Liu R Y, Lyu J, Luo C H, Wei M, Wan Y H, Wang L P
Department of Public Health Information, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China.
Institute for Acute Communicable Disease Control and Prevention, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Mar 10;41(3):412-416. doi: 10.3760/cma.j.issn.0254-6450.2020.03.025.
To understand the discovery of human brucellosis cases in new affected counties in Sichuan province, 2015-2017, and provide evidences for prevention and control of human brucellosis. The incidence data and outbreak data of human brucellosis in Sichuan were collected from Chinese Infectious Disease Surveillance Reporting System, and face to face interview, telephone interview and on-line survey were conducted to collect the case information, such as epidemiological characteristics, medical care seeking. The incidence of human brucellosis in Sichuan has increased obviously since 2013, and 103 counties reported human brucellosis cases for the first time. A total of 23 cases of human brucellosis were investigated, and the common symptoms of the cases was fever, accounting for 91.30 (21/23). The cases mainly sought medical care in hospitals under county-level for the first time, accounting for 73.91 (17/23), and the misdiagnosis rate was 91.30 at the first diagnosis (21/23). The median interval between onset and diagnosis was 52 days, and the longest one was 142 days. Only 4.35 (1/23) cases knew human brucellosis, and when they contacted with suspected livestock, the use rate of protective clothing was 30.43 (7/23), the use rate of gloves was 8.70 (2/23), the use rate of mask was 4.35 (1/23), and the rate of washing hands with disinfectant after contact with livestock was 4.35 (1/23). Goat was suspected to be the infection source of all the cases, and 34.75 (8/23) of the cases were from Gansu, Qinghai and other provinces. The overall awareness rate of human brucellosis in the doctors was 34.58 (102/295), and the training rate was 58.31 (172/295). Only 33.33 (11/33) of the hospitals could perform laboratory diagnosis of human brucellosis and 34.78 (8/23) of county CDCs could carry out laboratory test of human brucellosis. The prevention and control of human brucellosis is facing challenge in Sichuan. The misdiagnosis rate was very high in newly affected counties, and the diagnosis were delayed obviously. The awareness of human brucellosis was low in the cases, and their awareness of self-protection was poor. The awareness rate about human brucellosis in doctors was low and they need more training; the capacity of brucellosis laboratory diagnosis in hospitals and CDCs at county-level should be improved.
为了解2015 - 2017年四川省新出现布病病例的县的发病情况,为人间布病的防控提供依据。收集四川省人间布病的发病数据和疫情数据,通过中国传染病监测信息报告系统获取,并采用面对面访谈、电话访谈和网络调查等方式收集病例信息,如流行病学特征、就诊情况等。四川省人间布病发病率自2013年以来明显上升,有103个县首次报告人间布病病例。共调查23例人间布病病例,病例常见症状为发热,占91.30%(21/23)。病例首次就诊主要集中在县级及以下医院,占73.91%(17/23),首诊误诊率为91.30%(21/23)。发病至确诊的中位间隔时间为52天,最长达142天。仅4.35%(1/23)的病例知晓布病,接触可疑牲畜时,防护服使用率为30.43%(7/23),手套使用率为8.70%(2/23),口罩使用率为4.35%(1/23),接触牲畜后用消毒水洗手率为4.35%(1/23)。所有病例均怀疑羊为传染源,34.75%(8/23)的病例来自甘肃、青海等省份。医生对人间布病的总体知晓率为34.58%(102/295),培训率为58.31%(172/295)。仅33.33%(11/33)的医院能开展人间布病实验室诊断,34.78%(8/23)的县级疾控中心能开展人间布病实验室检测。四川省人间布病防控面临挑战。新发病县误诊率极高,诊断明显延迟。病例对布病知晓率低,自我防护意识差。医生对布病知晓率低,需加强培训;县级医院和疾控中心布病实验室诊断能力有待提高。