徐州市睢宁县恙虫病病例回顾性调查
|
摘要
目的了解徐州市睢宁县恙虫病疫情形势及相关特征,诊疗现状及患者经济负担等,为当地恙虫病防控提供有针对性的建议。方法回顾性搜索辖区内医疗机构恙虫病病例,选取2015年新发病例开展个案调查,采用描述流行病学方法对病例资料进行分析。结果主动搜索该地病例45例,集中分布在每年10—12月,涉及12个镇,32个行政村,2个社区,呈散在分布,病例均为当地农民,中位年龄57岁,文化程度以小学为主,患者平均住院费用为3 685.45元。调查病例发病前3周内均有户外活动史,发病后多有恙虫病典型临床表现,给予多西环素抗感染并辅以补液、护肝等对症、支持治疗后取得良好疗效。患者对恙虫病相关知识知晓率为零,基层医疗机构可及性强,但诊疗水平一般,仅县人民医院具有恙虫病诊治能力。结论恙虫病作为睢宁县的新发传染病对当地农民的健康和经济构成威胁,高度提示在该地区应对恙虫病保持足够的重视,推广落实诊疗技术和有效的预防控制措施当是该地下阶段防控恙虫病的重点工作。
[Objective] To understand the epidemic situation and relevant characteristics,current status of diagnosis and treatment,and patients' economic burden of sutsugamushi disease cases in Suining County of Xuzhou City,provide pertinent suggestions for the prevention and control of tsutsugamushi disease.[Methods]The cases of tsutsugamushi disease were retrospectively collected in medical institutions of Suining County,to investigate the new cases in 2015. The data of cases were analyzed by the descriptive epidemiological method.[Results]There were 45 cases of tsutsugamushi disease,which concentrated in the period of October to December. The patients distributed in 12 towns,32 villages and2 communities,with a scattered distribution,and all of them were local farmers. The median age was 57 years old,and Most of the patients had the education level of primary school. The average hospitalization expenses were 3 685.45 RMB. All patients had a history of outdoor activities within 3 weeks before the onset of the disease,and most of them had typical clinical manifestations of tsutsugamushi disease after the onset. Doxycycline combined with fluid infusion and liver protection therapy had good efficacy. The patients had no awareness of the related knowledge about tsutsugamushi disease. The diagnosis and treatment level of grassroots medical institutions were not satisfactory,and only the People's Hospital of Suining County had the capabilities to diagnose and treat the tsutsugamushi disease.[Conclusion]Tsutsugamushi disease is the new infectious disease which poses a threat to health and economics of local farmers in Suining County. It is necessary to pay more attention to tsutsugamushi disease,promote and implement the diagnostic and therapeutic techniques and effective prevention and control measures in the further.
[Objective] To understand the epidemic situation and relevant characteristics,current status of diagnosis and treatment,and patients' economic burden of sutsugamushi disease cases in Suining County of Xuzhou City,provide pertinent suggestions for the prevention and control of tsutsugamushi disease.[Methods]The cases of tsutsugamushi disease were retrospectively collected in medical institutions of Suining County,to investigate the new cases in 2015. The data of cases were analyzed by the descriptive epidemiological method.[Results]There were 45 cases of tsutsugamushi disease,which concentrated in the period of October to December. The patients distributed in 12 towns,32 villages and2 communities,with a scattered distribution,and all of them were local farmers. The median age was 57 years old,and Most of the patients had the education level of primary school. The average hospitalization expenses were 3 685.45 RMB. All patients had a history of outdoor activities within 3 weeks before the onset of the disease,and most of them had typical clinical manifestations of tsutsugamushi disease after the onset. Doxycycline combined with fluid infusion and liver protection therapy had good efficacy. The patients had no awareness of the related knowledge about tsutsugamushi disease. The diagnosis and treatment level of grassroots medical institutions were not satisfactory,and only the People's Hospital of Suining County had the capabilities to diagnose and treat the tsutsugamushi disease.[Conclusion]Tsutsugamushi disease is the new infectious disease which poses a threat to health and economics of local farmers in Suining County. It is necessary to pay more attention to tsutsugamushi disease,promote and implement the diagnostic and therapeutic techniques and effective prevention and control measures in the further.
引文
[1]丁恩庶,林继煌,陈观今,等.中国人兽共患病学[M].2版.福州:福建科学技术出版社,1996:481.
[2]张萌,王显军,赵仲堂.中国恙虫病流行态势及预防控制[J].中华流行病学杂志,2011,32(4):419-423.
[3]郭恒彬.吴光华,徐毛华,等.秋冬型恙虫病自然疫源地的调查研究[J].中华流行病学杂志,1994,15(I):27-30.
[4]杨玉富,王均利,姚云超,等.山东省首次发现恙虫病流行的调查[J].中华流行病学杂志,1987,8(5):280.
[5]于长水,张之伦,罗云秋,等.天津市北部农村首次发现恙虫病流行的报告[J].中华流行病学杂志,1992,13(4):212-215.
[6]胡玲美,鲁志新,蔡增林,等.我国东北地区恙虫病自然疫源地证实[J].传染病信息,1997,10(2):63.
[7]孙明,汪东亮,赵春云,等.宿迁地区32例恙虫病临床特征分析[J].中国血吸虫病防治杂志,2013,25(6):639-641.
[8]曾凡荣,蔡胜蓝,赵文海,等.63例恙虫病的流行病学与临床特征分析[J].实用预防医学,2014,21(3):315-317.
[9]于乐成,何长伦,王长军,等.安徽省恙虫病新疫源地疫情暴发特点及意义[J].传染病信息,2011,24(1):15-17,54.
[10]吴光华,郭恒彬,于明明.华东地区三种类型恙虫病自然疫源地调查[J].中华卫生杀虫药械,2012,18(2):92-95.
[2]张萌,王显军,赵仲堂.中国恙虫病流行态势及预防控制[J].中华流行病学杂志,2011,32(4):419-423.
[3]郭恒彬.吴光华,徐毛华,等.秋冬型恙虫病自然疫源地的调查研究[J].中华流行病学杂志,1994,15(I):27-30.
[4]杨玉富,王均利,姚云超,等.山东省首次发现恙虫病流行的调查[J].中华流行病学杂志,1987,8(5):280.
[5]于长水,张之伦,罗云秋,等.天津市北部农村首次发现恙虫病流行的报告[J].中华流行病学杂志,1992,13(4):212-215.
[6]胡玲美,鲁志新,蔡增林,等.我国东北地区恙虫病自然疫源地证实[J].传染病信息,1997,10(2):63.
[7]孙明,汪东亮,赵春云,等.宿迁地区32例恙虫病临床特征分析[J].中国血吸虫病防治杂志,2013,25(6):639-641.
[8]曾凡荣,蔡胜蓝,赵文海,等.63例恙虫病的流行病学与临床特征分析[J].实用预防医学,2014,21(3):315-317.
[9]于乐成,何长伦,王长军,等.安徽省恙虫病新疫源地疫情暴发特点及意义[J].传染病信息,2011,24(1):15-17,54.
[10]吴光华,郭恒彬,于明明.华东地区三种类型恙虫病自然疫源地调查[J].中华卫生杀虫药械,2012,18(2):92-95.