CT s42013067

Tie khda: Sol xudt huyet Dengue SXHD, mudi Aedes, ca binh, tu vong, ca mdc.. Bgnh Sdt xuat huyet Dengue SXHD li bgnh luu hinh d cic vung nhiet ddi, can nhigt ddi teen toin the gidi.. Tai

SO SANH S 6 CA M A C V A T C VONG DO SOT X U A T HUYET DENGUE

TAI VIET NAM N A M 2011 vA 2012 SO S A N H Vdl

TRUNG BINH 5 N A M 2006-2010

Le Trung Kien', Tran Thanh Dirffng', Nguyen Van Binh', Nguyen Ddc Khoa^ Le HSng Nga', Phan Thj Humg', Dinh Hii Llnh', Nguyin Minh Hing', Nguyen Thj Lien Hirffng*

T6m tit

Binh SXHD cd dien biin tdng gidm theo chu fcy 5 ndm vd luu hdnh phi biin a Viet Nam, tap trung a cdc linh dong bdng sdng Ciru Long, ding bdng Bdc bo vd vimg ven biin miin Trung vd khu vuc Tdy Nguyen Tgi Viit Nam, ndm 2012 ghi nhdn 86.026 Irudng hgp mac, 80 truang hap til vong, si ca mdc vd Id vong ndm 2011 Id 69.878 ca mdc vd 61 trudng hgp lu vgng So vdi ndm 2011, si mdc Idng 23,1% , lit vong tang 19 truang hgp (31,1%) So vdi Irung binh giai dogn 5 ndm 2006-2010, si mdc cd nuac ndm 2012 gidm 16,1%: lit vong gidm 10 Irudng hgp (11,3%) Sd mdc vd Id vong tap trung chu yiu tgi khu vuc miin Nam (67.852/61), chiem 78,9% so mdc vd 76,3% sd lit vong cda cd nudc Ty li binh nhdn trin 15 tudi mdc sot xudt huyil ndm 2012 cao han so vdi Irung binh giai dogn 2006-2010 a khu vuc miin Bdc, miin Trung, miin Nam, riing khu vuc Tdy Nguyen ty le benh nhdn > 15 tuii tuang duang so vdi trung binh 5 ndm tit 2006-2010

Tie khda: Sol xudt huyet Dengue (SXHD), mudi Aedes, ca binh, tu vong, ca mdc

1 B^T VAN Dfe

Bgnh Sdt xuat huyet Dengue (SXHD) li bgnh luu hinh d cic vung nhiet ddi, can nhigt ddi teen toin the gidi Benh SXHD gay ra bdi vi rut hg Flaviviradae dugc lay lan bdi mudi Aedes Nam 2012, bgnh SXHD tilp tuc diin bien phdc tap tai khu vuc Nam My, Tay Thii Bmh Duong, diin hinh mgt sd nudc cd s6 ca mic SXHD tang cao nhu: Uc tang 2 lan, Cam phu chia ting 2,6 lin, Lio tang 2,5 lin, Malaysia tang 10%, Philippin tang 29,7% so vdi cimg

ky nim 2011 [3]

Tai Viet Nam, bgnh SXHD cd diin bien ting giam theo chu ky 5 nam vi luu hinh phd bien d Vigt Nam, tip trung d cac tinh ddng bang sdng Cuu Long, ddng bang Bac bg vi vimg ven biln miin Trung va khu vuc Tay Nguyen[10] Theo nien giam thdng ke bgnh truyin nhilm cua Bg Y tl, bgnh SXHD la mgt trong 10 bgnh cd ty le mic va tu vong cao nhit Dinh gia t^ Ig mic/chit do SXHD va xu hudng trong nhimg nam gin diy dl dl xuit du bio, nhin dinh diin biln tinh hinh va dl ra cic bign phip phdng chdng higu qui li rit can thilt cho chuong trinh phdng chdng SXHD Vigt Nam [10]

