性病监测-课件

性病监测EpidemiologyinSTIPreventionandControl

性病预防和控制流行病学Descriptiveepidemiology描述流行病学Reportingsystem报告系统reportsofcases:disease,patientscharacteristics,geographiclocation,timeoftheyear.病例报告：病种、患者特征、地址、患病日期

reportsofpreventionandcontrolactivities:screening,casefinding,treatment,follow-up,contacttracing,controlofsources.预防和控制活动报告：筛查、病例发现、治疗、随访、追踪、传染源控制Diseasesurveillance疾病监测Sentinelsurveillance哨点监测Drugsensitivity药物敏感性Diseasespecificsurveillance:congenitalsyphilis,PID疾病专项监测：胎传梅毒、盆腔炎Sourcesofinfection传染源25-28November2008NationalTrainingWorkshoponAnalysisandEpidemiologyinSTIPreventionandControl(cont.)

性病预防和控制流行病学（续）Analyticalepidemiology分析流行病学Epidemiologicalresearch流行病学研究Outbreakinvestigation暴发调查Evaluationofcontrolprogrammes

控制项目的评估25-28November2008NationalTrainingWorkshoponAnalysisandEpidemiologyinSTIPreventionandControl(cont.)

性病预防和控制流行病学Operationalepidemiology应用性流行病学Managementofcontacts接触者管理Contacttracing接触者追踪Partnernotification性伴通知Controlsourceofinfections:传染源控制Mapping绘图Regularsurveysofentertainmentestablishmentsandsexworkpopulation娱乐场所和性服务人群的常规调查Outreachvisits外展ReduceSTItransmission降低性病传播Condompromotion安全套促进100%condomuseprogramme100%安全套项目25-28November2008NationalTrainingWorkshoponAnalysisandGuidelineDocument

onSTIsurveillance

性病监测指南文件GuidelinesforSexuallyTransmittedInfectionsSurveillance(WHO/CDS/CSR/EDC/99.3),1999ByUNAIDS/WHOWorkingGrouponGlobalHIV/AIDS/STISurveillance性传播感染监测指南(WHO/CDS/CSR/EDC/99.3)，1999年UNAIDS/WHO全球HIV/AIDS/STI监测工作组25-28November2008NationalTrainingWorkshoponAnalysisandDefinitionofSurveillance

监测的定义"...theongoing,systematiccollection,analysis,andinterpretationofhealthdataessentialtotheplanning,implementation,andevaluationofpublichealthpractice,closelyintegratedwiththetimelydisseminationofthesedatatothosewhoneedtoknow.“USCDC,1988连续、系统收集、分析、解释基本的卫生资料，为计划、实施和公共卫生实践评估提供依据，同时及时将资料分发到需要的人USCDC，198825-28November2008NationalTrainingWorkshoponAnalysisandMainObjectivesofSTISurveillance

性病监测的主要目的AssessingthesituationandtrendsofSTIsintargetpopulations评估性病在目标人群的流行情况和趋势Applyappropriateinterventionsanddefineneededresources应用恰当的干预，明确所需资源EvaluateeffectivenessofSTIinterventions评估性病干预的有效性AdvocacyontheSTIburdentothesociety性病疾病负担的社会倡导25-28November2008NationalTrainingWorkshoponAnalysisandSTISURVEILLANCECOMPONENTS

性病监测内容 ThefivecomponentsofSTIsurveillancethatarenecessaryforeffectivecontrolprogrammes:性病监测有5部分内容是有效控制项目所必需的Casereporting病例报告Prevalenceassessmentandmonitoring

患病率评估和监测AssessmentofSTIsyndromeetiologies性病病征病因评估Antimicrobialresistancemonitoring耐药监测Specialstudies专项研究25-28November2008NationalTrainingWorkshoponAnalysisandImprovePatientCare提高患者治疗EffectiveTreatmentServices有效的治疗服务AntimicrobialResistanceStudies耐药研究AetiologiesofSTISyndromes性病病征的病因ImproveProgrammeManagement改进项目管理MagnitudeofSTIProblem

inTargetPopulation目标人群性病问题的大小Case

Reporting病例报告PrevalenceAssessments患病率评估Aetiologic病因Syndromic病征CoreComponentsofSTISurveillance性病监测核心内容SpecialStudies专项调查25-28November2008NationalTrainingWorkshoponAnalysisandCASEREPORTING

