| Background:Japanese encephalitis (JE) is composed of Japanese encephalitis virus by vector mosquitoes induced central nervous system damage in acute infectious disease.China in the nineteen fifties,60’s and early70’s had a pandemic occurs, the incidence is high up to20/100000or so, the high fatality rate of25%.Since the nineteen eighties, with the wide use of JE vaccine, Japanese encephalitis incidence has decreased greatly.Since90time Zibo JE incidence in middle-aged and older age group accounted for the most, caused wide concern.It is therefore necessary to understand Zibo JE epidemiological features changes, analysis of adult JE incidence, mortality, sequelae, understanding of adult JE burden of diseases, for the prevention and control of epidemic encephalitis B and provide the basis for the formulation of information, provide the basis for prevention and control strategies of adult JE.ObjectiveThe purpose of this study is to describe the epidemiological characteristics of Zibo City in different JE vaccine immunization strategy, analysis of the clinical outcome of JE cases, a preliminary understanding of the JE disease burden, To provide a reference for the next step JE prevention and control strategy of adjustment. Materials and Methods1. JE epidemiological data was collected over the years in Zibo, and then we described the epidemiological distribution characteristics in different JE vaccine immunization strategy period, using descriptive epidemiological methods.2. We analyzed the clinical outcomes of JE cases reported in Zibo. Six months after the disease, JE cases reported in2006-2010were investigated by professionals in county-level center for disease control and prevention by telephone or household survey.3. We studied the disease burden of JE cases in2009in Zibo preliminarily. We carried out follow-up survey for JE cases in2009in Zibo to understand the total cost of treatment of cases through questionnaires,and to analyze direct medical costs (e.g. hospitalized costs) and direct non-medical costs (e.g. traveling expenses) of patients.4. The data was analyzed by Excel2003and SPSS13.0. we studied some associated indicators by yl test.Results1.2268cases were reported in1956～2010in Zibo. The annual incidence rate fluctuates between0.1/100000and27.14/100000, the average annual incidence rate is1.52/100000. The average annual incidence rate in19561967,1968～1985,1986～2003and2004～2010is6.42/100000,1.72/100000,0.80/100000and0.52/100000separately. JE prevails in the season from July to September.2. There were JE cases reported in7districts among8in Zibo in19962010. in which Zichuan District reported the most, accounting for36.34%of the total number of JE cases in Zibo; Cases in Zichuan District. Linzi District, Zhangdian District and Boshan District account for89.62%of the total number of JE cases in Zibo. There was no JE case reported in Yiyuan County in the past15years.3.(1) Age:The number of JE cases over the age of20in1956～1967,1968～1985,1986～2003and2004-2010accounts for20.47%,33.13%,80.17%and 96.67%of the total number of cases separately; While the number of JE cases under the age of20in1956～1967,1968～1985,1986～2003and2004～2010accounts for7942%,51.72%,19.7%and8.33%respectively. The number of JE cases over the age of40accounts for82.05%of the reported cases in2004～2010. there was statistical significance between different age groups of in different JE vaccine immunization strategy period.(2) Gender:1327male cases and941female cases were reported in Zibo in1956～2010, the ratio of male to female is1:1.039. The ratio of male to female in1956～1967,1968～1985,1986～2003and2004～2010is1.41:1,1.88:1,0.92:1and0.79:1separately. There was statistical significance between different gender of in different JE vaccine immunization strategy period.(3) Occupation:Children account for the most of the cases in1956～1967, which is50.76%, followed by students of20.26%, farmers of19.72%; Farmers account for the most of the cases in1968～1985, which is32.97%, followed by children of22.34%, students of20.31%; Farmers account for the most of the cases in1986-1991, which is47.00%, followed by children of24.00%, students of12.00%; Farmers account for the most of the cases in2004～2010, which is62.82%, followed by workers of18.37%, and housekeeping, housework, unemployed and retired staff of18.37%. There was statistical significance between different occupation of in different JE vaccine immunization strategy period.4. The fatality rate of JE after6months in2006～2010is35.24%, Cases over the age of40account for94.59%of deaths. Sequela rate of22.06%.5. The direct economic disease burden of JE in2009is238032vuan.Conclusions and Recommendations1. With the JE immunization strategy adjustment, in recent years Zibo City JE incidence for40years old mainly farmers. JE incidence rate in Zichuan District is significantly higher than other districts.2. The mortality rate and sequelae rate of adult are all high, so we should strengthen follow-up track on JE cases with sequelae.3. JE patients have to bear the high cost of treatment, as a result, the economic burden caused by JE can not be underestimated. 4. Study on the risk factors of adult Japanese encephalitis JE vaccine, adult cost-benefit analysis, for the formulation of adult disease prevention control strategy. |
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