The Epidemiological Trend Of The Law-required-to-report Communicable Diseases In Luliang Area From 1972 To 2002

Objective: To explore the trend and characteristics of communicable diseases(CD) in Luliang area within 31 years from 1972 to 2002, and to find out the actual status in incidence of CD through analyzing missing reporting cases; to compare the incidence of CD in Luliang area with that in whole country and Shanxi province in 1990s; and to provide evidence and suggestions for CD prevention and control in the area.Matheds: The data came from The Epidemic Report of the Law-Required-to-Report Communicable Diseases from 1972 to 2002 and surveys on CD missing reporting cases since 1985, the descriptive study was used to analyze the trend and characteristics of CD; Five leading incidence of CDs in 1990s were primarily analyzed, including hepatitis, dysentery, pulmonary tuberculosis, measles and sexually transmitted disease (STD); The index used in this study included incidence, mortality, adjusted incidence, constituent ratio, relative ratio with fixed base, link relatives ratio and ratio etc.. And compare the standardizing incidence of CD in Luliang area with that in Shanxi province and whole country. Excel 2003 was used to process and analyze the data.Results: A total of 24 types of Class A and B communicable diseases were reported in Luliang area from 1972 to 2002. There is the highest yearly incidence of law-required-to-report communicable diseases in 1970s, and it declined from 1980s, the lowest incidence of CD appeared within 2000-2002. The incidence of 1970 was defined as fixed base (100%), the incidence and mortality within 2000-2002 reduced by 89.85% and 99.00% respectively compared with those in 1970s. The primary route of transmission was digestive infection, the following was respiratory infection, and the third was vector-borne infection which was higher than STD in 1990s while lower than STD after 1990s. The five leading incidence of CDs were dysentery, measles, pertussis, hepatitis and scarlet fever, the first three of which were 95.46% out of the incidence of whole CDs; the incidence of hepatitis increased while the incidence of other CDs decreased in 1980s; the incidence of hepatitis kept on increasing in 1990s, and gonorrhea became the fifth leading incidence of CD; from 2000 to 2002, the incidence of pulmonary tuberculosis sharply increased, the incidence of other CDs decreased. The five leading mortality of CDs were dysentery, measles, epidemic meningitis, Japanese B encephalitis and pertussis; the rabies was the CD with first leading mortality in both 1980s and 1990s while Japanese B encephalitis from 2000 to 2002. The months with high incidence of CDs were June, July, August, and September, while high mortality appeared in March, April and August. The age of incidence of CDs focused on two populations, which were individual less than ten years and individual with the age from 25 to 34 years old, and the incidence of the former was significantly higher than that of the latter. The whole city was divided into three parts which were eastern part, southern part and northern part. There was the highest incidence in northern part in both 1970s and 1980s, the following was southern part and the third was the eastern part; while there was the highest incidence in southern part in 1990s and 2000-2002, the next was eastern part and the third was the northern. The occupational distribution was that, the ratio of farmer was most, the next was the children, and the third was students. The ratio of worker and cadre was small, the ratio of the retired, the unemployed, and other was significantly lower than other occupations. The incidence for men was higher than that for women every year. The adjusted incidence was calculated on the basis of medical institution omitted reporting rate of CDs, which was 1.15-1.69 time than reporting incidence, while the adjusted incidence on the basis of citizen omitted reporting rate of CDs was 1.39-1.81 time than reporting incidence. The national standardized incidence and standardized incidence from Shanxi province were significantly higher than that from Luliang area. The national standardized incidence was 3.44-5.44 times and standardized incidence from Shanxi province was 2.41-6.07 times than Luliang area. The hepatitis A had higher ratio than other viral hepatitis before 1996, the major patients were children. While the hepatitis B exceed the hepatitis A after 1996, and the major patients were adults. The incidence of dysentery had been the highest until 2000, and the incidence was fluctuant and became lower since 1980s, individuals who were 0-4 years old and 25-44 years old had higher incidence. The incidence of measles decreased obviously from 1980s, and reached the bottom in late 2002. The individuals who were 0-9 years old had higher incidence. The incidence of pulmonary tuberculosis had the increasing trend, the individuals who were 25-34 had higher incidence, and the incidence for man was higher than women. The incidence of gonorrhea and syphilis had the increasing trend too.Conclusion: The incidence and mortality of CDs decreased from 1972 to 2002 in Luliang area, hepatitis. dysentery, measles, pulmonary tuberculosis and STD were the most serious CDs which should be prevented. It is the important measures to prevent the incidence of CDs which are improving prophylactic immunization policy, CDs surveillance system and reporting system to reduce the missing reporting rate and establishing the system for new CDs.