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目的了解2001-2011年浙江省宁波市新生儿破伤风(neonatal tetanus,NT)的流行病学特征以及影响因素,探讨消除NT的策略和措施。方法对2001-2011年NT监测资料进行描述性流行病学统计分析。结果宁波市2001-2011年共报告NT确诊病例287例,死亡77例,年平均发病率为0.35‰活产儿,年平均死亡率0.09‰活产儿,呈现出缓慢下降的趋势。病例主要发病年龄为3～9日龄,男性多于女性,男女性别比为1.66∶1,主要集中在工业发达、流动人口密集的地区,外省流动人口最多(95.12%)。患儿以在家分娩,由未经过培训的人员(接生婆、家人以及邻居)为主,患儿母亲中,未接受产前检查占71.43%,未接种破伤风疫苗占86.76%。结论加强对流动人口,尤其是育龄期妇女以及儿童的管理,普及住院分娩、新法接生和开展高危地区、高危人群中育龄期妇女破伤风类毒素接种是宁波市消除NT的有效措施。
Objective To understand the epidemiological characteristics and influencing factors of neonatal tetanus (NT) in Ningbo City, Zhejiang Province from 2001 to 2011 and to explore the strategies and measures to eliminate NT. Methods Descriptive epidemiological analysis of NT surveillance data from 2001 to 2011 was conducted. Results A total of 287 confirmed cases of NT were reported in Ningbo from 2001 to 2011, with 77 deaths and a mean annual incidence of 0.35 per thousand live births. The average annual mortality rate of 0.09 per thousand live births showed a slow decline. The main age of onset was from 3 to 9 days of age. There were more males than females, with a sex ratio of 1.66: 1, which was mainly concentrated in developed areas and densely populated areas. The floating population in other provinces was the highest (95.12%). Children were delivered at home with untrained staff (midwife, family and neighbors). Among the mothers, 71.43% did not receive prenatal tests and 86.76% did not receive tetanus vaccines. Conclusion Strengthening the management of floating population, especially of women of childbearing age and children, popularizing hospital delivery, taking birth of new law and carrying out tetanus toxoid inoculation of women of childbearing age in high-risk areas is an effective measure to eliminate NT in Ningbo City.