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[中国四个地区急性脑膜炎和脑炎综合征监测的疾病负担]

[Acute meningitis and encephalitis syndrome surveillance disease burden in four China prefectures].

作者信息

Wu D, Li Y X, Shao Z J, Wang H Y, Ning G J, Li J H, Yin Z D

机构信息

Department of National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

National Institute For Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Feb 6;53(2):164-168. doi: 10.3760/cma.j.issn.0253-9624.2019.02.008.

Abstract

To explore acute meningitis and encephalitis syndrome (AMES) surveillance in 4 China prefectures, to understand the epidemiological features and disease burden of () meningitis, () meningitis, haemophilus influenza type b (Hib) meningitis and Japanese encephalitis and provide evidence for related disease prevention and control. AMES surveillance were conducted in Jinan, Shandong Province and Yichang, Hubei Province in September 2006, and in 13 districts of Shijiazhuang, Hebei Province and Guigang City, Guangxi Zhuang Autonomous Region in April 2007. Six hospitals in each city were selected as monitoring pilot hospitals to carry out reports of suspected cases of acute meningitis and encephalitis, case investigation, blood specimens and cerebrospinal fluid specimen collection, anti-JEV IgM antibody enzyme-linked immunosorbent assay, , and Hib culture and polymerase chain reaction detection, etc. According to the age group, the incidence of bacterial meningitis and Japanese encephalitis in local residents <20 years old was estimated. From 2006 to 2013, a total of 19 423 surveillance cases were reported in four cities, of which 11 071 (56.99%) were reported in the pilot hospitals. Of the 11 071 cases, 5 315 were tested for bacteriology and 9 180 were tested for anti-JEV IgM antibodies. Among the bacteriological tests, 176 cases were positive, including 75 cases of positive, 91 cases of positive and 10 cases of Hib positive. The incidence of three bacterial meningitis is estimated for people under 20 years old, with estimated incidence of , and Hib meningitis in children 5 years old was 0.46/100 000-0.71/100 000, 0.34/100 000-0.83/100 000 and 0.32/100 000-0.57/100 000 respectively; the estimated incidence of and meningitis in children aged 5-9 years was 0.59/100 000-1.14/100 000 and 0.50/100 000-1.66/100 000 respectively. In 732 cases of positive JE cases, the positive detection rates of <5 years old, 40-49 years old and ≥50 years old were 9.51% (95/999), 28.09% (66/235) and 33.85% (130/384), respectively. The estimated annual incidence rate of JE was 0.12/100 000-0.79/100 000.ratio of cases 1.19∶1. Most of cases (27.30%) were children and adolescents aged 5-14 years and those (26.84%) aged over 45 year. The study found that primary and secondary school students are the key population of meningitis, suggesting that it is necessary to explore the enhanced immunization study of meningococcal vaccine in this population; has the possibility of occurrence in all age groups; <5 years old children are the main population of Hib meningitis.

摘要

为探索中国4个地区的急性脑膜炎和脑炎综合征(AMES)监测情况,了解()脑膜炎、()脑膜炎、b型流感嗜血杆菌(Hib)脑膜炎和日本脑炎的流行病学特征及疾病负担,为相关疾病的预防控制提供依据。2006年9月在山东省济南市和湖北省宜昌市开展AMES监测,2007年4月在河北省石家庄市13个区和广西壮族自治区贵港市开展监测。每个城市选取6家医院作为监测试点医院,开展急性脑膜炎和脑炎疑似病例报告、病例调查、血液标本和脑脊液标本采集、抗日本脑炎病毒(JEV)IgM抗体酶联免疫吸附测定、(此处原文缺失部分内容)以及Hib培养和聚合酶链反应检测等工作。根据年龄组估算当地<20岁居民细菌性脑膜炎和日本脑炎的发病率。2006年至2013年,4个城市共报告19423例监测病例,其中试点医院报告11071例(56.99%)。在11071例病例中,5315例进行了细菌学检测,9180例进行了抗JEV IgM抗体检测。细菌学检测中,176例呈阳性,其中(此处原文缺失部分内容)阳性75例,(此处原文缺失部分内容)阳性91例,Hib阳性10例。估算<20岁人群三种细菌性脑膜炎的发病率,5岁儿童中(此处原文缺失部分内容)脑膜炎、(此处原文缺失部分内容)脑膜炎和Hib脑膜炎的发病率估计分别为0.46/10万 - 0.71/10万、0.34/10万 - 0.83/10万和0.32/10万 - 0.57/10万;5 - 9岁儿童中(此处原文缺失部分内容)脑膜炎和(此处原文缺失部分内容)脑膜炎的发病率估计分别为0.59/10万 - 1.14/10万和0.50/10万 - 1.66/10万。在732例日本脑炎阳性病例中,<5岁、40 - 49岁和≥50岁人群的阳性检出率分别为9.51%(95/999)、28.09%(66/235)和33.85%(130/384)。日本脑炎的估计年发病率为0.12/10万 - 0.79/10万。病例比为1.19∶1。大多数病例(27.30%)为5 - 14岁儿童和青少年,以及45岁以上人群(26.84%)。研究发现,中小学生是(此处原文缺失部分内容)脑膜炎的重点人群,提示有必要探索该人群中脑膜炎球菌疫苗的强化免疫研究;(此处原文缺失部分内容)在各年龄组均有发生的可能;<5岁儿童是Hib脑膜炎的主要人群。

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