【医学ppt课件之抗生素】性传播感染预防控制监测数据的利用

,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,25-28 November 2008,National Training Workshop on Analysis and,Utilization of STI Surveillance Data,Hefei, Anhui,【医学精品课件之抗生素】性传播感染预防控制监测数据的利用,【医学精品课件之抗生素】性传播感染预防控制监测数据的利用,【医学ppt课件之抗生素】性传播感染预防控制监测数据的利用,【医学ppt课件之抗生素】性传播感染预防控制监测数据的利用,STI Cases Reported and Incidence Rate in China (1985-2004),中国性病病例报告和发病率,Source: China National Center for STD Control and Prevention,来源：中国,CDC,性病控制中心,25-28 November 2008,National Training Workshop on Analysis and,STI Cases Reported and Inciden,Congenital Syphilis Cases Reported in China(1991-2004),中国先天梅毒病例报告,Increase: 76.19%,Source: China National Center for STD Control and Prevention,25-28 November 2008,National Training Workshop on Analysis and,Congenital Syphilis Cases Repo,Incidence of Major STIs in Thailand, 1988 and 2000,泰国主要性病发病率,STI 1988 2000,病人数,Number Incidence Number Incidence,发病率,of patients per 1,000 of patients per 1,000,Syphilis 21,7000.402,7610.04,Gonorrhea216,1074.015,6220.09,Chancroid40,0030.741270.00,LGV20,0300.37780.00,NSU85,3231.587,0120.11,Total383,1637.1115,6000.25,25-28 November 2008,National Training Workshop on Analysis and,Incidence of Major STIs in Tha,What Information can be obtained from STI Surveillance (2),从性病监测可获得什么信息？,（,2,）,Demographic characteristics of STI cases,性病报告病例的人口学特征,Age,年龄,Sex,性别,Education,教育状况,Occupation,职业,Location (region, urban-rural),地区（城市、农村）,25-28 November 2008,National Training Workshop on Analysis and,What Information can be obtain,What Information can be obtained from STI Surveillance (3),从性病监测可获得什么信息？（,3,）,Sources of STI,性病感染来源,Contacts,接触者,Primary contact,首发接触,Secondary contact,二代接触,Characteristics of contacts,接触者特征,Sex worker, spouse, casual partners, others,性工作者、配偶、偶然性伴及其他,Duration between the possible exposure and the development of disease,在可能的暴露和疾病发展之间的时间,The use of condom,安全套使用情况,Location to trace the contacts,性伴追踪确定感染场所,25-28 November 2008,National Training Workshop on Analysis and,What Information can be obtain,Source of STIs Among Male Patients, Thailand, 1986-1990,泰国男性性病病人来源,Year Number of % contracted Contracted,patients from sex workers from others,1986239,70497.52.5,1987237,23797.52.5,1988217,26696.73.3,1989199,04896.33.7,1990125,37996.13.9,Remark: Others = spouse, casual partners, etc.,注：其他指配偶、偶然性伴等,从其他来源感染,性工作者来源感染,25-28 November 2008,National Training Workshop on Analysis and,Source of STIs Among Male Pati,What Information can be obtained from STI Surveillance (4),从性病监测可获得什么信息？（,4,）,Behavioral data among target populations:,目标人群行为学数据,Sexual behavior, including sexual preference and the use of condoms,性行为，包括性取向和安全套使用情况,2,）,Health seeking behavior,求医行为,3,）,Access to treatment and type of commonly accessed facilities,治疗的可及性和通常寻求治疗的医疗机构的类型,25-28 November 2008,National Training Workshop on Analysis and,What Information can be obtain,What Information can be obtained from STI Surveillance (5),从性病监测可获得什么信息？ （,5,）,Treatment data, including antibiotic sensitivity,治疗数据，包括抗生素敏感性,Number of STI clinic clients,性病门诊就诊者数量,Number with STIs,性病病人数量,Number complete treatment,全程治疗人数,Number cured,治愈人数,Clinical characteristics of STIs,性病病例临床特征,Differentiation of STI pathogens,性病病原体的区别,Antimicrobial sensitivity pattern,抗生素敏感性模式,25-28 November 2008,National Training Workshop on Analysis and,What Information can be obtain,Etiology of male urethral discharge, Fujian provincial STD clinic,福建省性病门诊男性尿道分泌物的病因学,Source: China National Center for STD Control and Prevention,淋球菌衣原体淋球菌与衣原体未查出病原体,25-28 November 2008,National Training Workshop on Analysis and,Etiology of male urethral disc,Proportion of,Neisseria Gonorrhoeae,Isolates Resistant to,Ciprofloxacin,分离的奈瑟氏淋球菌对环丙沙星耐药的比例,Source: China National Center for STD Control and Prevention,25-28 November 2008,National Training Workshop on Analysis and,Proportion of Neisseria Gonorr,What Information can be obtained from STI Surveillance (6),从性病监测可获得什么信息？ （,6,）,Development of prevention interventions based on STI surveillance data,在性病监测数据基础上制定预防干预的策略和措施,Case finding activities:,syphilis screening programme,病例发现：梅毒筛查项目,Contact tracing and partner notification,性伴追踪与性伴通知,Control sources of infections (e.g. Regular check-up of sex workers),控制感染来源（例如，性工作者常规体检）,The 100% condom use programme,100%,安全套使用项目,25-28 November 2008,National Training Workshop on Analysis and,What Information can be obtain,What Information can be obtained from STI Surveillance (6),从性病监测可获得什么信息？ （,6,）,Success or failure of STI control,性病控制工作的成败,Assessment of disease situation and trends,评估疾病疫情和趋势,Evaluation of control programme,评估性病防治项目,25-28 November 2008,National Training Workshop on Analysis and,What Information can be obtain,Number of Sexually Transmitted Disease Cases in Thailand, 1970-2000,泰国性病病例数,X 1000 cases,25-28 November 2008,National Training Workshop on Analysis and,Number of Sexually Transmitted,X 1000 cases,Rate of condom use,100%,Number of STI Cases, 1970-2004, and Condom Use Rate in Sex Establishments, Thailand,泰国性病病例数，性服务场所安全套使用率,25-28 November 2008,National Training Workshop on Analysis and,X 1000 casesRate of condom use,Use of Surveillance Data for STI/HIV/AIDS Prevention and Control,利用性病,/,艾滋病预防控制的监测数据,25-28 November 2008,National Training Workshop on Analysis and,25-28 November 2008National Tr,Utilization of STI surveillance data begin with correct interpretation of the data,正确解读数据,-,利用性病监测数据的第一要务,Examples:,举例,Ineffective STI treatment,性病治疗效果较差,Low level of health seeking behavior,求医行为比例较低,Low level of acceptance of public STI services,公共性病服务的可接受性较低,Ineffective prevention,预防措施效果较差,25-28 November 2008,National Training Workshop on Analysis and,Utilization of STI surveillanc,Ineffective STI treatment,性病治疗效果较差,Efforts to improve:,改善措施,Improvement of diagnosis.,提高诊断率,Development and utilization of patient record forms.,设计和使用病例记录表格,Appropriate lab support.,适宜的实验室技术支持,Test of cure (good patient follow-up).,对治愈者的检测（良好的病例随访）,Antimicrobial susceptibility vs resistance data.,抗生素敏感性与耐药性监测数据,National treatment guidelines.,国家诊疗指南,Trainings of STI personnel.,培训性病防治人员,25-28 November 2008,National Training Workshop on Analysis and,Ineffective STI treatment性病治疗效,Low level of health seeking behavior,求医行为比例较低,Efforts to improve:,改善措施,Education (IEC) on STI and HIV/AIDS,针对性病和艾滋病的健康教育（信息教育交流）,Advertisement on STI services.,性病服务的宣传广告,User-friendly