病媒蚊指數分析與登革熱防治：以臺北市2010-2015年為例

Abstract

摘要 背景：本研究旨在探討病媒蚊指數與登革熱防治的相關性。先以臺北市2010-2015 年為例，分析臺北市各行政區病媒蚊指數與登革熱疫情概況，再針對中正區的登革熱防治實務，探討登革熱防治相關策略並建置防疫網。 方法：以描述性流行病學方法，運用傳染病個案通報系統及傳染病防治資料整合系統，分析臺北市各行政區登革熱病媒蚊調查資料，以及登革熱通報陽性病例之流行病學趨勢。使用QGIS 2.6.1版及Google Earth Pro繪製病媒蚊分布圖及確診病例分布圖。 結果：從2010到2015的六年期間，臺北市登革熱陽性確診病例以境外移入居多 (311 例，佔70.1%)，本土病例相對較少 (133 例，佔30.0%)。中正區民眾的問卷調查發現，將近20%的居民不知該里有登革熱疫情。例行性的病媒蚊指數調查，多數僅限於地面街道與一樓住戶，高樓層的住戶往往拒絶讓防疫人員入內查核孳生源。另外，病媒蚊密度調查時，常只有衛生單位的人員，而無環保單位人員共同出隊，使得孳生源的清除時效受限。境外感染國家的前3名依序為馬來西亞、菲律賓及印尼。病媒蚊及確診病例的分布圖顯示，學校及市場是中正區登革熱病媒蚊存在的高危險地區。 結論：都會區的登革熱的防治，需強化預防性疫情監測及多元化防治病媒蚊策略深耕社區，包括強化第一線人員對疫情警覺性並及時通報，建構跨單位合作機制，爭取第一時間撲滅疫情，及提升社區自主管理之能力。

Background: The purpose of this study was to investigate the relationships between vector-borne mosquito index and dengue fever preventive measures. Taking Taipei City from 2010 to 2015 as an example, this study aimed to analyze the vector-borne mosquito index and dengue fever cases in each district of Taipei City, and then using Zhongzheng District as an example to explore the utility of practical preventive measures and establish an epidemic prevention network. Methods: Using descriptive epidemiological methods, the infectious disease case notification system and the infectious disease prevention data integration system were used to analyze the distribution of dengue vector mosquitoes in various administrative districts of Taipei and the epidemiological trends of positive cases of dengue fever. We then applied QGIS version 2.6.1 and Google Earth Pro to map the distribution of vector mosquitoes and the distribution of confirmed cases. Results: From 2010 to 2015, the majority of confirmed dengue fever cases in Taipei City was imported from abroad (n = 311, 70.1%), whereas domestically acquired cases comprised only a minority (n = 133, 30.0%). The results of questionnaire among residents of Zhongzheng District revealed that about 20% of residents were not aware of the dengue fever epidemics in their neighborhood. The conduct of routine vector mosquito index surveys were mostly limited to the road planes and first-floor households, whereas the residents of the high-floor household tended to not let in the inspection team. Furthermore, the inspection of the vector mosquito density was typically conducted solely by the personnel of health sectors, not accompanied by the personnel of environmental protection sectors, which tended to render the cleaning of the vector sources less timely. The top three countries from which the imported dengue fever cases were infected were Malaysia, the Philippines, and Indonesia. The mapping of the distribution of vector mosquitoes and confirmed cases in Zhongzheng District indicated that schools and markets were high-risk areas for dengue fever. Conclusions: Successful preventive measures of dengue fever in a metropolitan area need to deepen the community with preventive epidemic monitoring and diversified prevention and control of vector mosquitoes using a multifaceted approach, including strengthening the first-line personnel's alertness to the epidemic situation and timely report, constructing a cross-unit cooperation mechanism, striving to fight the epidemic in the first time, and enhancing the ability of the community to manage the prevention independently.