2012年消除麻风运动云南省疾病预防控制中心课件

云南省消除麻风运动实施方案 云南省疾病预防控制中心麻防科云南省疾病预防控制中心麻防科 税铁军税铁军 2012.5.282012.5.28 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 主 要 内 容 目的 目标 实施时间 组织领导 实施步骤 评估 资料归档 考核方案 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 云卫发（2008）541号 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n一类县（市、区） 每年开展一次消除 麻风运动 n二类县（市、区） 每二年开展一次消 除麻风运动 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 目 的 消除麻风运动（LEC），是通过短期内开展强化 的麻风病防治行动，使医务人员及广大人民群众 正确认识麻风病，懂得麻风病防治基本知识，充 分发挥基层防保网的特色和优势，最大限度地早 期发现隐藏病例，给予规范联合化疗，控制传染 源，缩短患者发病和治疗延迟期，避免畸残，保 证基本消灭麻风病目标的顺利实现。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 在麻风高流行区开展消除麻风运动（LEC），强化早期发 现病人并给予治疗，是世界卫生组织倡导的将麻风作为公 共卫生问题加以消灭的主要战略 云南省1997年-1999年在18个县开展了LEC，发现了337 个病人，有15个县的发现率超过了前5年的平均数，最高 超出了6倍，20011年消除麻风运动中发现了全省新发现 麻风病例的37% Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 目 标 （总目标 n最大限度早期发现麻风病患者，并给予联合化疗， 减少患者畸残发生。 n提高基层医务人员的麻风病防治水平。 n健全以县级专业机构为技术指导、乡镇卫生院为枢 纽、村卫生室为基础的麻风病防治网络 n提高社区群众对麻风病防治知识的了解水平 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n举办乡、村级防保人员及综合医院皮肤科医生麻风病防 治知识培训班，覆盖率达100 n开展麻风病防治知识宣传及健康教育，覆盖率大于95 通过短期内，使医务人员及广大人民群众正确认识麻风病，懂得 麻风病防治基本知识，加强自报及互报 n对历年治愈者及其家属进行全面体检，体检率大于97 n对现症病例及其家属进行全面体检，体检率大于98 最近10年间，家内感染约占总新发现病例的30% 具体目标 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 具体目标 n 对有现症病例和历年治愈者的自然村15-60岁的人群进行 口头调查，以自然村为单位，调查人数不得低于该人群的 20 n 对无病例自然村15-60岁的人群进行口头调查，以自然村 为单位，调查人数不得低于该人群的10 n 对提供的可疑线索进行核实，复核率达100 通过广泛的群众运动，发现人群中有麻风类似症状患者 由专业人员对发现麻风6大线索复核，发现隐匿的麻风患 者 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 实施时间 l34个月 第1个月 成立消除麻风运动实施领导小组和 技术指导小组 消除麻风运动启动会及县、乡级培训 第24个月 开展宣传及健康教育活动 开展查病工作 第4个月 可疑线索核实，诊断并治疗管理新病 例，对本次消除麻风运动进行评估 形成报告 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 组织领导 以县级为主，成立消除麻风运动实施领导小组和 技术指导小组 n县级领导小组组长由政府分管领导担任，成员包括卫 生、民政、广播电视 、各乡（镇）政府分管卫生工作 的领导。各乡镇也应成立相应的项目领导小组和办公 室，负责辖区内的麻风病线索调查、上报和宣传工作 n县级技术指导小组组长由县疾病预防控制中心（皮防 站）领导担任，成员包括疾控中心有关科室和综合医 院皮肤科业务骨干 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 工作职责 项目领导小组负责项目工作的领导、组织、 指挥、协调和正常开展；技术指导小组负责项 目的督导，提供技术支持、指导和对患者的复 核和确诊。 组织领导 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 实施步骤 召开消除麻风运动项目启动大会 n参会人员：消除麻风运动项目领导小组及技 术指导小组成员、县乡级有关部门负责人等 n内容：动员及布置具体工作 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 培训 县级培训 对象：辖区内的麻风病防治专业人员、各乡镇卫生院长 、防保组长、防保科医务人员、综合医院皮肤科医生、 乡镇（街道）负责人及防疫专干及志愿者等 广泛动员社会力量，充分发挥基层防保网的特色和优势，加大病 例发现力度 内容：开展LEC的目的、意义和方法；麻风的早期临 床体征、诊断及鉴别诊断、治疗及患者管理等 使医务人员及广大人民群众正确认识麻风病，懂得麻风病防治基 本知识 实施步骤 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 培训 乡级培训 对象：辖区村干部、村卫生所医务人员 内容：简要麻风病防治知识，重点是用图片展示麻 风的8条可疑线索；早期症状；现场调查方法；可疑 线索填写与报告 村级及乡级防保网以发现可疑症状为主，一旦发现可疑 线索，立即上报县级专业机构，县级专业机构应尽快对 可疑线索进行核实 实施步骤 县乡两级培训，均要进行效果评估！ Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 开展宣传及健康教育活动 通过电视、报纸、广播、小册子、宣传单、标 语、墙报、海报等多种形式，用3-5天在全区范 围内集中宣传“麻风病是可以防治的”，使“ 消除麻风运动”家喻户晓 通过宣传的方式，增强公众知晓率，增加自报和互报 进行健康教育效果评价！ Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 八大可疑线索 n 经常红眼，酒醉面容 n 眉毛稀疏脱落 n 长期不愈的红白斑疹、结节、斑块 n 躯干、四肢局部皮肤麻木、闭汗 n 虎口肌肉萎缩，爪型手 n 足底破溃，无明显疼痛 n 口角歪斜，闭眼不拢 n 单脚高抬走路，步态异常 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n经常红眼，酒醉面容； Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n眉毛稀疏脱落 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n长期不愈的红白斑疹、结节、斑块 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n躯干、四肢局部皮肤麻木、闭汗 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n虎口肌肉萎缩，爪型手 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n足底破溃，无明显疼痛 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n口角歪斜，闭眼不拢 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. n单脚高抬走路，步态异常 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 发病调查 调查方式 n 接触者检查：对历年治愈者及其家属（覆盖率应达到97%以 上） 、现症病例及其家属进行全面体检（覆盖率应达到98% 以上） n 疫点与非疫点调查：对有现症病例和历年治愈病例的自然村 (覆盖率20%以上)及无病例自然村进行口头调查（覆盖率 10%以上） 可疑线索上报 n对经调查有麻风病早期临床表现或疑似麻风病症状者由村卫 生所将线索上报乡镇卫生院。 n经乡镇卫生院筛查后，报县级项目技术指导小组。 对自报、互报经确诊者，给予现金奖励！ Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 确诊与治疗 n项目技术指导小组派出由专业防治人员组成的确诊 小组对可疑线索逐个进行临床检查，必要时做细菌 和病理检查。核查时要严格掌握以下麻风诊断标准 ： 皮损伴明确的感觉障碍 周围神经粗大伴相应的功能障碍 皮肤涂片查抗酸杆菌阳性 组织病理检查有麻风特异性病理改变和（或）查抗酸杆菌 阳性 n对确诊的新病例即给予联合化疗，并按方案进行病 例管理 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 评 估 总结的内容包括 n基本情况：地理、行政区划，防治机构情况，疫情概况 n组织领导与项目启动：领导和技术指导小组，启动会 n实施措施：技术培训，宣传工作，调查、检查及核查情 况。要对培训效果和新病例发现情况进行前后比较 n实施效果：治愈者复查、接触者检查、互报和自报、新 病例发现情况 n经费使用情况 n下步工作计划 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 资料归档 LEC结束后，应将相关资料分类归档， 包括影像、纸质及电子版本等，以便今后查 阅。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 附 表 1、县基本情况调查表 2、近五年新发现病例情况调查表 3、麻风防治管理体系调查表 4、开展消除麻风运动培训情况调查表 5、消除麻风运动培训效果评估表 6、开展消除麻风运动宣传情况调查表 7、历年治愈存活病例复查登记表 8、现症病例复查登记表 9、治愈存活病例/现症病例家属检查表 10、可疑线索上报表 11、可疑线索复核表 12、有现症病例、治愈病例/无病例自然村调查表 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 2008-2010年消除麻风运动工作概况 为最大限度地早期发现隐藏病例，控制传染源， 缩短延迟期，减少畸残，2008-2010年，分3年分别在 麻风病疫情相对较严重的60个县（市、区）开展消除 麻风运动。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 实施结果（2008年） 县(市、 区)名 08年-07 年 09年-08 年 10年-09 年 县(市、区) 名 08年-07年09年-08年10年-09年 禄劝县2-22广南县-1-83 鲁甸县3-4-2翠云区3-20 巧家县7-1-3澜沧县4-4-1 大关县12-1景洪市-10-4 永善县3-2-1勐海县-810 大姚县-24-2大理市003 元谋县4-3-1宾川县2-31 禄丰县23-3南涧县2-22 通海县2-3-1永胜县-2-1-2 开远市11-13-1华坪县10-2 元阳县2-40香格里拉3-2-2 文山县0-20德钦县1-10 砚山县-311-6双江县1-20 丘北县-1-4-9合计36-42-30 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 实施结果（2009年） 县(市、区)名09年-08年10年-09年县(市、区)名09年-08年10年-09年 富民县11泸西县4-5 晋宁县-10马关县3-9 寻甸县3-6西畴县-21 镇雄县01富宁县-10 沾益县21普洱县2-4 会泽县-2-2景东县3-2 师宗县3-6镇源县1-1 牟定县0-2永平县00 武定县1-5洱源县00 华宁县2-1昌宁县-14 易门县-10宁蒗县8-16 弥勒县1-6临翔区-10 蒙自县2-4云县00 个旧市2-1合计29-62 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 实施结果（2010年） 县(市、区)名10年-09年县(市、区)名10年-09