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目的了解河北省正定县农村地区细菌性痢疾的疾病负担。方法于2002年对河北农村地区进行了以人群和医疗机构为基础的细菌性痢疾发病率监测。对同意参与研究的腹泻病例采集大便标本,分离、鉴定志贺菌并确诊菌痢病例。计算年龄别菌痢发病率。并对确诊菌痢病例进行90 d随访,监测菌痢相关的后遗症。结果全年共调查10105例腹泻病例,人群腹泻率为133/千人年。其中,0岁组腹泻率最高为1 388/千人年;其次为5岁以下儿童,发病率为618/千人年。共确诊菌痢331例。3岁组儿童发病率最高,为32/千人年,其次为60岁以上老年人,为7/千人年。发热及脓血便为菌痢的重要临床特征。未发现与菌痢相关的后遗症与死亡。菌痢的发病率与月平均气温及月平均降雨量密切相关。结论细菌性痢疾在正定县农村地区所导致的疾病负担巨大,远远高于传染病报告的发病率。应考虑针对5岁以下儿童及60岁以上老年人实施疫苗免疫,以控制该地区志贺菌感染与流行。
Objective To understand the burden of bacterial dysentery in rural areas of Zhengding County of Hebei Province. Methods In 2002, the incidence of bacterial dysentery in Hebei rural areas was monitored based on population and medical institutions. Stool specimens were collected from patients who agreed to participate in the study, and Shigella was identified and identified as cases of bacillary dysentery. Calculate the age of dysentery incidence rate. The cases of confirmed bacillary dysentery were followed up for 90 days to monitor the sequelae associated with bacillary dysentery. Results A total of 10 055 cases of diarrhea were investigated throughout the year, with a diarrhea rate of 133 per thousand person-years. Among them, the highest rate of diarrhea in the 0-year-old group was 1 388 per thousand person years, followed by children under 5 years old, with a prevalence of 618 per thousand person-years. A total of 331 cases of bacillary dysentery were diagnosed. The highest incidence of children in the 3-year-old group was 32 per 1,000 person-years, followed by the elderly over the age of 60, at 7 per 1,000 person-years. Fever and pus and blood will be an important clinical feature of bacillary dysentery. No sequelae and death associated with bacillary dysentery were found. The incidence of bacillary dysentery is closely related to the monthly average temperature and monthly average rainfall. Conclusion Bacterial dysentery causes a huge burden of disease in rural areas of Zhengding County, far higher than the reported incidence of infectious diseases. Vaccination should be considered for children under 5 and over the age of 60 to control Shigella infections and epidemics in the area.