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目的探索可行的麻疹爆发高危县预测甄别方法和控制麻疹措施。方法采用以县为单位历年麻疹疫情曲线中最近一次流行峰的流行高峰间隔为基础,结合最近一次流行峰发病率,预测甄别当年可能出现爆发的高危县。当有≥2个高危县相邻时,将1~2个相夹或周边相邻的非高危县带入,以使麻疹疫苗(MV)强化免疫达到成片效应。结果在未开展MV强化免疫干预的情况下,经1998年流行间隔到期的40个县中有27个发生麻疹爆发,发生率达67.50%。由此,广西壮族自治区1999~2005年平均每年约有24个麻疹爆发高危县,并对高危县8月龄~14岁儿童进行MV强化免疫。全自治区麻疹发病率由1998年的13/10万降至2004年2.9/10万和2005年的3.23/10万。结论流行高峰间隔法预测甄别麻疹爆发高危县不但准确率较高,而且能定时定点。采取流行高峰间隔法预测甄别麻疹爆发高危县,并进行局部MV强化免疫的定点清除、提前主动干预策略和措施是经济欠发达地区控制麻疹的有效手段。
Objective To explore feasible high-risk counties for measles outbreak screening methods and measles control measures. Methods Based on the peak interval of epidemic peak of the most recent measles epidemic in counties over the past years, the highest incidence of epidemic peak was predicted to identify the high risk counties in which the outbreaks could occur in that year. When there are ≥2 high-risk counties adjacent to each other, 1 or 2 non-high-risk counties with adjacent folders or adjacent borders may be brought in to enhance the measles vaccine (MV) immunity to a patch effect. Results In the absence of MV-intensive immunization, 27 out of 40 counties in the epidemic interval of 1998 had an outbreak of measles, accounting for 67.50%. As a result, an average of 24 high-risk measles outbreaks occurred annually in Guangxi Zhuang Autonomous Region from 1999 to 2005, and MV-boosting was conducted in children aged 8 months to 14 years in high-risk counties. The incidence of measles in the Autonomous Region dropped from 13% in 1998 to 2.9% in 2004 and 3.23% in 2005. Conclusion The method of epidemic peak interval method in predicting the high risk of screening outbreaks of measles not only has high accuracy but also can be fixed at fixed time. The epidemic peak interval method is used to predict and screen the high risk counties for measles outbreaks and to carry out the site-specific clearance of local MV intensified immunity. The strategies and measures for proactive intervention are effective measures to control measles in economically underdeveloped areas.