'Vien Sot r«-KST-CT Tir

'CvicYt^dirph6ng, B^Yt4

2 D 6 I Tir<?NG VA PHirofNG P H A P NGHlfiN COtJ

2.1 Doi tugng, dja dilm, thdi gian nghiSn cuu

Thong kd tit ci cic ca mic vi cic tiirdng hgp td vong do SXHD tai Vi$t Nam tti nim

2006 din nim 2012

2.2 Phuong phip nghiSn cihi

Nghidn ciru hoi cdu so li$u b^nh s6t xuit huylt td nim 2006-2012 vi phin tich md

t i s6 ligu

So ligu thu thip vi phin tich trdn ca sd bio cio ting kit cua cua cic Vign V^ sinh Djch tl/ Pasteur vi bio cio cua 63 tinh/ thinh phi vl so ca mic.chlt, s6 li^u giim sit

huylt thanh, giim sit vie to theo quy djnh bio cio cda Bd Y te (Hudng din giim sit, vi

phdng chdng SXHD ban hinh kim theo Quylt djnh sd 1499/QD-BYT ngiy 17/5/2011 eua

Bg trudng Bd Y tl) Phan tich vi xd 1^ so ligu bing phin mIm Epi Info

3 KET QUA VA BAN LUAN

3.1 So mae vi tir vong do sot xuat huyet:

fl si mic, tif vong do sit xuit huyit cd nudc ndm 2012

TT

Ci nudc

Mien Bic

Mien Trung

Mien Nam

Tiy Nguyen

Nim 2012

M

86.026

2.007

(2,3%)

14.275

(16,6%)

67.852

(78,9%)

1.891

(2,2%)

C

80

0 (0%)

17 (21,2%)

61 (76,3%)

2 (2,5%)

Nim 2011

M 69.878 5.378

3.421

60.596

483

C

61

0

2

59

0

So vdi ciing

ky nim

2011

M (%)

• H 2 3 , l

-62,7

+317,3

•H2,0

+291,7

C + 19

0

+15

+2

+2

Trung binh

5 nim

2006-2010

M 102.527 6.968

15.136

76.838

3.586

C

90

1

10

77

2

So vdi ciing kyTB 2006-2010

M (%) -16,1 -71,2

-5,7

-11,7

-47,2

C -10 -1

+7

-16

0

Ghi chit: M- so mdc vd ly If mdc, C: so ca tic vong (chit)

So vdi nim 2011, sd mic ting 23,1% , tu vong ting 19 tiirdng hgp (31,1%) Khu vvrc miin Trung vi Tay Nguyen ghi nhan sd mic vi td vong ting cao so vdi nam 2011 (Miin

Trung: sd mic ting 317,3%, tit vong tang 15 tiirdng hgp; Tiy nguyen: so mic tang 291,7%, tiJt

vong ting 2 tiirdng hgp) Cd 39 Hnh/fliinh phd teen ci nudc ghi n h ^ sd mic ting so vdi cdng

So vdi trung binh giai doan 5 nim 2006-2010, sd mic ci nudc nim 2012 giam 16,1%;

td vong giim 10 trudng hgp (11,3%) Cic khu vuc dlu ghi nhin sl mic sot xuit huylt giim, ri&ig khu vuc miin Trung, s6 td vong nim 2012 ting cao hem so vdi tiimg binh 5 nim

2006-2010 li 7 trudng hgp (17/10) Nim 2012, cd 17 tinh/thanh pho cd so mic ting so vdi tiimg bmh giai doan 2006-2010: Miin Bic (8/28), miin Trung (3/11), miin Nam (6/20)

- ^ — - TB 0 « dofn 2006-2010

Biiu do 1: Phdn bo so mdc theo thdng cda cd nudc ndm 2012 so vdi ndm 2011 vi

trung binh giai dogn 2006-2010

a Diin Men si mac theo thing nam 2012, 2011 va TB giai dogn 2006-2010

14000

12000

10000

8000

6000

4000

2000

0

^ % ^

—^v ^^^

1B2DOS-2010

«?• ,tf'^^,t/,i/.cf^ fxf^f^y

-•—TBICWWOIO

Khu vyc miin Nam: s6 mic vi td vong nim

2012 ting so vdi nim 2011 (sd mic ting 12%

vi tii vong ting 2 trudng hgp), giim so vdi

tning binh giai doan 2006-2010 (sd mic giim

11,7%, til vong giim 16 tiirdng hgp)

