陆川县应用间歇式麻疹减毒活疫苗补充免疫控制麻疹流行效果分析

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目的了解陆川县实施麻疹减毒活疫苗(MV)补充免疫活动(Supplementary SIA)前8年(1996~2003)及后11年(2004~2015)麻疹流行状况,评估控制麻疹效果,为消除麻疹提供参考。方法采用描述性流行病学方法,分析和比较陆川县从2004年起应用间歇式开展MV SIA前后麻疹发病资料。结果陆川县实施MV SIA前8年的麻疹年平均发病率为6.54/10万,下降到实施MV SIA后11年的年平均发病率0.78/10万(P<0.01),下降88.07%。麻疹流行小高峰周期延长,间隔时间从原来2~3年变为4~5年。实施MV SIA前全县16个乡镇均有病例报告,年平均发病率最高为陆城、珊罗和温泉3个乡镇,分别为20.46/10万、15.46/10万和12.99/10万;实施MV SIA后,年平均发病率最高为珊罗、温泉和横山3个乡镇,分别为2.50/10万、1.26/10万和1.07/10万,与实施前相比大幅降低。结论陆川县从2004年起应用每间隔4~5年一次的间歇式开展MV SIA后,麻疹发病大幅度下降,麻疹流行周期延长,流行期缩短。城镇和城乡结合部为免疫规划工作薄弱地区。 Objective To understand the epidemic situation of measles in Luchuan County during the eight years (1996-2003) and the last 11 years (2004-2015) of implementing Supplementary SIA of measles vaccine in Luchuan County to evaluate the measles control effect and provide measles elimination reference. Methods Descriptive epidemiological methods were used to analyze and compare the incidence of measles before and after MV SIA was applied in Luchuan County from 2004 onwards. Results The annual average incidence of measles in the first eight years of implementation of MV SIA in Luchuan County was 6.54 / 100000, down to 0.78 / 100000 (P <0.01) after 11 years of MV SIA implementation, with a decrease of 88.07%. The peak period of the epidemic of measles is prolonged, with an interval of 4 to 5 years from the original 2 to 3 years. The implementation of MV SIA 16 counties throughout the county have case reports, the highest annual average incidence Lucheng, Shan Luo and Hot Springs 3 townships, respectively 20.46 / 100,000, 15.46 / 100,000 and 12.99 / 100,000; implementation of MV After SIA, the annual average incidence was the highest among the three townships of Shanluo, Hot Spring and Hengshan, with 2.50 / 100000, 1.26 / 100000 and 1.07 / 100000, respectively, significantly lower than those before the implementation. Conclusion The application of intermittent MV SIA once every 4-5 years in Luchuan County since 2004 markedly reduced the incidence of measles and prolonged the epidemic period of measles and shortened the prevalence period. The town and urban-rural integration department is a weak area for immunization planning.
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