1、25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,STI SURVEILLANCE 性病监测,Dr. Wiwat Rojanapithayakorn HIV/AIDS Team Leader WHO China Email: wiwatrchn.wpro.who.int Website: http:/www.wpro.who.int/china,25-28 November 2008,National Training Workshop on A
2、nalysis and Utilization of STI Surveillance Data,Epidemiology in STI Prevention and Control 性病预防和控制流行病学,Descriptive epidemiology描述流行病学 Reporting system 报告系统 reports of cases: disease, patients characteristics, geographic location, time of the year. 病例报告：病种、患者特征、地址、患病日期 reports of prevention and cont
3、rol activities: screening, case finding, treatment, follow-up, contact tracing, control of sources. 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 Disease surveillance疾病监测 Sentinel surveillance哨点监测 Drug sensitivity药物敏感性 Disease specific surveillance: congenital syphilis, PID疾病专项监测：胎传梅毒、盆腔炎 Sources of infection 传染
4、源,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,Epidemiology in STI Prevention and Control (cont.) 性病预防和控制流行病学（续）,Analytical epidemiology分析流行病学 Epidemiological research流行病学研究 Outbreak investigation暴发调查 Evaluation of control programmes 控制项目的评估,25-
5、28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,Epidemiology in STI Prevention and Control (cont.) 性病预防和控制流行病学,Operational epidemiology 应用性流行病学 Management of contacts接触者管理 Contact tracing 接触者追踪 Partner notification 性伴通知 Control source of infections:传染
6、源控制 Mapping 绘图 Regular surveys of entertainment establishments and sex work population 娱乐场所和性服务人群的常规调查 Outreach visits 外展 Reduce STI transmission降低性病传播 Condom promotion安全套促进 100% condom use programme100%安全套项目,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveilla
7、nce Data,Guideline Document on STI surveillance 性病监测指南文件,Guidelines for Sexually Transmitted Infections Surveillance (WHO/CDS/CSR/EDC/99.3), 1999 By UNAIDS/WHO Working Group on Global HIV/AIDS/STI Surveillance 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,25-28 November 2008,Na
8、tional Training Workshop on Analysis and Utilization of STI Surveillance Data,Definition of Surveillance 监测的定义,“.the ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated wit
9、h the timely dissemination of these data to those who need to know.“ US CDC, 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 US CDC，1988,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,Main Objectives of STI Surveillance 性病监测的主要目的,Asse
10、ssing the situation and trends of STIs in target populations 评估性病在目标人群的流行情况和趋势 Apply appropriate interventions and define needed resources 应用恰当的干预，明确所需资源 Evaluate effectiveness of STI interventions 评估性病干预的有效性 Advocacy on the STI burden to the society 性病疾病负担的社会倡导,25-28 November 2008,National Training
11、 Workshop on Analysis and Utilization of STI Surveillance Data,STI SURVEILLANCE COMPONENTS 性病监测内容,The five components of STI surveillance that are necessary for effective control programmes:性病监测有5部分内容是有效控制项目所必需的 Case reporting病例报告 Prevalence assessment and monitoring 患病率评估和监测 Assessment of STI syndr
12、ome etiologies性病病征病因评估 Antimicrobial resistance monitoring耐药监测 Special studies专项研究,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,Improve Patient Care 提高患者治疗,Effective Treatment Services有效的治疗服务,AntimicrobialResistance Studies 耐药研究,Aetiologies of S
13、TI Syndromes 性病病征的病因,Core Components of STI Surveillance 性病监测核心内容,Special Studies 专项调查,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,CASE REPORTING 病例报告,Case reporting is the process of reporting cases of notifiable diseases from health care prov
14、iders or laboratories to public health authorities. 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 STIs may be reported either syndromically or etiologically, depending on the availability of laboratory tests in clinical care settings 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,25-28 November 2008,National Training Workshop
