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目的了解广东省2010年和2011年手足口病高峰期流行特征,探讨预防控制策略。方法利用2008~2010年疾病监测信息报告管理系统广东省报告手足口病周分布为基准,利用控制图法确定2010年和2011年广东省手足口病高峰期。对2010年和2011年手足口病高峰期的人口学特征、病原学资料、病例临床诊断标准的一致性和病例报告质量进行分析比较。结果 2010年与2011年高峰期分别报告手足口病病例127 543和148 613例。2011年高峰期男性、女性发病率均高于2010年(Z=33.86,P<0.05;Z=15.02,P<0.05);2011年0~2岁组儿童发病率高于2010年(Z=51.07,P<0.05)。2010年和2011年高峰期哨点监测医院分别采集标本633份和699份,其他肠道病毒感染阳性率分别为12.64%和34.76%,2011年其他肠道病毒感染阳性率高于2010年(Z=9.42,P<0.05)。经电话核实240名散居儿童的症状及职业,208例(87%)病例符合手足口病诊疗指南(2010年版)的诊断依据,44例(18%)实为幼托机构儿童。结论 2011年广东省手足口病高峰期较2010年滞后并呈现高强度流行,主要原因为优势病原体转换、病例诊断质量有待提高,气候因素对广东省手足口病疫情的影响仍有待深入分析。疾控部门应加强手足口病病原学监测,提高疫情报告质量,继续开展气候等因素对手足口病发病影响研究。
Objective To understand the epidemiological characteristics of HFMD in Guangdong Province in 2010 and 2011, and to explore preventive and control strategies. Methods Using the distribution of HFMD in Guangdong Province from 2008 to 2010 as the baseline, the control plot was used to determine the peak HFMD in Guangdong Province in 2010 and 2011. Demographic characteristics, etiological data, consistency of clinical diagnostic criteria and case report quality of HFMD in 2010 and 2011 were analyzed and compared. Results HFMD cases 127, 543 and 148 613 cases were reported in 2010 and 2011 respectively. The morbidity of males and females in the peak of 2011 was higher than that of 2010 (Z = 33.86, P <0.05; Z = 15.02, P <0.05) , P <0.05). In 2010 and 2011, the sentinel surveillance hospitals collected 633 and 699 specimens respectively. The positive rates of other enterovirus infections were 12.64% and 34.76% respectively. The positive rates of other enterovirus infections in 2011 were higher than those in 2010 (Z = 9.42, P <0.05). The symptoms and occupations of 240 scattered children were verified by telephone. The diagnosis of 208 cases (87%) was in accordance with the Handbook of Diagnosis and Treatment of Hand-Foot-Mouth Disease (2010 Edition). Forty-four (18%) were children in the kindergarten. Conclusions The peak period of hand-foot-mouth disease in Guangdong province lagged behind that in 2010 and showed a high-intensity epidemic in 2011 mainly due to the switchover of dominant pathogens and the improvement of diagnosis quality. The impact of climatic factors on HFMD in Guangdong Province remains to be further analyzed. Disease control departments should strengthen hand-foot-mouth disease etiology monitoring, improve the quality of the epidemic report, continue to carry out climate and other factors on the incidence of hand-foot-mouth disease research.