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目的了解2013—2014年安徽省全国疾病监测点死亡漏报情况,评估死因监测系统的完整性。方法采用多阶段整群随机抽样方法,从粗死亡率与所在县(区、市)平均死亡率相近的乡镇(街道)中,随机抽取3个乡镇(街道),再从每个抽中的乡镇(街道)随机抽取3个行政村(居委会),从死因监测系统之外的多种渠道收集2013—2014年间抽样点常住居民死亡数据,通过与抽中村(居委会)同期常规网络报告系统数据进行比较,标记重复个案,计算漏报率。结果 2013—2014年安徽省23个国家死因监测点合计漏报率为8.26%,各监测点漏报率在1.43%~25.60%;不同年龄组的漏报率分别为≤14岁(26.61%)、15~44岁(11.45%)、45~64岁(6.23%)、≥65岁(8.13%),差异有统计学意义(χ~2=69.05,P<0.001);城市(10.25%)漏报率高于农村(5.66%),差异有统计学意义(χ~2=59.99,P<0.001)。结论安徽省全国疾病监测点死因监测数据完整性总体较好,但漏报率在不同县区、城乡、年龄组间存在不平衡现象,仍需用漏报调查来调整人群死亡水平。应切实加强常规死因监测系统报告和管理,不断完善死亡登记制度。
Objective To understand the deaths and omissions reported in the national disease surveillance sites in Anhui province from 2013 to 2014 so as to evaluate the integrity of the surveillance system. Methods A multistage cluster random sampling method was used to randomly select three villages and towns (streets) from villages and towns (streets) where the crude mortality rate was similar to the average mortality rate of the county (district or city) (Neighborhoods), three administrative villages (neighborhood committees) were randomly selected to collect data on death toll of residents aged from 2013 to 2014 from various sources other than the cause-of-death monitoring system and compared with the conventional network reporting system data of pumping villages (neighborhood committees) , Mark the repeated cases, calculate the false negative rate. Results The total omission rate was 8.26% and the rate of false negatives was 1.43% ~ 25.60% in all 23 countries in 2013-2014 in Anhui Province. The false negative rates were ≤14 years (26.61%) in different age groups, , 15-44 (11.45%), 45-64 (6.23%), ≥65 (8.13%), the difference was statistically significant (χ ~ 2 = 69.05, P <0.001) The reported rate was higher than that in rural areas (5.66%), the difference was statistically significant (χ ~ 2 = 59.99, P <0.001). Conclusion The data of the cause of death monitoring in the national disease surveillance sites in Anhui province are generally good in data integrity. However, there is an imbalance between the rate of missing reports in different counties and districts, urban and rural areas, and age groups. Population underdistribution should still be adjusted with the underreporting survey. The reporting and management of routine causes of death monitoring system should be strengthened and the death registration system should be continuously improved.