15、on Analysis and Utilization of STI Surveillance Data,Objectives of case reporting 病例报告的目的,Assess disease burden, by providing an indicator of minimum incidence of recently acquired infections 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 Monitor trends in incidence of recently acquired infections. 监测最近获得感染的发病趋势 Provid
16、e information required for management of patients and their sex partners 提供患者及其性伴管理的信息 Provide information on which providers in the health care system are diagnosing and reporting the major STIs, to assist in planning and managing programme efforts 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 Provide other data n
17、ecessary for managing health services (e.g., pharmaceutical distribution) 提供管理医疗服务的其他必需资料(如药品分配),25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,Syndromic case reporting 病征病例报告,Syndromic case reports require no laboratory diagnostic tests 症状病例报告不需要
18、实验室诊断性检测 Genital ulcer syndrome生殖器溃疡病征 Urethral discharge syndrome尿道分泌物病征 Vaginal discharge syndrome阴道分泌物病征 Lower abdominal pain in women女性下腹痛,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,Etiologic case reporting 病因病例报告,Etiologic case reporting
19、requires diagnosis based on laboratory testing病因病例报告需要基于实验室检测的诊断Most common STI etiologies are:最常见性病病因 Syphilis: different staging 梅毒：各期 Gonorrhoea淋病 Chlamydial infection衣原体感染 Chancroid软下疳,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,UNIVERSAL C
20、ASE REPORTING 全国性的病例报告,Mainstay of STI surveillance at national level国家级性病监测主要部分 Data collection mechanisms exist in most countries (Integrated Communicable Diseases Surveillance System) 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 “minimum essential data” for the facilities with no routine laboratory-suppor
21、ted diagnosis of STIs 建议无常规性病实验室支持诊断机构，收集最少基本资料 Total Number of STIs性病病例总数 Urethral Discharge Syndrome 尿道分泌病征,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,SENTINEL SYNDROMIC CASE REPORTING 哨点病征病例报告,Complementary to universal case reporting 全国病例报
22、告的补充 Selective representative clinics 选择有代表性的门诊 Collect data by types of STI syndrome 依据性病病征类型收集资料 Demographic & other information人口统计学和其他信息 Age groups & Gender年龄组和性别 Syphilis Serology Tests梅毒血清检测 Partner Notification性伴通知,25-28 November 2008,National Training Workshop on Analysis and Utilization of
23、STI Surveillance Data,2. STI PREVALENCE ASSESSMENT AND MONITORING 性病患病率评估和监测,The primary purposes of STI prevalence assessment and monitoring are the following: 性病患病率评估和监测的主要目的如下： Identify population subgroups with high prevalence of STIs 确定性病患病率高的亚人群 Monitor trends in STI prevalence among defined p
24、opulations. 监测已规定人群的性病患病率趋势,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,3. AETIOLOGY OF STI SYNDROMES 性病病征的病因,To develop effective treatment protocols 制定有效的治疗方案 Aetiological distribution of STI syndromes and antimicrobial susceptibilities vary
25、between different geographical areas, and change temporally 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 Periodic aetiology studies required to validate the effectiveness of treatment protocols 定期病因研究，以验证治疗方案的有效性 Information could be used to estimate aetiology-specific disease morbidity 信息应该用来估计特定病因疾病的发病率,25-28 Novem
26、ber 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,4. ANTIMICROBIAL RESISTANCE MONITORING 耐药性监测,Essential to maintain effectiveness of treatment protocols 对保持治疗方案有效性很必须 Identify newly emerging resistance 确定新出现的耐药 Promote through existing networks (such as GASP)
27、通过现有网络促进（如GASP）,25-28 November 2008,National Training Workshop on Analysis and Utilization of STI Surveillance Data,5. SPECIAL STUDIES AS A COMPONENT OF STI SURVEILLANCE 专项研究性病监测的一部分,Address important STI surveillance issues that are not part of routine case reporting or prevalence assessments. 注重于重
28、要的性病监测问题，它不是常规病例报告，或患病率评估的一部分 Suggested topics include:建议的题目包括 Outbreak investigations 暴发调查 Evaluation of STI syndromic management algorithms性病病征处理流程图的评估 Incidence and prevalence of STI-related complications:性病相关并发症的发病率和患病率 PID盆腔炎 Ectopic pregnancy异位妊娠 Cervical cancer宫颈癌 Estimation of economic costs of STIs性病经济费用评估,
