本文選題：傳染病 + 流行特征　； 參考：《山東大學(xué)》2007年碩士論文

【摘要】： 研究目的 通過對(duì)泰安市1961～2005年傳染病監(jiān)測(cè)資料的分析，全面了解不同時(shí)期傳染病的發(fā)病水平及構(gòu)成，探索影響傳染病消長(zhǎng)的相關(guān)因素，為制定衛(wèi)生政策提供科學(xué)依據(jù)，為其他相關(guān)政策的制定提供基礎(chǔ)資料。 研究方法 運(yùn)用描述性流行病學(xué)的方法對(duì)資料進(jìn)行分析。 傳染病發(fā)病分析：通過1961～2005年各年份的傳染病發(fā)病率曲線、動(dòng)態(tài)數(shù)列分析傳染病發(fā)病強(qiáng)度的變化趨勢(shì)及變化速度；將1961～2005年傳染病發(fā)病分成三個(gè)時(shí)期，通過比較不同時(shí)期各傳染病構(gòu)成比，分析不同時(shí)期傳染病疾病譜的改變。 重點(diǎn)傳染病發(fā)病分析：選擇每類傳染病中的代表性疾病進(jìn)行分析。通過每種傳染病各年份發(fā)病率，分析該疾病的長(zhǎng)期變化趨勢(shì)；通過不同年份各地區(qū)、各月份傳染病發(fā)病率，以及年齡、性別、職業(yè)發(fā)病構(gòu)成比分析各傳染病的流行特征。 研究結(jié)果 (1) 1961～2005年泰安市累計(jì)報(bào)告?zhèn)魅静?4種，年平均發(fā)病率為700.67／10萬，年平均死亡率為3.76／10萬，年平均病死率為0.54％。發(fā)病呈下降趨勢(shì)，發(fā)病率從1961年2865.87／10萬下降至2005年的173.66／10萬，下降了93.94％。在1961～1979年傳染病的年平均發(fā)病率為1369.22／10萬，居發(fā)病前五位的疾病主要有瘧疾、麻疹、流腦、百日咳、痢疾、肝炎；在1980～1989年傳染病的年平均發(fā)病率為336.04／10萬，居發(fā)病前五位的疾病主要有痢疾、肝炎、瘧疾、出血熱、百日咳，在1990～2005年傳染病的年平均發(fā)病率為136.27／10萬，居發(fā)病前五位的疾病主要有肝炎、痢疾、出血熱、肺結(jié)核、淋病。 (2) 1961～1971年病毒性肝炎發(fā)病呈現(xiàn)下降的趨勢(shì)，年平均發(fā)病率為18.19／10萬，無明顯的高發(fā)月份；1972～1994年病毒性肝炎發(fā)病率分布在87.01／10萬～355.64／10萬之間，出現(xiàn)了6次流行高峰，一般每3～5年出現(xiàn)一次，8～12月份發(fā)病較多：1995～2005年間病毒性肝炎發(fā)病表現(xiàn)為先緩降后上升的態(tài)勢(shì)，年平均發(fā)病率為69.54／10萬，無明顯的高發(fā)月份。在病毒性肝炎發(fā)病構(gòu)成中，1990～1994年甲肝占病毒性肝炎病例的73.79％，乙肝占21.67％，1995～2005年乙肝發(fā)病占病毒性肝炎的86.86％，未分型肝炎占病毒性肝炎的6.35％，甲肝發(fā)病占病毒性肝炎的6.12％。 (3) 1961～2005年瘧疾發(fā)病呈下降趨勢(shì)；1961～1986年的本地病例流行期，年平均發(fā)病率為289.46／10萬，年平均死亡率為0.004／10萬，年平均病死率為0.001％，出現(xiàn)了1961年、1971年兩個(gè)發(fā)病高峰年，病例主要分布在7～10月份；1987～2005年，病例均為輸入性，年均發(fā)病率為0.036／10萬，無死亡病例，無明顯的高發(fā)月份。 (4) 1984～2005年腎綜合癥出血熱發(fā)病呈下降趨勢(shì)，出現(xiàn)1985～1987年、1994～1996年兩次發(fā)病高峰，2003年發(fā)病大幅下降，至2005年降至1.22／10萬；病例主要分布在3～6月份和9～10月份；發(fā)病較多的職業(yè)為農(nóng)民、學(xué)生、工人。 (5) 1997～2003年肺結(jié)核發(fā)病比較平穩(wěn)，2004年之后發(fā)病呈明顯上升趨勢(shì)。