| Background:Measles is an acute respiratory infection that is caused by the measles virus. It is a disease of harming the health of children with high incidence of cyclical epidemic. Measles virus only has one serum type and its antigenic is stable. After infection, human can produce long-lasting immunity and human is the only host. During2009to2010, the average of measles incidence is8.721cases per1,000,000. Except for Diqing, all the16prefectures have reported measles cases. Recent years, reported vaccination rate of measles vaccine has remained at more than95%in Yunnan province, but the reported incidence rate of measles has a slight fluctuation with2cases per1.000,000; During2005to2008, the antibody level monitoring results of0-20years old healthy people in cities of Yunnan Province shows that the lowest antibody positive rate of prefectures is only59.6%where the measles is a great hidden danger; The economic development of Yunnan province lags relatively, the staff configuration of public health has not reached to the national standards. Especially for public health service staff working at the grass-roots level in basic, their academic structure and knowledge level cannot meet the demands of local public health service. But until now, personnel allocation system research of public health services have not studied in Yunnan Province.Therefore, according to the actual situation of Yunnan Province, systematic research is necessary to explore the possible factors of measles morbidity and to know the current measles antibody level of people and primary status of immunization service. Moreover preventive measures should be taken. Not only so, the solid theory basis for eliminating measles as soon as possible should be provided.Objective:Explore the morbidity risk factors of measles elimination phase of measles in Yunnan province:describing the Epidemiological Characteristics of measles of Yunnan province in2011; exploring the natural and social factors of affecting measles incidence; knowing of population measles immune level in Yunna province; describing relevant public health staffing situation for the measles vaccination and epidemic control.Methods:Descriptive epidemiological method will be taken to describe measles distribution in different populations, regions and time in2011in Yunnan Province, and to observe the possible risk factors of measles; Using1:2matched case-control study method to explore risk factors associated with measles; a cross-sectional analysis method will be taken to describe recent measles antibody level for different populations in different areas of Yunnan Province; Descriptive epidemiological method will be taken to describe by the public health personnel allocation of Yunnan provinceResults: Yunnan province has a high incidence of measles in children aged0-1.5in59cases (50.43%) and20-49years adult in30cases (25.64%) in2011; scattered children have a high incidence of measles with a total of73patients (62%); winter and spring are along with high incidence of measles; areas with high incidence of measles are Lijiang prefecture, Banna prefecture, Pu'er prefecture which are charaterized by border and flowing population accumulation areas. The incidence of cases in Lijiang prefecture is more than20cases per1,000,000and there are30cases (25.64%) have the exact history of immunity; the components with measles vaccination rates were above99%in the whole of Yunnan province. Case-control study results show that:cases of children are related to with and without inoculation certificate (OR=9.128), the onset of7-21days to hospital history (OR=0.008), whether inoculate with the measles vaccine (OR=0.012) or not. Children without vaccination certificate and vaccinated against measles are more likely to be infected by measles. Adult measles is related to measles vaccine (OR＝4.326), which describes the measles vaccine is a risk factor for the onset of adult measles. A survey of86cases of measles vaccine, only26people (43.33%) are cognitive that measles vaccine can prevent from measles and47.7%patients know nothing at all with measles. It shows that hospital infection for children with measles has a greater impact. The3years' surveillance of Yunnan province on antibody level of measles showed that antibody positive rate were95%in2010, and the antibody positive rates in2009,2011were87.31%,88.83%respectively; age period of surveillance on antibody level of measles results showed that<1years old group and>15years group antibody positive rates were less than90%, the rates of the rest of the age group were more than90%. Staff of public health in Yunnan province with college education is accounting for-18.5%; including more public health professionals (41.9%), less nursing profession (7%); as to staff's titles, people with early grade and middle grade are accounting for61.6%. People with higher vocational education are accounting for16.7%, people without titles are accounting for21.7%.Suggestions:1. Further strengthening the basic work of measles immunization is in order to achieve and maintain high levels of immunization coverage rate of measles vaccine, strengthening measles vaccine immunization timely.2. Strict implementation of preschool children vaccination certificate inspection system.3. Strengthening the cooperation between hospital and disease prevention and control departments which is aiming at preventing from cross infection.4. Developing older age groups of measles vaccination timely5. Further increasing the contagious diseases such as measles propaganda.6. Further monitoring the measles epidemic, establishing cross-border measles control linkage mechanism, enhancing the level of measles antibody serological surveillance.7. Further strengthening the staff configuration of preventive inoculation. |
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