本文選題：布魯氏菌病 + 流行現(xiàn)狀��； 參考：《山東大學》2013年碩士論文

【摘要】：目的： 分析、研判淄博市1954～2011年布病流行特征及其動態(tài)變化規(guī)律,研究探討影響20世紀九十年代淄博市布病疫情上升的因素,預測預報淄博市人間布病疫情流行趨勢,準確掌握淄博市布病的防控狀況,科學評價布病防控工作措施效果,為制定并不斷完善淄博市布病防控策略提供切實可行的依據(jù),不斷改進防控措施,切實鞏固淄博市布病防控工作成果。 方法： 采用SPSS19.0對淄博市1954～2011年人間布病疫情報告資料、1958～2011年人間感染情況調查資料、1989～2011年布病病人個案調查資料以及1958～2011年畜間感染情況調查、畜間主動免疫與檢疫資料等相關資料進行統(tǒng)計分析,研究淄博市布病疫情流行現(xiàn)狀,并對采用加權算術平均預測法對淄博市布病疫情流行趨勢進行預測。 結果： 淄博市1954-2011年共報告人間布病病例380例,年平均發(fā)病率為0.2512/10萬,其中37年有疫情報告,無疫情報告的年份全部集中1955～1988年間。1989～2011年期間淄博市人間布病疫情年平均發(fā)病率是1954～1988年期間的2.01倍,兩個時間段發(fā)病頻率差異具有統(tǒng)計學意義(χ2=36.51,P0.01)。目前,呈現(xiàn)出歷史布病疫區(qū)疫情依然嚴重,新發(fā)布病疫區(qū)不斷出現(xiàn)的局面,淄博市布病疫情上升趨勢與全國及部分省市相一致,但其疫情上升趨勢早于全國,并且波動性與有關報道不完全一致。1954-2011年,淄博市布病病例分布在五區(qū)三縣56個鄉(xiāng)鎮(zhèn)118個村,近年來呈現(xiàn)出逐步增加趨勢,主要集中在淄川、臨淄兩個區(qū),這與當?shù)鼐用褚园朕r(nóng)半牧為主有關,張店、周村、桓臺、高青等區(qū)縣由于近年來發(fā)展奶牛、奶羊養(yǎng)殖業(yè),報告病例數(shù)也在不斷增加。淄博市報告的布病病例存在一定的家庭聚集性,并且近年來爆發(fā)疫情起數(shù)不斷增加。對1989～2011年283例病例統(tǒng)計分析,其發(fā)病性別、年齡分布符合布病的發(fā)病規(guī)律,但1989-2002年和2003-2011年兩個時期淄博市布病發(fā)病年齡分布出現(xiàn)新變化,2003～2011年期間40歲的各年齡組發(fā)病例數(shù)均少于1989～2002年,40～69歲的各年齡組均多于1989-2002年。發(fā)病時間分布與羊種菌布病疫區(qū)特點相吻合,6月份為發(fā)病高峰,占總病例數(shù)的15.55%,病例集中分布在3～7月份,共累計發(fā)病177例,占總病例數(shù)的62.54%。從淄博市1989～2011年個案調查資料完整的162例病例感染途徑(方式)的統(tǒng)計分析結果情況看,病例可能的感染方式或途徑仍然以飼養(yǎng)、放牧羊只和屠宰牲畜感染為主,分別占70.99%和11.11%,尤其要值得關注的是近年來8例布病患者系因飲用生羊奶(占總病例數(shù)的4.94%)而感染。1958～2011年,淄博市累計開展血清學主動監(jiān)測39361人(次),其中SAT試驗陽性者591人,平均陽性率為1.50%,結合臨床癥狀和流行病學調查結果共確診296例布病病人,確診率為50.08%,占總病例數(shù)的77.89%,其中有13年未開展人間主動監(jiān)測工作。1958～2011年,淄博市累計共血清學檢疫檢測140154只(頭)牲畜,檢疫陽性1162只(頭),陽性率為0.83%,其中16年未開展檢疫工作。淄博市1958～2011年期間歷年累計免疫接種牲畜88.49萬只,歷年平均免疫密度為20%～30%,其中29年未開展牲畜免疫接種工作。人、畜間共檢菌鑒定21株布氏菌,其中羊Ⅲ型19株,羊Ⅰ型2株。利用yt=(5yt-1+4yt-2+3yt-3+2yt-4+Yt-5)/(1+2+3+4+5),預測2012～2016年淄博市布病發(fā)病率依次為0.5991/10萬、0.6346/10萬、0.6579/10萬、0.6704/10萬、0.6764/10萬。 結論： 淄博市20世紀70到80年代布病防控工作積累了成功的經(jīng)驗,布病疫情一度得到了有效控制,5個縣達到了部頒控制區(qū)標準,2個縣達到了部頒穩(wěn)定控制區(qū)標準。但近年來由于牲畜養(yǎng)殖模式改變、畜及畜產(chǎn)品交易頻繁、畜間防控措施存在不到位問題等原因,導致了人、畜間布病疫情再度肆虐。而且通過疫情預測,未來一段時期,淄博市如不加大防控力度,布病疫情將會呈現(xiàn)進一步擴大的態(tài)勢。要想根本上徹底肅清布病傳染源、凈化疫源地,最終達到控制淄博市人間布病疫情發(fā)生爆發(fā)和流行的目標,必須圍繞消滅布病傳染源、控制傳播途徑和保護易感人群這三個流行環(huán)節(jié),進一步建立健全機制體制,真正做到群防群治、聯(lián)防聯(lián)治,逐步實現(xiàn)法制化、規(guī)范化、制度化管理。
[Abstract]:Objective:
Analysis was made to study the epidemic characteristics and dynamic changes of 1954~2011 years in Zibo. The factors affecting the rising epidemic situation in Zibo in 90s twentieth Century were studied, the epidemic trend of human cloth disease in Zibo was predicted, the prevention and control status of Zibo disease was accurately mastered, and the effect of the prevention and control measures of the disease was scientifically evaluated, and the effect of the disease prevention and control measures was scientifically evaluated. We will continue to improve the prevention and control strategy of brucellosis in Zibo and provide practical basis for improving the prevention and control measures in order to consolidate the results of brucellosis prevention and control in Zibo.