各年份的1月份發(fā)病最多，發(fā)病較多的年齡為15～24歲組、45～64歲組，發(fā)病較多的職業(yè)為農(nóng)民，其次為學(xué)生、工人。 (6) 1961～2005年麻疹年發(fā)病呈下降趨勢(shì)。1961～1975年麻疹發(fā)生了4次流行，，每間隔2～3年出現(xiàn)一次流行高峰，病例主要集中在冬春季節(jié)，15歲以下少年兒童發(fā)病較多；1985年以來，大年齡組的發(fā)病有明顯增多趨勢(shì)。 (7) 1961～2005年流腦發(fā)病呈下降趨勢(shì)。1961～1979年間出現(xiàn)了1965～1969年、1976～1978年兩次流行高峰；1980年后，流腦發(fā)病持續(xù)下降，近10年，流腦的發(fā)病一直處于較低水平。發(fā)病主要集中在冬春季節(jié)，以15歲以下年齡居多，近年高發(fā)年齡有明顯后移趨勢(shì)；發(fā)病較多的職業(yè)為散居兒童、中小學(xué)生，但近年發(fā)病構(gòu)成有降低的趨勢(shì)。 (8) 1961～2005年痢疾發(fā)病呈下降趨勢(shì)；病例主要分布在7～9月份，5歲以下兒童發(fā)病較多，其次為20～40歲青壯年。散居兒童居痢疾發(fā)病首位，其次為農(nóng)民、工人、學(xué)生。 (9) 1961～2005年傷寒發(fā)病呈下降趨勢(shì)，發(fā)病率由1961年的16.22／10萬，降至2005年的0.04／10萬。各月份均有病例，8～11月為發(fā)病較多：10～39歲青壯年農(nóng)民發(fā)病較多。 結(jié)論1961-2005年泰安市傳染病發(fā)病呈下降趨勢(shì)，在上世紀(jì)六七十年代，傳染病流行水平高，發(fā)病以麻疹、流腦、百日咳等呼吸道傳染病、瘧疾為主的蟲媒傳染病為主；八十年代及九十年代上半期，傳染病流行強(qiáng)度降低，發(fā)病以病毒性肝炎、痢疾等腸道傳染病為主；九十年代后半期至今傳染病發(fā)病處于較低水平，發(fā)病呈現(xiàn)穩(wěn)中微升的趨勢(shì)，傳染病發(fā)病以乙型肝炎為主的血傳疾病、肺結(jié)核為主的呼吸道傳染病為主。 對(duì)于疫苗可控制疾病應(yīng)在確保適齡人群預(yù)防接種的同時(shí)，加強(qiáng)疫情、病原或血清學(xué)監(jiān)測(cè)，適時(shí)調(diào)整接種策略，控制疾病流行或反彈。對(duì)于以管理傳染源為主的瘧疾、肺結(jié)核等傳染病的控制，應(yīng)積極開展疫源檢索，以及時(shí)發(fā)現(xiàn)、及早隔離治療感染者，防止傳播的發(fā)生；對(duì)于以出血熱為主的自然疫源性傳染病的防治應(yīng)采取以切斷傳播途徑為主的綜合性措施，加強(qiáng)疫情、鼠情、鼠帶毒率監(jiān)測(cè)，大力進(jìn)行防鼠滅鼠。加強(qiáng)食品衛(wèi)生監(jiān)督管理，改善公共衛(wèi)生設(shè)施，大力開展愛國(guó)衛(wèi)生運(yùn)動(dòng)及健康教育，以降低痢疾、傷寒副傷寒等腸道傳染病的發(fā)病。對(duì)于乙型肝炎、丙型肝炎等血傳疾病應(yīng)采取以切斷傳播途徑為主的綜合性防治措施，防止流行的發(fā)生。
[Abstract]:research objective
Through the analysis of the surveillance data of infectious diseases in Tai'an for 1961~2005 years, we fully understand the incidence and composition of infectious diseases in different periods, explore the related factors that affect the growth of infectious diseases, provide scientific basis for the formulation of health policies, and provide basic information for the formulation of other related policies.