Khu vuc miin Trung: sd mic vi tu vong nam 2012 tang so vdi nim 2011 (tu thing 3

vi cao hon so vdi tnmg binh giai doan 5 nim vao cic thing cudi nim (thing 11,12), die biet tai cic tinh/thinh phd: Khinh Hda,

70 S6 4-2013 TAP CHi P H 6 N G C H 6 N G BgNH S6T RJT vA CAC B|NH KY SINH TRPNG

600

400

200

0

- • - - T B 2 0 0 M 0 1 0

- 2 0 1 3 - -• - 1 3 200^2010

Khu vyc Tay Nguyen: s6 mdc vd tir vong Khu vyc nii^n BSc: ndm 2012 ghi n h ^ so tdng so v6i ndm 2011, nhung gidm so v6i mdc va tii vong gidm so vdi ndm 2011 vd trung binh giai doan 5 ndm 2006-2010 trung binh giai doan 5 ndm 2006-2010 3.2 Phan bo so mdc theo nh6m tuoi

Ty 1? b?nh nhan tren 15 tuoi mdc sot xuat huyet nam 2012 cao hem so vdi trung binh giai doan 2006-2010 a khu vuc miin Bdc, miin Trung, mien Nam, rieng khu v\rc Tay Nguyen ty

le b$nh nhan > 15 tuoi tucmg duong so vcri trung binh 5 nam tir 2006-2010

Mik

BacTB

2006-2012

Mik

Bao

2012

MiSn Trung

TB

2006-2012

MiJn Trung

2012

M i ^ Nam

2006-2012

M i ^ Nam

2012

Tly U y Nguyfin Nguyftn 2006- 2012

2012

• > 15 hioi • < 15 tuli

Bieu di 2: Phan bo ty If mic sit xuit huyit Dengue theo tuii nam 2012 vi trung binh giai

dogn 2006-2010

3.3 Phan bo theo mdc dg lam sing ca b^nh

Nam 2012, so trudng hgp mic sot xuit huylt Dengue vi sdt xuit huylt Dengue cd diu hieu canh bao chilm 92,9% tdng sd mic, cao hon so vdi cung ky nim 2011 la 90,0%; so trudng hgp mic sdt xuit huylt Dengue nang chilm 7,1% tong sd mic, giim so vdi cung ky nam 2011 la 10,0%); cic tiirdng hgp tu vong deu do mic sot xuit huyet Dengue njng

Bieu di 3: Phin bi ty If mic SXHD nam 2012 theo mirc dg lim sing

3.4 Phan tich cac trudng hgp tu vong do sot xuat huyet:

Tich luy nam 2012, ci nudc ghi nhin 80 trudng hgp tu vong do sit xuit huylt tai 24 tmh/thinh phd, so vdi cung ky nim 2011 (61 trudng hgp), sd tu vong ting 19 trudng hgp (31,1%) So vdi trung binh 5 nim giai doan 2006-2010, so tu vong giam 10 trudng hgp (80/90) Sd ca tu vong xuit hidn d nhieu tinh/ thanh phd va tap trung d nhirng tinh cd nguy co SXHD cao, die bi6t khu vuc mien Nam va mien Trung Phan bo cu the nhu sau:

- Theo khu vyc:

+ Khu vuc miin Nam: 61 teudng hgp (Ddng Nai: 10, TP HCM: 07, Binh Duong: 07, Bmh Phudc: 06, Ddng Thip: 06, Tay Ninh: 06, Long An: 04, An Giang: 03, Kien Giang: 02, Tiln Giang: 02, Soc Trang: 01, Bac Lieu: 01, Ba Ria Viing Tau: 01, Bin Tre: 01, Ci Mau: 01, Hau Giang: 01, Tri Vinh: 01)

