【摘要】 目的探讨莱芜市麻疹流行规律,为麻疹控制工作提供科学依据。方法对莱芜市1960~2012年麻疹疫情资料进行流行病学分析,用圆形分布法分析麻疹发病的集中时点和流行高峰期。结果麻疹疫苗使用前阶段、计划免疫前期、计划免疫初期、计划免疫阶段和消除麻疹阶段麻疹年均发病率分别为556.59/10万、228.88/10万、11.32/10万、0.40/10万和7.87/10万,麻疹发病呈现以下特征:城镇年均发病率显著高于农村(P<0.01);计划免疫前期(1960~1978年)麻疹发病高峰时点为3月29日,50%发病高峰期在3月7日至4月23日,计划免疫后(1979~2012年)发病高峰时点为4月11日,50%发病高峰期在3月13日至5月5日,发病高峰依然存在且明显拖后(P<0.01);1979~1984年、1985~2005年、2006~2012年1岁以下的麻疹病例构成比分别为1.45%、9.89%、16.83%,呈明显增加趋势,15岁以上的麻疹病例构成比分别为2.60%、20.88%、34.09%,呈明显增加趋势;职业分布以学生和散居儿童多发,其次是工人、农民和幼托儿童,流动人口构成比有明显增加趋势。结论成人麻疹和未免疫人群麻疹病例的增加给消除麻疹带来严峻挑战,流动人口病例的增加也不容忽视,要达到消除麻疹目标,除要做好适龄儿童常规免疫外,加强成人和流动人口的麻疹疫情监测和免疫预防具有重要意义。更多还原

【Abstract】 Objective To explore the epidemiological characteristics of measles in Laiwu city during 1960-2012,so as to provide scientific basis for strategy of measles prevention and control. Methods Epidemiological analysis was made on the surveillance data of measles in Laiwu city during 1960-2012.By circle distribution,the characteristics including peak day and crest time of measles incidence were studied. Results In five stages,including periods prior to the use of the measles vaccine and before implementation of EPI,the beginning and duration of EPI era,and the phase of measles elimination,the average incidence rates of measles were respectively 556.59/105,228.88/105,11.32/105,0.40/105,and 7.87/ 105.The epidemic features of measles were as follows:in town,the average incidence rate was significantly higher than that in country(P <0.01);in the pre-vaccination period(1960-1978),the peak day of incidence of measles was March 29th,and fifty percent of the crest time of incidence was between March 7th-April 23th.With the implementation of vaccination(1979-2012),the peak day was changed to April 11th,and fifty percent of the crest time became March 13th-May 5th,indicating that it remained exist but was put off apparently(P <0.01).The odds of incidence under 1-year-old between 1979-1984,1985-2005,2006-2012were 1.45%,9.89% and 16.83%,respectivelyly,increasing dramatically,as well as that above 15years old,which were respectively 2.6%,20.88% and 34.09%;the distribution of incidence of measles by occupation was mainly students and scattered children,followed by workers and farmers,and the constituent ratios of the floating population presented a rise tendency substantially. Conclusion Together with the rising incidence of the transient population,the increase in the cases of adults and people without immunization challenges the goal of measles elimination severely.Besides the routine immunization of school-aged children,what it takes to reach the objective of eliminating measles is that strengthening the surveillance and immunization of adults and the transient population,which will play important significance as well.更多还原