摘要
目的 (1)应用系统动力学方法建立数学模型,宏观地模拟严重急性呼吸综合征(SARS)疫情在自然人群和医院内传播的过程,以及患者通过就诊和社区隔离措施移出传播链的过程。(2)通过计算机对该模型的仿真模拟,分析在突发 SARS疫情的情况下,代表主要防控措施的变量对疫情曲线的影响模式和相对强度。(3)重点分析发热监测措施对疫情的影响,根据分析结果对今后SARS防控工作提出政策建议。方法 采用面访、问卷调查、文献检索、个案分析等方式,获取SARS传播的重要参数。应用系统动力学理论及计算机仿真系统建立数学模型,并进行 What if仿真分析。结果 建立了能够反映SARS自然传播、患者就诊及医院内传播、社区隔离措施、发热监测过程的计算机仿真模型,通过宏观模拟SARS患者从发病到被移出传播链的过程得出下列结果:(1)患者从发病到就诊的时间、患者每日平均接触人数、就诊时医院内接触人数等是对 SARS的院内、院外传播过程影响最大的几个变量;(2)隔离强度、接诊医生对 SARS的警惕性、医院通风消毒、医院优化患者流动路线、医生防护强度是影响疫情控制的主要变量;(3)医院入口的体温筛查措施对疫情控制的作用不大。结论 按照目前制定的SARS防治预案,卫生系统能够快速控制突发的SARS疫情。
Objective (1)Building a macroscopical systematic dynamic model of severe acute respiratory syndrome( SARS) transmission and disease control process. (2)To determine key variables on the control of SARS epidemic through computer simulation methodology, especially to analyze the effect of 'screening for fever' practice during the epidemics. (3)To provide evidence for related decision making. Methods Parameters in the model were collected from local hospitals and municapal CDC through interview,questionnaire survey,literature review and case analysis. A systematic dynamic model was built under similar studies. 'What if' analysis was used during the simulation process. Results (1)The mean duration between disease onset and hospital admission, rate of contacts of each infectious individual as well as the rate of contacts in hospital of each infectious individual appeared to be the key variables in the process of SARS transmission. (2)Physician's alertness/sense and practice of self protection on SARS,measures on quarantine and isolation to the patients,ventilation and disinfection process in the wards appeared to be the key variables for the control of epidemics. (3)'Screening for fever' practice on each patient at the entrance of the hospital did not seem to act as an important factor to the control of the epidemics. Conclusion The health system in Beijing can control SARS epidemic rapidly based on current applied disease control measures and plan.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2005年第3期159-163,共5页
Chinese Journal of Epidemiology
基金
国家"863"科技攻关课题资助项目(2003AA208412D)
