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目的了解狂犬病发展变化规律,为制定预防控制措施提供科学依据。方法根据桂林市1999-2012年狂犬病个案调查表及历年传染病疫情登记资料,采用χ2检验或精确概率法和对应分析方法,对不同年份狂犬病暴露因素进行比较分析,P<0.05为差异有统计学意义。结果 1999-2012年14年间共报告狂犬病687例。不同年份狂犬病的发病年龄、暴露后伤口处理、暴露方式、动物攻击方式和动物来源有差异,χ2=161.309、55.219、64.004、45.388、117.013,P均<0.05。1999-2001年30~50岁多发,占61.29%(76/124),2002-2005年40~60岁和10岁以下多发,分别占47.79%(130/272)和17.28%(47/272),2006-2012年50~70岁多发,占65.98%(192/291);2010-2012年伤口未处理者多发,占85.00%(85/100);1999-2008年、2009年与2010年、2011年与2012年暴露方式有明显聚集性;1999-2008年咬伤在47.06%~63.04%,2009年与2010年咬伤占84.44%(76/90),2011年与2012年抓伤占36.21%(21/58);1999-2003年其他致伤方式所占比例为23.11%(58/251)高于其他年份15.14%(66/436);1999-2010年以家养犬致伤引起的狂犬病为主,占75.68%(476/629),2011年和2012年流浪动物致伤引起的狂犬病明显增加,占63.79%(37/58)。多因素分析发现2008年以来中老年人狂犬病病例增多,流浪动物致伤引起的狂犬病病例增多。结论目前狂犬病病例以中老年人多发,流浪犬引起的狂犬病明显增加。提高中老年人对狂犬病防范意识和强化对流浪犬的捕杀工作是现阶段狂犬病防制工作重点。
Objective To understand the laws of rabies development and provide a scientific basis for making prevention and control measures. Methods According to the questionnaire of rabies from 1999 to 2012 in Guilin City and the registration data of epidemic situation of infectious diseases over the years, the factors of exposure to rabies in different years were analyzed by Chi-square test or exact probabilistic method and corresponding analysis method. P <0.05 was considered statistically significant significance. Results A total of 687 rabies cases were reported in the 14 years from 1999 to 2012. The age of onset of rabies in different years, the wound treatment after exposure, the way of exposure, the way of animal attack and the origin of animals were different, χ2 = 161.309,55.219,64.004,45.388,117.013, P <0.05. Between 1999 and 2001, 30 to 50 years old , Accounting for 61.29% (76/124) of the total number of cases, accounting for 47.79% (130/272) and 17.28% (47/272) respectively in the period of 40-60 years and under 10 years of age in 2002-2005 and 50-70 years in 2006-2012 (65/98) (192/291). The number of non-treated wounds in 2010-2012 was 85.00% (85/100). The pattern of exposure in 1999, 2008, 2009, 2010, 2011 and 2012 was significant The number of bites was between 47.06% and 63.04% in 1999-2008, 84.44% (76/90) in 2009 and 2010, 36.21% (21/58) in 2011 and 2012, In 2003, the rate of other injuries was 23.11% (58/251), higher than that of other years (15.14%). Rabies was mainly caused by domestic dog’s injury in 1999-2010, accounting for 75.68% (476%) / 629). In 2011 and 2012, rabies caused by stray animals increased significantly, accounting for 63.79% (37/58). Multivariate analysis found that the number of rabies cases in middle-aged and old people increased since 2008, and the incidence of rabies in stray animals increased. Conclusion The prevalence of rabies in middle-aged and elderly people is significantly higher than that of stray dogs. Raising the awareness of rabies prevention among middle-aged and elderly people and strengthening the hunting and killing of stray dogs are the key points in the prevention and control of rabies at this stage.