Objective:To analyze the epidemiological characteristics and related indicators of plague in Yulin City, Shaanxi Province, and to evaluate the risk of plague epidemic in the future and formulate scientific and reasonable prevention and control measures.Methods:The plague surveillance data of national (Dingbian County) and provincial (Yuyang District, Jingbian County, Hengshan District, Shenmu City, Fugu County) plague monitoring sites in Yulin City from 2011 to 2021 were collected through the China Disease Prevention and Control Information System Pestis Prevention and Control Management Information System, and the plague epidemic situation among humans and animals, the main host animals and their flea infection were analyzed by descriptive epidemiological methods. The expert consultation method and plague risk assessment tool V1.0 were used to assess the epidemic risk of the plague in Yulin City.Results:There was no human and animal plague epidemic in Yulin City from 2011 to 2021. In national monitoring site, the density of main host animal was 5.79/hm 2, ranging from 3.02/hm 2 to 9.08/hm 2,the dominant species was Mongolian gerbil, accounting for 98.21% (3 402/3 464); the capture rate of wild nocturnal rodents was 1.27% (350/27 600), ranging from 0.21% to 3.83%, the dominant species was Cricetulus barabensis, accounting for 44.86% (157/350); the flea infection rate of the rodent body was 16.91% (768/4 541), with a flea index of 0.40, the dominant flea species was the Nosopsyllus laeviceps kuzenkov, accounting for 66.54% (1 203/1 808). In provincial monitoring site, the density of main host animals was 0.49/hm 2, ranging from 0.31/hm 2 to 0.67/hm 2, the dominant species was Alashan ground squirrel, accounting for 63.61% (194/305); the capture rate of nocturnal rodents in the wild was 1.76% (560/31 795), ranging from 0.89% to 3.93%, the dominant species was Roborovski dwarf hamster, accounting for 26.61% (149/560); the capture rate of domestic rats was 2.37% (397/16 750), ranging from 1.48% to 3.10%, the rodents included Rattus norvegicus (47.36%, 188/397) and house mouse (52.64%, 209/397); the flea infection rate of the rat body was 13.26% (182/1 373), with a flea index of 0.40; the dominant flea species was Ophthalmopsylla jettmari, accounting for 45.23% (251/555). The 5 281 pathogenic culture samples and 2 110 serological test samples were all negative. The Pearson correlation analysis results showed that there was no correlation between rodent density and flea infection rate or flea index at national and provincial monitoring sites ( r = - 0.26, - 0.48, 0.09, 0.12, P > 0.05), while flea infection rate and flea index were positively correlated ( r = 0.67, 0.81, P < 0.05). In 2022, Yulin City, Shaanxi Province was not ruled out the possibility of human plague epidemic, and the risk of plague epidemic among animals was high. Conclusions:From 2011 to 2021, the density of the main host animals at the national and provincial monitoring sites in Yulin City has remained at a low level, and the flea index has increased. There is a risk of plague epidemic in Yulin City, so the monitoring work should be further strengthened, and emergency supplies and capacity reserves should be well prepared.

Objective:To construct a follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019), and provide a reference basis for the next revision and improvement of the standard.Methods:The evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was preliminarily established by consulting relevant references and materials. The experts in the field of diagnosis, treatment, prevention and control of brucellosis were selected, and two rounds of expert consultation were carried out in the form of questionnaires using the Delphi method. The necessity and availability of evaluation indicators were scored, and suggestions for modifying and adding indicators were put forward. Based on this, a standard follow-up evaluation index system was established. At the same time, a judgment matrix was constructed combined with the Saaty scale, and the analytic hierarchy process was used to calculate the weight of each index in the system.Results:After 2 rounds of expert ( n = 10) consultation, a standard follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) was constructed with 3 first-level indexes, 8 second-level indexes and 21 third-level indexes. The positive coefficients of experts in 2 rounds of questionnaires were both 100%; the coefficient of authority of experts was 0.82; the Kendall's coefficients of concordance of first-level, second-level and third-level indexes were 0.722, 0.260, and 0.181, respectively, with P < 0.05. Among the first-level indexes, the weight of standard quality evaluation was the highest (0.364), and the weight of standard implementation status was the lowest (0.278); among the second-level indexes, the combined weight of social benefits was the highest (0.186), and the combined weight of advanced nature was the lowest (0.043); among the third-level indexes, the combined weight of timely diagnosis rate was the highest (0.096), and the combined weight of consistency with technical data was the lowest (0.009). Conclusions:The constructed follow-up evaluation index system for "Diagnosis of Brucellosis" (WS 269-2019) is scientific and reliable, which evaluated qualitatively and quantitatively, reduces the defects of a single evaluation, and provides a basis for subsequent revision and improvement of the standard.

