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目的:分析麻疹传染源从发病至控制诸环节的及时性,探讨其影响因素,为今后麻疹疫情的快速控制提供依据。方法:对杭州市拱墅区2005年报告的210例疑似麻疹病例进行分析,计算其就诊及时性、诊断及时性、诊断符合率、住院隔离率、控制及时性等指标。结果:就诊及时性方面疑似麻疹病例到卫生院的就诊要比到传染病医院更早;实验室诊断方面传染病医院要比疾控中心及时;临床诊断符合率为54.59%,传染病医院、县级以上综合性医院和卫生院三者之间无统计学意义;住院隔离81例,住院隔离率71.68%;传染源的控制环节中,发病到诊断中位数为4天,四分位数间距为3天,诊断到控制的中位数为0天,四分位数间距为1天,两环节间经配对t检验有统计学意义(P=0.000)。结论:麻疹病例的住院隔离率、疫情控制的及时性有待提高,医疗卫生机构的诊断、报告、疫情处置能力需要进一步加强。
OBJECTIVE: To analyze the timeliness of the source of measles infection from onset to control and to explore the influencing factors so as to provide evidence for the rapid control of measles epidemic in the future. Methods: A total of 210 cases of suspected measles reported in 2005 in Gongshu District of Hangzhou City were analyzed. Timeliness of diagnosis, timeliness of diagnosis, coincidence rate of diagnosis, isolation rate of hospitalization, and timeliness of control were calculated. Results: In the timely diagnosis of measles cases, the visits to hospitals were earlier than those to hospitals with infectious diseases; the laboratories with infectious diseases were more timely than CDCs; the coincidence rate of clinical diagnosis was 54.59%. Infectious diseases hospitals and counties There was no significant difference between the three general hospitals and clinics above grade level. There were 81 hospitalizations isolated and 71.68% hospitalized. Among the control links of infection sources, the median of diagnosis to four days, interquartile range For 3 days, the median control was 0 days and the interquartile range was 1 day. There was a statistically significant (P = 0.000) paired t-test between the two sessions. Conclusion: The hospital isolation rate of measles cases and the timeliness of epidemic control should be improved. The diagnosis, report and epidemic situation disposal capacity of medical and health institutions need to be further strengthened.