The effect of hospital isolation in mid-stage dengue epidemic control
-
摘要: 目的 评价住院隔离在登革热疫情中期的控制效果。方法 选择广州市采取住院隔离措施后2014年10月27日~12月14日为研究时间段,以住院隔离率为研究因素,以报告发病率、平均报告街镇率为结局指标进行多重线性回归分析。结果 2014年10月27日~12月14日,全市共报告2 956例,应住院隔离2 039例,实际住院隔离1 264例,住院隔离率61.99%。周平均报告422例,周平均报告发病率3.29/10万,周平均报告街镇率49.70%。在校正人口密度、平均布雷图指数后,随着住院隔离率的上升,分区县总报告发病率(R2=0.613 8,P=0.045)、分区县周平均报告发病率(R2=0.625 3,P=0.041)、分区县周平均报告街镇率(R2=0.634 1,P=0.037)均随之下降。在校正周次、人口密度和滞后2周的周平均气温、周平均降雨量、周平均布雷图指数后,随着分区县周住院隔离率的上升,周报告发病率(R2=0.520 4,P<0.001)、周平均报告街镇率(R2=0.681 3,P<0.001)亦下降。结论 传染期登革热患者采取住院隔离措施可以降低新病例的发生速度和地理扩散速度,今后应重视住院隔离措施在疫情防控中的积极作用。Abstract: Objective To evaluate the effect of hospital isolation in mid-stage dengue epidemic control. Methods The interval between Oct 27 and Dec 14,2014 after the implement of hospital isolation was slected as the study period, the hospital isolation rate and reporting incidence rate were investigated, the average reporting community rate was selected as the effective indicators for multiple linear regression analysis. Results A total of 2 956 cases were reported with reporting incidence rate 23.02 per 100 000, 1 264(61.99%) cases were actually isolated in total 2 039 patients who should received isolation. Weekly average reporting cases was 422 with weekly average reporting incidence rate 3.29 per 100 000 and weekly average community rate 49.70%. With population density and average Breteau Index adjusted, along with hospital isolation rate increasing, the district reporting incidence rate(R2=0.613 8,P=0.045), weekly district average reporting incidence rate(R2=0.625 3,P=0.041), weekly district average reporting community rate(R2=0.634 1,P=0.037) was decreasing. With week, population density, and lag of 2 weeks for weekly average air temperature, weekly average rainfull and weekly average Breteau Index adjusted, and with the weekly district hospital isolation rate increasing, the weekly average reporting incidence rate (R2=0.520 4,P<0.001), and the average reporting community rate(R2=0.681 3,P<0.001)were decreasing. Conclusions Hospital isolation of cases in the period of communicability plays an important role in reducing the velocity of incidence and geographical diffusion, and should be aroused more attention in dengue control.
-
Key words:
- Hospitalization /
- Patient Isolation /
- Dengue /
- Epidemiologic methods
-
Stoddard ST, Forshey BM, Morrison AC, et al. House-to-house human movement drives dengue virus transmission [J]. Proc Natl Acad Sci USA, 2013,110(3):994-999. Wu JY,Lun ZR,James AA, et al. Dengue Fever in mainland China [J]. Am J Trop Med Hyg, 2010,83(3):664-71. 张顺先,王英,闫磊,等. 我国2005-2012年登革热流行特征分析 [J]. 中国医药指南, 2013,(16):401-402. Zhan Y,Bi P,Hiller JE. Climate change and the transmission of vector-borne diseases: a review [J]. Asia Pac J Public Health, 2008,20(1):64-76. Cummings DA, Iamsirithaworn S, Lessler JT, et al. The impact of the demographic transition on dengue in Thailand: insights from a statistical analysis and mathematical modeling [J]. PLoS Med, 2009,6(9):e1000139. Barreto FR, Teixeira MG, Costa Mda C, et al. Spread pattern of the first dengue epidemic in the city of Salvador, Brazil [J]. BMC Public Health, 2008,8(1):51. Schmidt WP, Suzuki M, Thiem VD, et al. Population density, water supply, and the risk of dengue fever in Vietnam: cohort study and spatial analysis [J]. PLoS Med, 2011,8(8):e1001082. 周文,于德宪,湛柳华,等. 应用二次开发GIS实现登革热个案资料的管理 [J]. 中华疾病控制杂志, 2013,17(5): 447-450. Stoddard ST, Morrison AC, Vazquez-Prokopec GM, et al. The role of human movement in the transmission of vector-borne pathogens [J]. PLoS Negl Trop Dis, 2009,3(7):e481. 杨伟. 传染病动力学的一些数学模型及其分析 [D]. 上海:复旦大学, 2010. 柳合龙,郑丽丽. 带有脉冲免疫和脉冲隔离siqv传染病模型的全局结论 [J]. 信阳师范学院学报(自然科学版), 2005,18(4):381-383. 万维明,徐婧. 具有时滞隔离项的siqr传染病模型的稳定性分析 [J]. 大连交通大学学报, 2011,32(4):99-102. 王行兵,胡燕,吴满琳. 隔离措施对北京sars疫情控制影响的仿真分析 [J]. 计算机仿真, 2005,22(11):299-302. Chowell G, Fenimore PW, Castillo-Garsow MA, et al. SARS outbreaks in Ontario, Hong Kong and Singapore: the role of diagnosis and isolation as a control mechanism [J]. J Theor Biol, 2003,224(1):1-8. Yan X, Zou Y. Optimal and sub-optimal quarantine and isolation control in SARS epidemics [J]. Mathematical and Computer Modelling, 2008,47(1-2):235-245.
点击查看大图
计量
- 文章访问数: 422
- HTML全文浏览量: 77
- PDF下载量: 44
- 被引次数: 0