Ty le chlt/mic: 0,090%

+ Khu vuc miin Trung: 17 trudng hgp (Khanh Hda: 05, Binh Dinh: 05, Binh Thuan:

04, Phu Yen: 02, Da Ning: 01) Ty le chlt/mic: 0,119%

+ Khu vuc Tiy Nguyen: 02 trudng hgp (Gia Lai) Ty le chet/mSc: 0,106%

- Tuoi: < 15 tudi: 53 trudng hgp (66,3%); >15 tuli: 27 trudng hgp (33,7%)

- Gidi: Nam: 23 teudng hgp (28,8%),Nu: 57 trudng hgp (71,2%)

- Phan do lam sing: SXHD ning: 80 trudng hgp (100%)

- Thdi gian dieu trj:

+ Khdi phit - Nhip vien: 38 tiirdng hgp dlu nhip vien mudn (>3 ngay), 42 trudng hgp

nhip vien sdm (1-3 ngay)

+ Nhap vign - Td vong: 25 trudng hgp id vong sau 1 ngay, 47 tiirdng hgp id vong teong

+ Thdi gian tu khi khdi phit - tilr vong: 57 trudng hgp td vong teong tuin dau, 20 tindog hgp td vong trong tuan thir 2,03 trudng hgp tir vong teong tuin thd 3 kl td khi khdi phit bgnh

- Noi tu vong:

+ 14 tiirdng hgp td vgng tai BV Nhi Dong 1 & 2,15 trudng hgrp tii vong tai BV BND TP HCM, 39 trudng hgp tu vong d BVDK vi BV Sin Nhi tinh, 12 hudng hgp tir vong tai BV tuyin qu§n/huygn

4.BAN LUAN

Nim 2011- 2012, bgnh SXHD cd diu hi$u gia ting t^ nhilu nudc tiiugc khu v\rc Nam Mji, Tiy Thii Binh Duong Thee sg ligu cic b$nh truyin nhilm nim 2012 cua To chdc Y tl thi gidi, cd 6/7 nudc frong khu v\rc Tay Thii Binh Duong ghi nh|in so mic sdt xuat huylt ting cao so vdi nim 2011 (Cam pu chia: 2,7 lin, Lio: 2,6 lin, Uc: 1,8 lin, Philipm: 1,4 lan, Vigt Nam: 1,2 lin, Malaysia: 1,1 lin) Tai Vi$t Nam, bgnh sot xuat huylt teong nim 2012 sl mic va so tu vong ting ban so vdi nim 2011 Kit qui niy phin inh xu hudng gia ting b ^ SXHD khdng ehi d Vigt Nam ma xuit hign nhilu nudc cd nguy co SXHD

5 K £ T LUAN

Nim 2012, ci nudc ghi nhan 86.026 trudng hgp mic, 80 trudng hgp tii vong do sit xuit huyet, tang so vdi nim 2011 vi giim so vdi trung binh giai doan 5 nim 2006-2010 So mic vi

tu vong tap nung chd ylu tai khu vuc miin Nam (67.852/61), chilm 78,9% so mic va 76,3%

sd tu vong cua ca nudc Khu vuc miin Trung ghi nhan so mic ting cao so vdi nim 2011, die biet vao cic thing cudi nim Trong sd cac tiirdng hgp mic, SXH Dengue vi SXH Dengue cd diu hieu canh bio la chu ylu (92,9%), ti le SXH Dengue ning giim so vdi nim 2011 Trong

sd cac trudng hgp tii vong, da sd thugc nhdm <15 mdi (66,3%) vi gidi nd (71,2%) Nim 2012

van ghi nhan chi sd giim sat vie to d muc cao d nhilu tinh miin Nam, noi cd sd mic vi tu

vong do SXHD cao nhit ci nudc

T A I LIJ&U T H A M K H A O

1 WHO (2005), "International health Regulation (IHR)

2 BQ Y tl, Bdo cdo tdng kit tinh hinh sSt xudt huyit Dengue ndm 2009, 2010, 2011 2012 Die dn Phdng ehdng sot xudt huyit Qude gia

