摘要
目的 了解河南省脊髓灰质炎(脊灰)疫苗免疫策略转换(转换)对急性弛缓性麻痹(AFP)病例监测结果的影响。方法 对河南省两次转换(2016年5月1日和2019年10月1日)前后1年内AFP监测信息报告管理系统中报告的1 975例AFP病例共计3 949份粪便标本进行病毒分离培养鉴定,使用SPSS 19.0软件对AFP病例的流行病学数据进行统计分析。结果 第一次转换前后共报告AFP病例分别为467例和485例,发病率分别为2.38/10万和2.46/10万(P>0.05),残留麻痹的构成比分别为10.06%和12.99%(P>0.05),死亡的构成比分别为0.64%和1.24%(P>0.05),采集标本分别为934和970份,脊灰病毒(PV)分离率分别为1.07%和1.55%(P>0.05),PV I型分离率分别为0.43%和0.93%(P>0.05),PV Ⅲ型分离率分别为0.54%和0.62%(P>0.05),核苷酸变异数≤5分别占90.00%和80.00%,非脊灰肠道病毒(NPEV)分离率分别为6.85%和8.45%(P>0.05);第二次转换前后共报告AFP病例分别为544例和479例,发病率分别为2.75/10万和2.34/10万(P<0.05),残留麻痹的构成比分别为8.09%和6.05%(P>0.05),死亡的构成比分别为1.65%和0.42%(P>0.05),采集标本分别为1 087和958份,PV分离率分别为0.83%和0.42%(P>0.05),PV I型分离率分别为0.37%和0.21%(P>0.05),PV Ⅲ型分离率分别为0.46%和0.21%(P>0.05),核苷酸变异数≤5均占100.00%,NPEV分离率分别为4.14%和1.04%(P<0.05)。AFP病例主要集中在5岁以下儿童,占70.08%,其中3岁以下病例数最高,占51.80%,男女性别比1.80∶1。报告病例最多的3个地区分别为郑州市、南阳市、周口市,分别占24.00%、9.01%和9.01%;时间主要集中在春秋两季,疾病谱以吉兰-巴雷综合征和短暂性肢体麻痹为主。结论 河南省两次免疫策略转换前后AFP病例的地区、时间、人群分布、疾病谱以及60天后残留麻痹和死亡构成比均无明显变化,PV I型分离率高于Ⅲ型,核苷酸均以≤5个变异为主,AFP发病率和NPEV分离率在第二次转换后显著下降。
Objective To investigate the impact of poliomyelitis vaccine immunization strategy conversion on acute flaccid paralysis(AFP) case surveillance results in Henan province. Methods Virus isolation, culture and identification of 3 949 fecal specimens collected from 1 975 AFP cases reported in the AFP surveillance information reporting management system within one year before and after conversion of the two vaccine immunization strategies(May 1, 2016 and October 1, 2019). The epidemiological data were statistically analyzed using SPSS 19.0 software. Results A total of 467 and 485 AFP cases were reported before and after the first conversion of vaccine immunization strategy, with the incidence rates of 2.38/100 000 and2.46/100 000, respectively(P>0.05);the proportions of residual paralysis were 10.06% and 12.99%(P>0.05). respectively;the proportions of death were 0.64% and 1.24%, respectively(P>0.05);the collected standard samples were 934 and 970, and the isolation rates of poliovirus(PV) were 1.07% and 1.55%(P>0.05), respectively;the separation rates of PV type I were 0.43% and0.93%(P>0.05), and the separation rates of PV type Ⅲ were 0.54% and 0.62%(P>0.05), respectively;nucleotide variation ≤5accounted for 90.00% and 80.00% respectively, and the isolation rates of non-polio enterovirus(NPEV) were 6.85% and 8.45%(P >0.05), respectively. A total of 544 and 479 AFP cases were reported before and after the second conversion of vaccine immunization strategy, with the incidence rates of 2.75/100 000 and 2.34/100 000(P <0.05), respectively;the proportions of residual paralysis were 8.09% and 6.05%(P>0.05), respectively;the proportions of death were 1.65% and 0.42%(P>0.05),respectively;the collected standard samples were 1 087 and 958, respectively;the PV isolation rates were 0.83% and 0.42%(P>0.05), respectively;the separation rates of PV type I were 0.37% and 0.21%(P>0.05), and the separation rates of PV type Ⅲ were 0.46% and 0.21%(P>0.05), respectively;nucleotide variation ≤ 5 both accounted for 100.00%;the NPEV isolations rates were 4.14% and 1.04%(P <0.05), respectively. AFP cases before and after the two conversions were mainly concentrated in children under 5 years old, accounting for 70.08%, and the number of cases in the 0-<3 year-old group was the highest,accounting for 51.80%, and the male to female ratio was 1.80∶1. The three cities with the highest reported cases were Zhengzhou,Nanyang and Zhoukou, which had high population density and large floating population, accounting for 24.00%, 9.01% and9.01%, respectively. The case-reporting time was mainly concentrated in spring and autumn. The main diseases included Guillain-Barre syndrome and transient limb paralysis. Conclusion The region, time, person distribution, disease spectrum and the proportions of residual paralysis and death after 60 days did not change significantly before and after the two vaccine immunization strategy changes in Henan province. The isolation rate of PV type I was higher than that of PV type Ⅲ, and the nucleotide variants were both mainly ≤5. The incidence of AFP and the isolation rate of NPEV decreased significantly after the second immunization strategy conversion.
作者
杨建辉
白祎然
豆巧华
陈瑞琴
张璐
张明瑜
郭永豪
YANG Jianhui;BAI Yiran;DOU Qiaohua;CHEN Ruiqin;ZHANG Lu;ZHANG Mingyu;GUO Yonghao(Henan Center for Disease Control and Prevention,Provincial Key Medical Laboratory for Immunization Prevention,Zhengzhou,Henan 450016,China;Zhengzhou Jinshui District of Disease Control and Prevention)
出处
《河南预防医学杂志》
2023年第1期28-33,共6页
Henan Journal of Preventive Medicine
基金
河南省医学科技攻关计划项目(LHGJ20200133)。
关键词
脊髓灰质炎
疫苗免疫策略转换
急性弛缓性麻痹
监测
Poliomyelitis
Vaccine immunization strategy conversion
Acute flaccid paralysis
Surveillance
作者简介
杨建辉,主管技师,硕士研究生,研究方向:肠道病毒感染性疾病;通信作者:郭永豪,E-mail:cdcgyh@163.com。
