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甘肃省平凉市大骨节病三年攻坚行动防治结果分析

Analysis of prevention and control results of three-year campaign for Kashin-Beck disease in Pingliang City, Gansu Province

摘要目的:了解甘肃省平凉市大骨节病三年攻坚行动防治现况,为大骨节病防治提供科学依据。方法:采用回顾性分析,自"全国地方病防治综合管理系统(三年攻坚行动管理系统)"收集2019 - 2020年甘肃省平凉市所有大骨节病病区县(市、区)辖内全部病区村的大骨节病监测数据,包括7 ~ 12周岁儿童病情,防控措施落实情况,现症患者个案调查、健康档案建立与管理及治疗情况。结果:平凉市大骨节病患者分布在6个县(市、区)、64个乡(镇)、690个病区村,且全部为重病区。2019、2020年分别临床检查7 ~ 12周岁儿童40 537、41 053人,临床检出率分别为0.08%(31/40 537)和0.03%(12/41 053),X线检出率均为0。2018 - 2020年平凉市居民膳食结构中,大米、面粉、其他膳食的食用比例依次为15.03%、76.63%、8.34%,主食购入比例为19.28%;3年间累计搬迁病区群众9 564户、36 282人,7 ~ 12周岁儿童易地育人4 831人,改种经济作物占原耕地的14.81%(420 914/2 842 939),退耕还林(草)占原耕地的21.81%(620 045/2 842 939),发放6 ~ 24月龄儿童营养包231 811人份。共调查登记大骨节病现症患者6 269例,其中男性3 722例、女性2 547例,男女性别比为1.00∶0.68;临床分度以Ⅰ度患者最多,占78.00%(4 890/6 269),其他依次为Ⅱ度(15.89%,996/6 269)、Ⅲ度(6.11%,383/6 269);发病年龄为(64.57 ± 10.01)岁,范围为16 ~ 87岁,以50岁以上为主,占86.57%(5 427/6 269)。2019年治疗成人大骨节病患者1 659例,显效率、有效率、无效率分别为25.38%(421/1 659)、52.92%(878/1 659)、21.70%(360/1 659);2020年治疗成人大骨节病患者1 395例,显效率、有效率、无效率分别为19.50%(272/1 395)、61.65%(860/1 395)、18.85%(263/1 395)。结论:平凉市所有大骨节病病区村均达到消除标准,实现了消除目标;应继续做好病情动态监测,加强防控措施落实和大骨节病现症患者康复干预,提高患者生存质量。

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abstractsObjective:To learn about the current situation of prevention and control results of three-year campaign for Kashin-Beck disease (KBD) in Pingliang City, and to provide scientific basis for prevention and control of KBD.Methods:A retrospective analysis was carried out to collect the KBD surveillance data of all villages in the counties (cities, districts) affected by KBD in Pingliang City, Gansu Province during 2019 - 2020 from the "National Integrated Management System for Endemic Disease Prevention and Control (Three-year Campaign Action Management System)", including, the prevalence of children aged 7 to 12 years old, the implementation of prevention and control measures, and the case investigation, the establishment, management of health files and treatment of current patients.Results:Patients with KBD were distributed in 6 counties (cities, districts), 64 townships (towns), and 690 villages in Pingliang City, and all of them were seriously ill area. In 2019 and 2020, 40 537 and 41 053 children aged 7 to 12 years old were examined, respectively, and the clinical detection rate was 0.08% (31/40 537) and 0.03% (12/41 053), respectively; the X-ray detection rate was 0 in each year. In the dietary structure of residents in Pingliang City from 2018 to 2020, the consumption proportions of rice, flour and other diets was 15.03%, 76.63% and 8.34%, respectively, and the purchase proportion of staple food was 19.28%. From 2018 - 2020, 9 564 households and 36 282 people had been relocated from the affected areas, 4 831 children aged 7 to 12 years old had been raised in different places, 14.81% (420 914/2 842 939) of the original cultivated land had been converted to cash crops, 21.81%(620 045/2 842 939) of the original cultivated land had been converted from farmland to forest (grass), and 231 811 nutrition package for children aged 6 to 24 months had been given. A total of 6 269 KBD patients were investigated and registered, including 3 722 males and 2 547 females, with a gender ratio of 1.00 ∶ 0.68. The most clinical grading was grade Ⅰ, accounting for 78.00% (4 890/6 269), followed by grade Ⅱ (15.89%, 996/6 269) and grade Ⅲ (6.11%, 383/6 269); the age of onset was (64.57 ± 10.01) years old, ranging from 16 to 87 years old; most patients were over 50 years old, accounting for 86.57% (5 427/6 269). In 2019, 1 659 KBD patients were treated. The apparent efficiency, effective efficiency and ineffective efficiency were 25.38% (421 cases), 52.92% (878 cases) and 21.70% (360 cases), respectively. In 2020, 1 395 KBD patients were treated; the apparent efficiency, effective efficiency and ineffective efficiency were 19.50% (272 cases), 61.65% (860 cases) and 18.85% (263 cases), respectively.Conclusions:All villages in KBD area in Pingliang City have reached the elimination standard and achieved the elimination goal. We should continue to do a good job in the dynamic monitoring of the disease, strengthen the implementation of prevention and control measures and rehabilitation intervention for patients with KBD, and improve the quality of life of patients.

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