research method
Descriptive epidemiology was used to analyze the data.
Analysis of the incidence of infectious diseases: through the curve of the incidence of infectious diseases in 1961~2005 years, dynamic series analysis of the trend and speed of changes in the intensity of infectious diseases; the incidence of infectious diseases in 1961~2005 years was divided into three periods, and the changes in the spectrum of infectious diseases at different periods were analyzed by comparing the proportion of the various infectious diseases in different periods.
Analysis of the key infectious diseases: select the representative diseases of each type of infectious disease. Through the incidence of each year, the long-term trend of the disease is analyzed. The incidence of infectious diseases in different regions and months, and the incidence of age, sex and occupational disease are analyzed, and the epidemic characteristics of each infectious disease are analyzed.
Research results
(1) 24 kinds of infectious diseases were reported in Tai'an in 1961~2005 years. The average annual incidence rate was 700.67 / 100 thousand. The annual average mortality rate was 3.76 / 100 thousand. The average annual mortality rate was 0.54%. decline. The incidence rate decreased from 2865.87 / 100 thousand in 1961 to 173.66 / 100 thousand in 2005, decreasing the annual average of the infectious disease in 1961~1979 years. The incidence of the disease was 1369.22 / 100 thousand. The first five diseases in the first place were malaria, measles, meningitis, pertussis, dysentery, and hepatitis; the average annual incidence of infectious diseases in 1980~1989 years was 336.04 / 100 thousand. The main five diseases before the onset were dysentery, hepatitis, malaria, hemorrhagic fever, pertussis, and the average annual incidence of infectious diseases in 1990~2005 years. The rate was 136.27 / 100 thousand, and the main diseases of five were hepatitis, dysentery, hemorrhagic fever, pulmonary tuberculosis and gonorrhea.
(2) the incidence of viral hepatitis was declining in 1961~1971 years, with an average annual incidence of 18.19 / 100 thousand and no obvious month of high incidence. The incidence of viral hepatitis in 1972~1994 years was between 87.01 / 100 thousand to 355.64 / 100 thousand, and there were 6 peaks of epidemic, usually once every 3~5 years, and 8~12 months were more: 1995~20. In the past 05 years, the incidence of viral hepatitis was first slowly and then rising, with an average annual incidence of 69.54 / 100 thousand, no obvious high month. In the constitution of viral hepatitis, 1990~1994 years of hepatitis A accounted for 73.79% of viral hepatitis cases, hepatitis B accounted for 21.67%, and 1995~2005 years of hepatitis B accounted for 86.86% of viral hepatitis. Hepatitis accounts for 6.35% of viral hepatitis, and hepatitis A accounts for 6.12%. of viral hepatitis.
(3) the incidence of malaria was declining in 1961~2005 years; the average annual incidence rate of 1961~1986 years was 289.46 / 100 thousand, the annual average mortality was 0.004 / 100 thousand and the average mortality rate was 0.001%. In 1961, there were two peak years in 1971, and the cases were mainly in 7~10 months; in 1987~2005 years, the cases were all The annual incidence rate was 0.036 / 100 thousand, with no mortality and no significant monthly incidence.