病例报告Casereportingistheprocessofreportingcasesofnotifiablediseasesfromhealthcareprovidersorlaboratoriestopublichealthauthorities.病例报告是医务人员或实验室向公共卫生机构报告法定疾病病例的过程STIsmaybereportedeithersyndromicallyoretiologically,dependingontheavailabilityoflaboratorytestsinclinicalcaresettings根据医疗机构有无实验室，性病报告可以是病征报告，也可以是病因报告25-28November2008NationalTrainingWorkshoponAnalysisandObjectivesofcasereporting

病例报告的目的Assessdiseaseburden,byprovidinganindicatorofminimumincidenceofrecentlyacquiredinfections通过提供最近获得的感染最低发病率的指标，估计疾病负担Monitortrendsinincidenceofrecentlyacquiredinfections.监测最近获得感染的发病趋势Provideinformationrequiredformanagementofpatientsandtheirsexpartners提供患者及其性伴管理的信息ProvideinformationonwhichprovidersinthehealthcaresystemarediagnosingandreportingthemajorSTIs,toassistinplanningandmanagingprogrammeefforts提供医务人员诊断和报告的主要性病的信息，协助计划和管理项目Provideotherdatanecessaryformanaginghealthservices(e.g.,pharmaceuticaldistribution)提供管理医疗服务的其他必需资料(如药品分配)25-28November2008NationalTrainingWorkshoponAnalysisandSyndromiccasereporting

病征病例报告Syndromiccasereportsrequirenolaboratorydiagnostictests

症状病例报告不需要实验室诊断性检测Genitalulcersyndrome生殖器溃疡病征Urethraldischargesyndrome尿道分泌物病征Vaginaldischargesyndrome阴道分泌物病征Lowerabdominalpaininwomen女性下腹痛25-28November2008NationalTrainingWorkshoponAnalysisandEtiologiccasereporting

病因病例报告Etiologiccasereportingrequiresdiagnosisbasedonlaboratorytesting病因病例报告需要基于实验室检测的诊断MostcommonSTIetiologiesare:最常见性病病因Syphilis:differentstaging

梅毒：各期Gonorrhoea淋病Chlamydialinfection衣原体感染Chancroid软下疳25-28November2008NationalTrainingWorkshoponAnalysisandUNIVERSALCASEREPORTING全国性的病例报告MainstayofSTIsurveillanceatnationallevel国家级性病监测主要部分Datacollectionmechanismsexistinmostcountries(IntegratedCommunicableDiseasesSurveillanceSystem)资料收集机制在很多国家都存在(和传染病监测系统结合)Proposed“minimumessentialdata”forthefacilitieswithnoroutinelaboratory-supporteddiagnosisofSTIs建议无常规性病实验室支持诊断机构，收集最少基本资料TotalNumberofSTIs性病病例总数UrethralDischargeSyndrome尿道分泌病征25-28November2008NationalTrainingWorkshoponAnalysisandSENTINELSYNDROMICCASEREPORTING哨点病征病例报告Complementarytouniversalcasereporting

全国病例报告的补充Selectiverepresentativeclinics

选择有代表性的门诊CollectdatabytypesofSTIsyndrome依据性病病征类型收集资料Demographic&otherinformation人口统计学和其他信息Agegroups&Gender年龄组和性别SyphilisSerologyTests梅毒血清检测PartnerNotification性伴通知25-28November2008NationalTrainingWorkshoponAnalysisand2.STIPREVALENCEASSESSMENTANDMONITORING性病患病率评估和监测TheprimarypurposesofSTIprevalenceassessmentandmonitoringarethefollowing:性病患病率评估和监测的主要目的如下：IdentifypopulationsubgroupswithhighprevalenceofSTIs确定性病患病率高的亚人群MonitortrendsinSTIprevalenceamongdefinedpopulations.监测已规定人群的性病患病率趋势25-28November2008NationalTrainingWorkshoponAnalysisand3.AETIOLOGYOFSTISYNDROMES性病病征的病因Todevelopeffectivetreatmentprotocols制定有效的治疗方案AetiologicaldistributionofSTIsyndromesandantimicrobialsusceptibilitiesvarybetweendifferentgeographicalareas,andchangetemporally性病病征的病因构成，不同地区抗生素敏感性的差异及变化Periodicaetiologystudiesrequiredtovalidatetheeffectivenessoftreatmentprotocols

定期病因研究，以验证治疗方案的有效性Informationcouldbeusedtoestimateaetiology-specificdiseasemorbidity信息应该用来估计特定病因疾病的发病率25-28November2008NationalTrainingWorkshoponAnalysisand4.ANTIMICROBIALRESISTANCEMONITORING耐药性监测Essentialtomaintaineffectivenessoftrea