STI services,针对就诊者友好的性病服务,25-28 November 2008,National Training Workshop on Analysis and,Low level of health seeking be,Low level of acceptance of,public STI services,公共性病服务的可接受性较低,Efforts to improve:,改善措施,User-friendly STI services: staff attitudes, short waiting time, less boring, less noisy, privacy, instruction on the services, good quality of services, good public utility (toilet, public phone).,针对就诊者友好的性病服务：工作人员的态度，缩短候诊时间，避免嘈杂的环境，注重保护隐私，就诊服务指导，良好的服务质量，良好的公用设施（卫生间、公用电话等）,Collaboration with private STI services and pharmacies.,与私人性病诊疗服务和药房的协作,25-28 November 2008,National Training Workshop on Analysis and,Low level of acceptance of Eff,Ineffective STI prevention,性病预防措施效果较差,Efforts to improve:,改善措施,Epidemiological approach in the STI clinics.,性病门诊的流行病学方法,Contact tracing and partner notification;,性伴追踪和性伴通知,Individual health education and STI counseling;,个体化健康教育和性病咨询,Provision of condoms.,安全套供应,Screening among some target groups.,在某些目标人群实施筛查,Monitoring partner (contact) management.,性伴（接触者）管理的监督,Monitoring sources of STI infections.,性病感染来源的监测,Referral system for clinical management of contacts.,性伴临床管理的转介系统,Implementing effective prevention programme: The 100% Condom Use Programme.,开展有效的预防项目：,100%,安全套使用项目,25-28 November 2008,National Training Workshop on Analysis and,Ineffective STI prevention性病预防,Approaches for,Effective Uses of STI Data,有效利用性病数据的方法,1. Management of sexual contacts or partners,性接触者或性伴管理,Development of contact tracing guideline:,设计性伴追踪指南,Management guideline for primary contacts,首发接触者的管理指南,Management guideline for secondary contacts,二代接触者的管理指南,Setting-up contact tracing mechanism,建立性伴追踪机制,Collection of Data: getting information of contacts from clinical interview,数据收集：接诊就诊者获得相关信息,Performing contact tracing activity,开展性伴追踪活动,Monitoring and assessment of contact tracing activities,监督和评估性伴追踪活动,25-28 November 2008,National Training Workshop on Analysis and,Approaches for Effective Uses,2. Assessing the risk situation on STI transmission,性病传播危险性的评估,Collection of Data:,数据收集,(1) collect information from clinical interviews with clinic clients,接诊临床病人时收集信息,(2) sentinel surveillance of STI risk behavior,性病危险行为的哨点监测,(3) surveys of entertainment places and number of sex workers.,娱乐场所数量和性工作者人数的调查,Mapping and listing of potential “STI transmitters”,潜在的“性病传播者”的分布图和清单,Regular surveillance on sources of infection from clinical interviews with STI patients.,接诊临床病人时对感染来源的常规监测,Approaches for,Effective Uses of STI Data,有效利用性病数据的方法,25-28 November 2008,National Training Workshop on Analysis and,2. Assessing the risk situatio,3. Implementation of effective condom promotion programme: the 100% CUP,有效开展安全套促进项目：,100%,的安全套使用项目,Collection of Data:,数据收集,(1) collect information from clinical interviews with clinic clients (on the primary contacts, location and the use of condom) and,接诊临床病人时收集信息（首发病例的感染场所和安全套使用情况）,(2) routine surveillance on the sources of STI,对性病感染来源的常规监测,Providing the information to the 100% CUP monitoring team for programme monitoring,为,100%,安全套使用项目督导队伍提供信息,Approaches for,Effective Uses of STI Data,有效利用性病数据的方法,25-28 November 2008,National Training Workshop on Analysis and,3. Implementation of effective,