3.WHO report, DengueSituationUpdates,

http://wvvw.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/index.html

4 BQ Yte(2011) "Hudng ddn gidm sdt vd phdng chong sdt xudt huyit", Trang 1

5 WHO (1999) "Prevention and control of Dengue and Dengue Haemorrhagic Fever", pp 4-10

6 Nguyen Thi Kim Ti6n, Nguyen Trpng T o ^ (2000), "Phan tich mpt s6 dSc dilm dich te vh

cdc trufmg hpp tir vong do b^nh s6t xuit huylt Dengue tai khu vuc phia Nam trong

nam 1999", Tgp ehi Yhgc du phdng, Tfip 10, S6 3, Trang 83-87

7.Trinh Quan Huan, Vu Sinh Nam, Nguyin Van Biln (1998), "S6t Dengue/S6t xu4t huyet

Dengue 6 mpt so tinh mien Nam-Thuc trang, nguyen nhan va giai phap", Tgp chi Y hoe du phdng, tap 13, So 2, Trang 125

8 Phan Trpng Lan (2009), "Nghien cuu cac trucmg hpp tu vong do sot xuat huyet tai Vipt

Nam nam 2007", Tgp chi Yhgc diiphong Tap 14, So 3, Trang.8

9 Vu Sinh Nam, T r k Dac Phu, Vu Him Viet, Do Due Luu (2001), "Mot s6 dac dilm dich tl

b6nh s6t Dengue/s6t xuit huylt Dengue tai Nam Ha, 1991-2000", Tgp ehi Y hgc thuc hdnh So 5

10 Phan Trpng Lan, Nguyen Van Binh, Pham Hirng, Nguyin Thi Kim Tiln (2011), "Mot s6 dac dilm dich tl hpc benh s6t Dengue/s6t xuat huyet Dengue giai doan 2006-2010 t^

Viet Nam", Tgp chi Y hoc Viet Nam, S6 1

A RETROSPECTIVE STUDY ON DENGUE FEVER IN VIETNAM DURING 2011-2012 COMPARED TO THE AVERAGE DURING

THE PREVIOUS 5 YEARS (2006-2012)

Le Trung Kien*, Tran Thanh Duong', Nguyen Van Biah^ Nguyen Due Khoa' ,Le Hang Nga^ Phan Thi Huong', Dinh Hai Linh', Nguyen Minh Hang', Nguyen Thi Lien Huong^

Dengue is a disease with periodic epidemic cycles at 5-year Intervals, ll is endemic in Vietnam, particularly in Cuu Long Delta river Red Delta river Central coastal and Central Highland The study has retrospectively investigated all cases and deaths in Vietnam with results indicated In 2012, there were 86,026 confirmed infected cases and 80 death cases which were higher Ihan that of the year 2011 (61/69.878) Thus, the prevalence increased 32.1%, and Ihe mortality increased 31.1% in comparison with that in 2011 However, compared to the 5-year period of 2006-2010 these rales decreased 16,1% of prevalence and 11.3% of mortality Most of Ihe cases and deaths (67,852/61) occurred mainly

in the South of Vietnam, accounting for 78.9% of cases, and 76.3% of deaths nationwide The disease affected mainly children, but in recent years it is becoming more of an adult disease

In 2012, the percentage of adult patients of Dengue (>15 years) was higher than the average percentage of adult patients of Dengue in Ihe period 2006-2012 in Southern, Northern, Central, except Highland Central with the equivalent number

Keywords: Dengue fever, Aedes mosquitoes, case, deallh

C i n bg phin hi^n

TS Pham Thi Khoa

Ngdy nhgn bdi: 21/07/2012 Ngdy gdi phdn biin: 22/07/2013 Ngdy ddng bdi: 30/07/2013

' National Instiuite of Malariology, Parasitology and Entomology;

' General Department of Preventive Medicine, Ministry of Health