目的 了解《布鲁氏菌病诊断》(WS 269-2019)(简称标准)的宣贯、实施和使用情况以及使用过程中存在的问题,为标准的修订和完善提供参考.方法 采用分层抽样调查和国家布病监测防控工作系统公开广泛调查相结合的方法,对全国布病一、二、三类部分流行地区的各级疾病预防控制中心(简称疾控机构)和临床医疗机构中从事布病流行病学调查、实验室检验和临床诊治的卫生专业人员开展问卷调查和访谈.结果 参与问卷调查的省份(直辖市)有16个,共调查疾控机构和临床医疗机构763家,收回问卷1 479份,问卷有效率为100.00％,其中调查疾控机构261家,完成问卷调查530份;调查临床医疗机构502家,完成问卷调查949份.调查对象平均年龄为(40.29±9.62)岁,学历中本科及以上占56.19％,职称以中初级职称占比最高(占34.75％),专业以临床诊断治疗为主(占48.88％),专业年限以5年以下为主(占54.02％).1 479名调查对象中,标准知晓率为88.30％(1 306/1 479),其中疾控机构知晓率为92.83％(492/530),临床医疗机构知晓率为85.77％(814/949),两者差异具有统计学意义(x2=16.391,P＜0.001);布病相关实验室检验项目开展率为79.86％(1 043/1 306),且调查对象所在的省市级医疗机构布病相关实验室检验项目开展率最高,为88.79％(285/321),其次为县区级(87.79％,460/524)和乡镇级(64.64％,298/461)医疗机构,差异有统计学意义(X2=102.752,P＜0.001).1.35％(20/1 479)认为该标准与国家法律法规及其他相关标准、现行教材矛盾.通过问卷调查和电话回访共收集到关于布病检验、病例诊断和宣贯培训3个方面的意见和建议.结论 该标准是现阶段开展布病诊断工作的唯一指导性文件,建议进一步完善和修订该标准,加强该标准的宣贯和培训,提高临床医疗机构对该标准的使用和掌握,提升布病检测水平和特异性,从而有效推进布病防治工作的开展.

