2018年阿速坡省洪涝灾害中腹泻疾病的调查分析
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摘要
目的分析"2018-中老和平列车"在老挝阿速坡省溃坝洪涝灾害医学救援中收集患者疾病发生的特点,为热带、亚热带气候雨季洪涝灾害的异国救援及疾病防治提供依据及经验。方法根据伤病员的病因、临床症状、既往病史等进行诊断,采取国际疾病分类法(ICD-10)收集整理资料,采用描述性分析方法对洪涝灾害后人数最多的腹泻病员的年龄分布、高发时间及发热时间进行回顾性分析。结果共收集1000例完整病例资料,其中腹泻病例高达169例,男性45.56%(77/169),女性54.44%(92/169),男女比例为0.84∶1;年龄跨度0～87岁,平均(58.3±19.6)岁,其中4～6岁构成比较高,为21.30%,>66岁老年人构成比高达27.81%。洪涝灾害后腹泻病员量在第3～5天上升较快,高峰出现在第5天,第9～10天为稳定期;发热人数的升高或降低与腹泻人数整体一致,并低于不发热者,第6天发热人数达高峰,第7～8天明显下降。结论腹泻疾病在洪涝灾害后极易出现暴发流行,伴发热的腹泻更是多种传染性疾病的暴发点,因此,腹泻病员的早期监测、预防和治疗能有效降低相关疾病的暴发风险。
Objective To analyze the characteristics of diseases during the medical rescue of flood disasters in Asopo Province of Laos by "2018-China-Laos Peace Train",and to provide evidence and experience for the rescue and disease prevention in rainstorms associated with tropical and subtropical climates. Methods According to the cause of disease,clinical symptoms and past medical history of the patients,the International Classification of Diseases(ICD-10)was used to collect and sort out data. The age distribution,high incidence time and fever time of diarrhea patients after flood disaster were analyzed retrospectively with the descriptive analysis method.Results A total of 1000 complete cases were collected,including 169 cases of diarrhea,45.56%(77/169)of whom were males and 54.44%(92/169)females. The ratio of males to females was 0.84∶1. The age of patients ranged from 0 to 87(58.3 ± 19.6 average years old). The composition ratio of 4-6-year-olds was 21.30%,and that of the elderly over 66 years old was as high as 27.81%. The number of diarrhea patients after the flood disaster increased rapidly on the 3 rd to 5 th day,the peak appeared on the 5 th day,and remained stable on the 9 th to 10 th days. The change of the number of febrile patients was consistent with the overall diarrhea patients. The number of fever patients reached the peak on the 6 th day,but decreased significantly on the 7 th to 8 th days.Conclusion Diarrheal diseases are prone to outbreaks after floods,and diarrhea complicated with fever promises the outbreak of many infectious diseases. Early surveillance,prevention and treatment of diarrhea can effectively reduce the risk of outbreaks of related diseases.
Objective To analyze the characteristics of diseases during the medical rescue of flood disasters in Asopo Province of Laos by "2018-China-Laos Peace Train",and to provide evidence and experience for the rescue and disease prevention in rainstorms associated with tropical and subtropical climates. Methods According to the cause of disease,clinical symptoms and past medical history of the patients,the International Classification of Diseases(ICD-10)was used to collect and sort out data. The age distribution,high incidence time and fever time of diarrhea patients after flood disaster were analyzed retrospectively with the descriptive analysis method.Results A total of 1000 complete cases were collected,including 169 cases of diarrhea,45.56%(77/169)of whom were males and 54.44%(92/169)females. The ratio of males to females was 0.84∶1. The age of patients ranged from 0 to 87(58.3 ± 19.6 average years old). The composition ratio of 4-6-year-olds was 21.30%,and that of the elderly over 66 years old was as high as 27.81%. The number of diarrhea patients after the flood disaster increased rapidly on the 3 rd to 5 th day,the peak appeared on the 5 th day,and remained stable on the 9 th to 10 th days. The change of the number of febrile patients was consistent with the overall diarrhea patients. The number of fever patients reached the peak on the 6 th day,but decreased significantly on the 7 th to 8 th days.Conclusion Diarrheal diseases are prone to outbreaks after floods,and diarrhea complicated with fever promises the outbreak of many infectious diseases. Early surveillance,prevention and treatment of diarrhea can effectively reduce the risk of outbreaks of related diseases.