Method:
The data of the 1954~2011 years' epidemic situation of human cloth disease in Zibo, the data of 1958~2011 years of human infection, the data of the cases of the sick patients in the past 1989~2011 years and the investigation of the infection among the animals in the past 1958~2011 years, the data of the active immunity and quarantine data among the animals were statistically analyzed to study the epidemic situation of the disease in Zibo. The epidemic situation is forecasted and the epidemic trend of brucellosis in Zibo is forecasted by the weighted arithmetic average prediction method.
Result:
In 1954-2011 years, 380 cases of human disease were reported in Zibo, with an average annual incidence of 0.2512/10 million, of which 37 years had an epidemic report. The annual average incidence of human cloth disease in Zibo, which was not reported in the year of.1989 to 2011, was 2.01 times more than that of 1954~1988 years, and the incidence of the disease was poor in two periods. The difference has statistical significance (2=36.51, P0.01). At present, the epidemic situation in the historical epidemic area is still serious, the situation of the newly issued disease epidemic area is constantly emerging, the trend of the epidemic situation in Zibo is consistent with that of the whole country and some provinces and cities, but the trend of the epidemic situation is earlier than that of the whole country, and the volatility is not exactly consistent with the related reports for.1954-2011 years, Zibo disease cases are distributed in 118 villages of 56 villages and towns in three counties of five districts. In recent years, it has been increasing gradually, mainly in Zichuan and Linzi two districts, which is related to the local residents with half agricultural and semi animal husbandry, and Zhangdian, Zhoucun, Huantai, and Gaoqing County have been increasing the number of reported cases in recent years. There are certain family aggregation in the reported cases of disease in Zibo, and the number of outbreaks has increased in recent years. For 283 cases of 1989~2011 years, the sex and age distribution of the disease conforms to the regularity of the disease, but the distribution of the age distribution of the disease in the city of Zibo in 1989-2002 and 2003-2011 years has been changed, 200 The number of cases of all age groups at the age of 40 years was less than 1989~2002 years, and all age groups at the age of 40~69 were more than 1989-2002 years. The time distribution of the onset was consistent with the characteristics of the disease epidemic area of the sheep. In June, it was the peak of the disease, accounting for 15.55% of the total cases, and the cases were concentrated in 3~7 months, with a total of 177 cases in total, accounting for the total number of cases. 62.54%. according to the statistical analysis results of 162 cases of cases of infection in Zibo, 1989~2011 years of case investigation data, the possible way or way of infection of the cases is still reared, the shepherd sheep and the slaughter cattle are the main infection, accounting for 70.99% and 11.11% respectively. In particular, it is worth paying attention to the causes of 8 cases of disease patients in recent years. Drinking raw sheep milk (4.94% of the total number of cases) and infected.1958 to 2011, 39361 people (Times) were actively monitored by serology in Zibo. Among them, 591 people with positive SAT test were 591, the average positive rate was 1.50%. Combined with clinical symptoms and epidemiological investigation, 296 cases of disease were diagnosed, the rate of diagnosis was 50.08%, which accounted for 77.89% of the total number of cases. For 13 years, no human active monitoring was carried out from.1958 to 2011. In Zibo, 140154 (head) livestock were detected by the total serological quarantine inspection in Zibo. The positive rate was 0.83%. Among them, the quarantine was not carried out in 16 years. 884 thousand and 900 animals were inoculated for 1958~2011 years in the past 1958~2011 years. The average annual immunization density of Zibo was 20% to 30. %, of which 29 years had not carried out the vaccination of livestock. 21 strains of Brucella were identified by the common bacteria among the animals, including 19 sheep and 2 sheep. Using yt= (5yt-1+4yt-2+3yt-3+2yt-4+Yt-5) / (1+2+3+4+5), it was predicted that the incidence of brucellosis in Zibo was 0.5991/10 million, 0.6346/10 million, 0.6579/10 million, 0.6704/10 million and 0.6764/10 million in 2012~2016 years.
Conclusion:
Zibo city has accumulated successful experience in prevention and control of disease from 70 to 80s twentieth Century. The epidemic situation has been effectively controlled, 5 counties have reached the standard of the Ministry of control and 2 counties have reached the standard of the stability control area. However, in recent years, due to the change of livestock breeding mode, the trade of livestock and livestock products is frequent and the prevention and control measures between animals are not in place. Problems and other reasons have led to the recurrence of disease epidemic among people and animals. And through the forecast of the epidemic situation, the epidemic situation in Zibo will be further expanded in the next period of time. The epidemic situation of the disease will be further expanded. It is necessary to thoroughly eliminate the infectious source of the disease and purify the source of the epidemic, and finally achieve the control of the epidemic situation of human cloth disease in Zibo. The target of outbreak and epidemic must revolve around the three popular links of eradication of the infectious source of disease, the control of the way of transmission and the protection of the susceptible population, and further establish and perfect the mechanism system, truly achieve group prevention and treatment, joint prevention and treatment, and gradually realize the legalization, standardization and institutionalized management.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R516.7

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