2013年和2014年中非共和国军事和政治冲突期间的脊髓灰质炎流行病学监测

Epidemiological Surveillance of Poliomyelitis During the Military and Political Conflict in the Central African Republic, 2013 and 2014.

作者信息

Farra Alain, Gonofio Ella C, Manirakiza Alexandre, Mazitchi Arthur, Mbaïlao Raphaël, Manengu Casimir, Gouandjika-Vasilache Ionela

机构信息

Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui.

Epidemiology Unit, Institut Pasteur de Bangui.

出版信息

Open Forum Infect Dis. 2017 Jan 11;4(1):ofw279. doi: 10.1093/ofid/ofw279. eCollection 2017 Winter.

DOI:10.1093/ofid/ofw279

PMID:28480271

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5414109/

Abstract

BACKGROUND

Since December 2012, the Central African Republic (CAR) has been undergoing a severe military and political conflict. This situation has resulted in general insecurity and total disorganization of surveillance activities, including those for acute flaccid paralysis (AFP). In this study, we used laboratory data to evaluate surveillance of AFP in 2013 and 2014, the most critical period of the conflict.

METHODS

The laboratory data on AFP were analyzed retrospectively for the age, sex, vaccination status (oral poliovirus vaccines), and geographical origin of the samples. The χ test was used, with < .05 as the threshold for significance.

RESULTS

Decreased activity of AFP surveillance of 57% was registered in 2013 and 36% in 2014 compared with previous years. Only 37.3% and 49.7% of children with AFP were vaccinated in 2013 and 2014, respectively, but no wild poliovirus or vaccine-derived poliovirus (VDPV) was isolated. Laboratory performance concerning the timeliness of cell culture and intratypic differentiation/VDPV results was only 65.5% and 66.7% of the target in 2013 but reached 95.5% and 100% in 2014.

CONCLUSIONS

All personnel involved in the monitoring of AFP must be mobilized to improve vaccination coverage and surveillance activities in the CAR.

摘要

背景

自2012年12月以来，中非共和国一直在经历严重的军事和政治冲突。这种情况导致普遍不安全，监测活动完全混乱，包括急性弛缓性麻痹（AFP）监测。在本研究中，我们利用实验室数据评估了2013年和2014年（冲突最关键时期）的AFP监测情况。

方法

对AFP的实验室数据进行回顾性分析，分析样本的年龄、性别、疫苗接种状况（口服脊髓灰质炎疫苗）和地理来源。采用χ检验，以P<0.05作为显著性阈值。

结果

与前几年相比，2013年AFP监测活动减少了57%，2014年减少了36%。2013年和2014年分别只有37.3%和49.7%的AFP患儿接种了疫苗，但未分离出野生脊髓灰质炎病毒或疫苗衍生脊髓灰质炎病毒（VDPV）。2013年细胞培养及时性和型内鉴别/VDPV结果的实验室表现仅为目标的65.5%和66.7%，但2014年达到了95.5%和100%。