引文
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[10]Cariappa MP,Khanduri P.Health emergencies in large populations:the Orissa experience[J].Med J Armed Forces India,2003,59(4):286-289.
[11]Salazar MA,Pesigan A,Law R,et al.Post-disaster health impact of natural hazards in the Philippines in 2013[J].Glob Health Action,2016,9:31320.
[12]Bhuyan SK,Vairale MG,Arya N,et al.Molecular epidemiology of Vibrio cholerae associated with flood in Brahamputra River valley,Assam,India[J].Infect Genet Evol,2016,40:352-356.
[13]凌磊,张绍维,叶晓卉,等.中国首支赴刚果(金)维和医疗分队疟疾发病情况及防护措施效果评价[J].解放军医学杂志,2004,29(10):915-916.
[14]Rosinger AY.Household water insecurity after a historic flood:diarrhea and dehydration in the Bolivian Amazon[J].Soc Sci Med,2018,197:192-202.
[15]李志强,盛珺,叶丽娟,等.玉树、芦山、九寨沟地震灾区巡诊疾病分析[J].中华灾害救援医学,2018,6(8):421-424.
[2]Jones FK,Ko AI,Becha C,et al.Increased rotavirus prevalence in diarrheal outbreak precipitated by localized flooding,Solomon Islands,2014[J].Emerg Infect Dis,2016,22(5):875-879.
[3]Anon.Early warning disease surveillance after a flood emergency--Pakistan,2010[J].MMWR Morb Mortal Wkly Rep,2012,61(49):1002-1007.
[4]Gao L,Zhang Y,Ding G,et al.Identifying flood-related infectious diseases in Anhui Province,China:a spatial and temporal analysis[J].Am J Trop Med Hyg,2016,94(4):741-749.
[5]Schnitzler J,Benzler J,Altmann D,et al.Survey on the population's needs and the public health response during floods in Germany 2002[J].J Public Health Manag Pract,2007,13(5):461-464.
[6]龚磊,吴家兵,王爱红,等.2007-2012年安徽省其他感染性腹泻流行特征分析[J].中华疾病控制杂志,2014,18(10):972-975.
[7]Schwartz BS,Harris JB,Khan AI,et al.Diarrheal epidemics in Dhaka,Bangladesh,during three consecutive floods:1988,1998,and 2004[J].Am J Trop Med Hyg,2006,74(6):1067-1073.
[8]Zhang F,Liu Z,Gao L,et al.Short-term impacts of floods on enteric infectious disease in Qingdao,China,2005-2011[J].Epidemiol Infect,2016,144(15):3278-3287.
[9]Ribeiro P,Bhatt N,Ali S,et al.Seroepidemiology of leptospirosis among febrile patients in a rapidly growing suburban slum and a flood-vulnerable rural district in Mozambique,2012-2014:implications for the management of fever[J].Int J Infect Dis,2017,64:50-57.
[10]Cariappa MP,Khanduri P.Health emergencies in large populations:the Orissa experience[J].Med J Armed Forces India,2003,59(4):286-289.
[11]Salazar MA,Pesigan A,Law R,et al.Post-disaster health impact of natural hazards in the Philippines in 2013[J].Glob Health Action,2016,9:31320.
[12]Bhuyan SK,Vairale MG,Arya N,et al.Molecular epidemiology of Vibrio cholerae associated with flood in Brahamputra River valley,Assam,India[J].Infect Genet Evol,2016,40:352-356.
[13]凌磊,张绍维,叶晓卉,等.中国首支赴刚果(金)维和医疗分队疟疾发病情况及防护措施效果评价[J].解放军医学杂志,2004,29(10):915-916.
[14]Rosinger AY.Household water insecurity after a historic flood:diarrhea and dehydration in the Bolivian Amazon[J].Soc Sci Med,2018,197:192-202.
[15]李志强,盛珺,叶丽娟,等.玉树、芦山、九寨沟地震灾区巡诊疾病分析[J].中华灾害救援医学,2018,6(8):421-424.
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