Objective:To understand the changes of brucellosis prevention and control knowledge awareness among breeders in Chunhua County, Xianyang City, Shaanxi Province before and after the publicity intervention.Methods:A multi-stage cluster sampling method was adopted to select 10 townships with more reported cases of human brucellosis in Chunhua County from January 2019 to June 2020, and each township was given priority to select the administrative village with the largest number of reported cases for investigation. At least 20 breeders aged 20 years old and over in each administrative village were selected, and if the number was insufficient, supplementary surveys would be conducted in other administrative villages with the larger number of breeders in the township. Questionnaire survey was conducted on all subjects, including general demographic characteristics, brucellosis prevention and control knowledge and related protective behaviors. After the baseline investigation, 6 months of brucellosis prevention and control knowledge publicity was carried out in the administrative villages included in the investigation, and the awareness rate of brucellosis prevention and control knowledge before and after the publicity intervention was compared to evaluate the effect of publicity intervention.Results:After the publicity intervention, a total of 240 breeders were investigated, and 176 people were aware of brucellosis prevention and control knowledge, with an overall awareness rate of 73.33% (176/240), which was significantly higher than that before the publicity intervention (57.50%, 115/200), and the difference was statistically significant (χ 2 = 12.21, P = 0.005). After the publicity intervention, the awareness rates of breeders on "can cattle and sheep transmit diseases to humans" and "do you know that cattle and sheep can only be purchased after passing the quarantine inspection" were relatively high, they were 95.83% (230/240) and 95.00% (228/240), respectively, and the differences were statistically significant (χ 2 = 50.04, 112.64, P < 0.001) compared with that before the publicity intervention [71.50% (143/200) and 51.00% (102/200)]. The awareness rate of breeders on "how brucellosis is transmitted from livestock to humans" was the lowest, it was 53.33% (128/240), which was not significantly different (χ 2 = 0.82, P = 0.370) from that before the publicity intervention (49.00%, 98/200). Conclusions:After the publicity intervention, the overall awareness rate of brucellosis prevention and control knowledge of breeders in Chunhua County has improved, but the awareness rate of some individual issues is still low. It is suggested to strengthen the pertinence of publicity and education.

目的 分析2016-2020年陕西省榆林市布鲁氏菌病(简称布病)发病的流行特征和时空聚集性,为制订布病防控策略提供依据.方法 通过中国疾病预防控制信息系统收集2016-2020年陕西省榆林市布病发病数据,进行描述性流行病学分析,同时利用ArcGIS 10.8、GeoDa 1.6、SaTScan 9.4.1软件分别进行三维分析、空间 自相关分析和时空扫描分析.结果 2016-2020年陕西省榆林市共报告布病病例1 773例,年均发病率为10.40/10万.病例报告以5-8月为主,病例性别比为3.53 ∶ 1(1 382/391),年龄以45～64岁人群为主(占60.46％),职业以农民为主(占89.57％).三维趋势分析显示榆林市布病发病率呈现由北向南、由西向东逐渐升高.空间 自相关分析显示,2016-2020年榆林市布病发病率Moran's I值分别为0.478 0、0.444 0,0.289 0、0.322 0、0.260 3,局部Moran's I系数检验发现榆林市布病发病有2个"高-高"聚集县区和3个"低-低"聚集县区.时空扫描分析显示,2016-2020年榆林市布病发病扫描到1个一类时空聚集区和1个二类时空聚集区,聚集时间为2019年.其中一类聚集区(LRR=57.97,RR=2.49,P＜0.001)以米脂县为中心,半径为51.62 km,涉及5个县区.结论 2016-2020年榆林市布病呈现明显的时空聚集性,应结合布病发病流行高峰期、发病人群、时空聚集区、羊只存栏量等情况,采取分区域、有重点、人畜同步联防的布病防控策略.

Objective To understand the epidemiological characteristics and incidence trend of brucellosis in Shaanxi province from 2019 to 2020 and provide evidence for the targeted brucellosis prevention and control. Methods The incidence data of brucellosis cases and outbreaks in Shaanxi from 2019 to 2020 were collected for a descriptive epidemiological analysis to understand the population, area and time distributions of brucellosis cases in Shaanxi by using software SPSS25.0 and Arc GIS10.8. At the same time, the characteristics of outbreaks and risk of different infection routes were also analyzed. Results A total of 2 254 brucellosis cases were reported in Shaanxi from 2019 to 2020, with an annual incidence rate of 2.93/10 0 000. The cases were mainly reported from April to September, which were mainly distributed in Guanzhong and northern Shaanxi, and there was statistically significant difference in the annual incidence rate among Guanzhong, northern Shaanxi and southern Shaanxi (χ2=1338.771, P Conclusion It is necessary to adhere and improve the joint prevention and control mechanism, strengthen the quarantine of sick animal and improve people’s knowledge, attitude and practice of brucellosis prevention and control to prevent and control brucellosis in Shaanxi.