(4) the incidence of hemorrhagic fever with renal syndrome in 1984~2005 years was declining, 1985~1987 years and two times in 1994~1996 years. In 2003, the incidence of hemorrhagic fever was reduced greatly, to 1.22 / 100 thousand in 2005; the cases were mainly in 3~6 months and 9~10 months; the majority of the cases were farmers, students and workers.
(5) the incidence of pulmonary tuberculosis was more stable in 1997~2003 years. After 2004, the incidence of disease showed an obvious upward trend. In January, the incidence of the disease was the most. The age of the disease was 15~24 years old, 45~64 years old, the more diseases were farmers, followed by students and workers.
(6) the incidence of measles was declining in 1961~2005 years from.1961 to 1975, and measles occurred in 4 times. One epidemic peak appeared at each interval of 2~3 years. The cases mainly concentrated in winter and spring season, and children under 15 years of age had more disease. Since 1985, the incidence of the large age group was obviously increasing.
(7) the incidence of the onset of the 1961~2005 years had a downward trend of 1965~1969 years from.1961 to 1979 and the peak of two times in 1976~1978 years. After 1980, the incidence of flow of the brain continued to decline, and the incidence of the brain was at a low level for nearly 10 years. The incidence of the disease was mainly in the winter and spring season, with the majority of the age below 15 years, and the age of high incidence in recent years. The trend of morbidity is more. The most common occupation is scattered children, primary and secondary school students, but in recent years, the incidence of diseases is decreasing.
(8) the incidence of dysentery was descending in 1961~2005 years; the cases were mainly distributed in the month of 7~9, the children under 5 years of age had more morbidity, followed by 20~40 year old young adults. The scattered children were the first among the dysentery diseases, followed by farmers, workers and students.
(9) the incidence of typhoid fever was declining in the last 1961~2005 years. The incidence was from 16.22 / 100 thousand in 1961 to 0.04 / 100 thousand in 2005. There were cases in each month, and 8~11 months were more: there were more diseases in the young adults of 10~39 years old.
Conclusion the incidence of infectious diseases in Tai'an was declining in the last 1961-2005 years. In the 60s and 70s of last century, the epidemic level of infectious diseases was high. The incidence of infectious diseases was measles, meningitis, pertussis and other infectious diseases of the respiratory tract. In the first half of 80s and 90s, the epidemic intensity of infectious diseases was reduced, viral hepatitis and dysentery were found. Infectious diseases such as disease were the main diseases, and the incidence of infectious diseases was at a low level in the second half of 90s. The incidence of infectious diseases showed a trend of steady and micro rise. The infectious diseases were mainly blood borne diseases of hepatitis B, and the main respiratory infectious diseases of tuberculosis were mainly tuberculosis.
At the same time, the vaccine control disease should be taken to ensure the vaccination of the age population, to strengthen the epidemic situation, the pathogen or the serological monitoring, the timely adjustment of the vaccination strategy, control the epidemic or the rebound. For the control of infectious diseases such as malaria and tuberculosis, the control of the infectious diseases, such as the management of infectious sources, should carry out the search of the epidemic source, and find out the early isolation treatment. Infection, prevent the occurrence of transmission; for the prevention and control of natural epidemic infectious diseases based on hemorrhagic fever, the prevention and treatment of infectious diseases should be taken mainly by the comprehensive measures of cutting off the transmission route, strengthening the epidemic situation, the rat situation, the monitoring of the virus rate of mice and the anti rat deratization, strengthening the supervision and management of food hygiene, improving the public health facilities and vigorously carrying out the patriotic health movement. And health education, in order to reduce the incidence of intestinal infectious diseases such as dysentery, typhoid and paratyphoid fever. For hepatitis B, hepatitis C and other blood borne diseases, comprehensive prevention and control measures should be taken to prevent the prevalence of epidemic.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R181.3

【引證文獻(xiàn)】

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