Naumova E N, Chen J T, Griffiths J K, Matyas B T, Estes-Smargiassi S A, Morris R D
Dept of Family Medicine and Comm Health, Tufts University School of Medicine, Boston, MA 02111, USA.
Public Health Rep. 2000 Sep-Oct;115(5):436-47. doi: 10.1093/phr/115.5.436.
The goal of this study was to evaluate temporal and spatial variations in the reporting of cases of giardiasis and cryptosporidiosis to a passive surveillance system, and to assess the relationship of those variations to source of drinking water, adjusting for socioeconomic variables.
The authors analyzed temporal and spatial patterns for 4,058 cases of giardiasis and 230 cases of cryptosporidiosis reported to the Massachusetts Department of Public Health for 1993-1996. They linked each reported case to a database containing information on source of residential water supply and socioeconomic characteristics and evaluated the association between these factors and reporting rates using regression techniques.
Reports of giardiasis and cryptosporidiosis were highest for the mixed unfiltered drinking water supply category. Reports of giardiasis were associated with income levels. Increases in reporting for both giardiasis and cryptosporidiosis were seen in summer to early fall. During a suspected outbreak of cryptosporidiosis n the city of Worcester in 1995, a significant increase in reported cases was also observed in the Boston metropolitan area. Following the suspected outbreak, weekly giardiasis rates increased slightly in Worcester and the Boston metropolitan area, while reporting of cryptosporidiosis increased dramatically.
Consistently collected passive surveillance data have the potential to provide valuable information on the temporal variation of disease incidence as well as geographic factors. However, passive surveillance data, particularly in the initial period of surveillance, may be highly sensitive to patterns of diagnosis and reporting and should be interpreted with caution.
本研究的目的是评估贾第虫病和隐孢子虫病病例向被动监测系统报告的时间和空间变化，并在调整社会经济变量的情况下，评估这些变化与饮用水水源的关系。
作者分析了1993 - 1996年向马萨诸塞州公共卫生部报告的4058例贾第虫病病例和230例隐孢子虫病病例的时间和空间模式。他们将每例报告病例与一个包含住宅供水水源和社会经济特征信息的数据库相链接，并使用回归技术评估这些因素与报告率之间的关联。
混合未过滤饮用水供应类别中贾第虫病和隐孢子虫病的报告率最高。贾第虫病的报告与收入水平相关。贾第虫病和隐孢子虫病的报告率在夏季至初秋均有所上升。1995年伍斯特市疑似隐孢子虫病暴发期间，波士顿大都市区报告病例也显著增加。疑似暴发后，伍斯特市和波士顿大都市区的贾第虫病每周报告率略有上升，而隐孢子虫病的报告率则大幅上升。
持续收集的被动监测数据有可能提供有关疾病发病率的时间变化以及地理因素的有价值信息。然而，被动监测数据，尤其是在监测初期，可能对诊断和报告模式高度敏感，应谨慎解读。
