热

English Key Word: Dengue fever Syndromic surveillance Fever

FundProject:国家高技术研究发展计划(863计划)(2011AA02A114)

Author Name	Affiliation	E-mail
Wu Shenggen	Department of Emergency Management and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China Priority Laboratory for Zoonosis Research of Fujian Province, Fuzhou 350001 China School of Public Health, Fujian Medical University, Fuzhou 350003, China
Weng Yuwei	Department of Prevention and Treatment of Viral Diseases, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
Ye Wenjing	Department of Emergency Management and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
Wang Linglan	Office, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China Priority Laboratory for Zoonosis Research of Fujian Province, Fuzhou 350001 China School of Public Health, Fujian Medical University, Fuzhou 350003, China	104225167@qq.com
Yan Yansheng	Office, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China	yysh@fjcdc.com.cn
Hong Rongtao	Department of Emergency Management and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
Ou Jianming	Department of Emergency Management and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
Chen Wu	Department of Emergency Management and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
Cai Shaojian	Department of Emergency Management and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China

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Abstract:

目的通过一次登革热暴发案例探讨症状监测在疾病暴发早期发现中的作用。方法 2014年9月19日福建省建瓯市东峰镇发生登革热暴发疫情,回顾性收集东峰镇卫生院2013年8-11月和2014年同期门诊日志及清开灵注射液10 ml(支)、利巴韦林注射液0.1 g(支)等药物的使用量。使用Excel软件从门诊日志中提取诊断名为发热的病例,统计每日发热人数、发热人次数。通过发热和药物数据判定异常事件出现时间;分析2014年发热人数、发热人次数与清开灵注射液、利巴韦林注射液等药物相关性。以清开灵注射液、利巴韦林注射液等药物为因变量,发热人次数(发热人数)为自变量进行线性回归分析。结果 2014年8-11月东峰镇卫生院门诊日志中发热2437人次,发热人数为1102例。与2013年同期(113人次、90例)相比分别上升19.6、10.2倍。1102例发热就诊患者男性499例(45.3%),女性603例(54.7%)。年龄构成呈现一个不典型的"M"形,5~10岁年龄组127人(11.5%)构成最多。2014年发热人数与清开灵注射液、利巴韦林注射液等药物相关系数为0.85~0.97(P<0.05)。从发热人数和药物使用量分析,异常均出现在8月23日。结论症状监测显示2014年福建省建瓯市东峰镇登革热暴发疫情在8月23日出现异常,比常规监测提早近1个月。应重视症状监测的公共卫生意义。

English Abstract:

Objective A Dengue outbreak was reported in Dongfen town Jianou county, Fujian province on September 19, 2014. The goal of this project was to explore the role of syndromic surveillance program in the practice of early detection on disease outbreak through the case mentioned above. Methods The authors retrospectively collected data related to Outpatient log and Pharmacy drug use in Dongfen township hospital through the electronic information system of the hospital from August to November, 2014. All the abnormal events were recorded, according to related data on fever and drug use. Description of fever, syndromic characteristics, correlation and Linear regression analyses were conducted, using the surveillance data on fever syndrome and drug use from the pharmacy. Results A total of 1102 cases with fever and 2437 fever-related clinic visits were reported which showing an increased number of 19.6, 10.2 times respectively, when compared to the same period of the previous year in which men accounted for 45.3%(499/1102) and female accounted for 54.7%(603/1102). Age groups presented an atypical type "M" type. 5 and 10 year olds groups formed the largest proportion, accounted for 11.5%(127/1102) of the total number os the patients. The correlation coefficient ranged from 0.85 to 0.97(P<0.05). Data from the syndromic surveillance program showed an "outbreak" was occured in August 23, 2014. Conclusions Compared to routine surveillance program, the syndromic surveillance program could detect the appearence of an outbreak, a month or even more earlier. The role of syndromic surveillance program needs to be further explored.

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