国家传染病自动预警系统运行状况分析

摘要

Objective To analyze the results of application on China Infectious Diseases Automated-alert and Response System(CIDARS)and for further improving the system. Methods Amount of signal, proportion of signal responded, time to signal response, manner of signal verification and the outcome of each signal in CIDARS were descriptively analyzed from July 1,2008to June 30, 2010. Results A total of 533 829 signals were generated nationwide on 28 kinds of infectious diseases in the system. 97.13% of the signals had been responded and the median time to response was 1.1 hours. Among them, 2472 signals were generated by the fixed-value detection method which involved 9 kinds of diseases after the preliminary verification, field investigation and laboratory tests. 2202 signals were excluded, and finally 246 cholera cases, 15 plague cases and 9H5N1 cases as well as 39 outbreaks of cholera were confirmed. 531 357 signals were generated by the other method - the 'moving percentile method' which involved 19 kinds of diseases. The average amount of signal per county per week was 1.65, with 6603 signals(1.24%)preliminarily verified as suspected outbreaks and 1594 outbreaks were finally confirmed by further field investigation. For diseases in CIDARS, the proportion of signals related to suspected outbreaks to all triggered signals showed a positive correlation with the proportion of cases related to outbreaks of all the reported cases (r=0.963, P＜0.01). Conclusion The signals of CIDARS were responded timely, and the signal could act as a clue for potential outbreaks, which helped enhancing the ability on outbreaks detection for local public health departments.%目的 了解国家传染病自动预警系统(预警系统)在全国的运行情况,为推进其应用提供依据.方法 对2008年7月1日至2010年6月30日预警系统产生的预警信号量、信号响应率、响应时间、信号核实方式及响应结果进行描述性分析.结果 全国范围内,预警系统中28种传染病共产生533 829条预警信号,信号响应率为97.13%,平均响应时间为1.1 h.其中,固定阈值预警方法产生2472条预警信号,涉及9种传染病,通过初步核实、现场调查与实验室检测,排除2202条预警信号,最终确认霍乱246例、鼠疫15例和人感染高致病性禽流感9例以及39起霍乱暴发事件;移动百分位数法共产生531 357条预警信号,涉及19种传染病,全国平均每县每周约产生预警信号1.65条,其中6603条信号(1.24%)经初步核实后判断为疑似事件,经过进一步现场调查最终确认1594起暴发.预警系统中各病种的疑似事件信号占总预警信号的比例与暴发相关病例占总报告病例数的比例成正相关(r=0.963,P＜0.01)预警系统中预警信号响应率和响应及时性较高,预警信号可作为传染病暴发的提示信息.