摘要
目的 分析塞拉利昂埃博拉疫情暴发期间实施的西区大会战（WAS）行动情况，并评估其实施效果。方法 研究对象为2014年11月19日至2015年1月27日塞拉利昂WAS行动实施前后报告出现的3 813例实验室确诊的埃博拉出血热病例，根据中国援塞移动实验室检测队在塞拉利昂疫情防控过程中的具体实践进行总结归纳，按照WHO公布的埃博拉出血热病例定义进行病例诊断，将所有病例数据纳入进行统计分析。比较WAS行动实施前后床位数、确诊病例数、检测样本数和阳性率的变化。结果 自2014年12月17日WAS行动开始实施至15 d后，埃博拉出血热留观中心和治疗中心合计床位数由640张增加至960张，实验室增加6家，2015年1月份，又增加来自美国和荷兰的实验室各1家。WAS行动实施前1个月的样本总数为7 891份，实施后1个月为9 783份，样本数增加了24.0%。送检样本的埃博拉病毒阳性率从WAS行动实施前1个月的22.2%（1 752/7 891）下降至11.0%（1 077/9 783），其中，血液标本检测阳性率从WAS行动实施前1个月的39.6%（248/626）下降至27.4%（131/478）（χ2=17.93，P〈0.001），尸体的口腔拭子检测阳性率从22.7%（103/454）下降至10.2%（62/609）（χ2=31.03，P〈0.001）。WAS行动实施3周后，西区和塞拉利昂其他4个热点地区报告埃博拉出血热确诊病例数均下降。WAS行动实施42 d后，塞拉利昂埃博拉确诊病例数由最初日均63例下降为10例。结论 WAS行动在快速控制塞拉利昂埃博拉出血热暴发疫情过程中发挥了关键作用，对今后防控类似重大传染病疫情具有重要的指导意义。
Objective To investigate the Western Area Surge （WAS） program in the Ebola outbreak of Sierra Leone, and to analyze its implementing effect. Methods The subject of this study was 3 813 laboratory confirmed Ebola hemorrhagic fever （EHF） cases reported in Sierra Leone from November 19, 2014 through January 27, 2015, a period before and after the implementation of the WAS program. To analyze and make conclusions according to the working experience of China Mobile Laboratory Reponses Team in the fight of Ebola outbreak, using WHO published EHF case definition to make diagnosis and compare the number of bed numbers, confirmed EHF cases, samples tested, and positive rates before and after implementation of WAS program. Results From the implementation of WAS program on 17th December 2014 to half a month later, the total numbers of Ebola holding and treatment centers increased from 640 to 960, six additional laboratories were established. On January, 2015, another two laboratories from America and The Netherlands were established. The numbers of samples tested one month before and after WAS program were 7 891 and 9 783, respectively, with an increase of 24.0 percent, while the positive rate of Ebola virus decreased from 22.2% （1 752/7 891） to 11.0% （1 077/9 783）. The positive rate of blood samples decreased from 39.6% （248/626） in the month before WAS program to 27.4% （131/478） （χ2=17.93,P〈0.001） in the mother after WAS program, the positive rate of blood samples 22.7% （103/454） to 10%（62/609）（χ2=31.03,P〈0.001）, accordingly. After 3 weeks of WAS program, in addition to Western Area, another four hotspots in Sierra Leone had also reported a significant decrease of the numbers of confirmed EVD cases. Forty-two days after implementation of WAS program, the daily number of laboratory confirmed EHF cases decreased from 63 to 10. Conclusion WAS program played a vital role in controlling the EHF outbreak rapidly in Sierra Leone. It could also provide guidance for the control similar large infectious diseases outbreak in the future.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2015年第10期888-891,共4页
Chinese Journal of Preventive Medicine
关键词
出血热
埃博拉
疾病暴发流行
塞拉利昂
西区大会战
效果评估
Hemorrhagic fever, ebola
Disease outbreaks
Sierra Leone
Western area surge
Effect evaluation
