2015-2017年山东省输入性疟疾的流行病学分析
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摘要
目的了解山东省输入性疟疾流行病学特征,为制定有针对性的防控策略和措施提供科学依据。方法收集2015-2017年山东省疟疾疫情资料及疟疾病例个案调查资料,采用SPSS 18.0统计学软件对疟疾病例诊断情况及流行特征进行统计分析。结果2015-2017年山东省共报告输入性疟疾病例676例,其中境外输入675例(99.85%),省外输入1例(0.15%); 96.75%(654/676)的病例由非洲输入,主要来自赤道几内亚(143例, 21.87%)和安哥拉(85例, 13.00%)。所有病例均为实验室确诊病例,其中恶性疟514例(76.04%)、间日疟66例(9.76%)、卵形疟76例(11.24%)、三日疟20例(2.96%)、无混合感染病例。报告病例中发病当日就诊的195例(28.85%),超过3 d就诊的258例(38.17%);初诊被诊断为其他疾病的214例(31.66%)。病例首诊确诊的253例(37.43%),超过3 d确诊的222例(32.84%)。经省级疾病预防控制中心复核,病例报告单位对网报的恶性疟、间日疟、卵形疟和三日疟病例的虫种判定准确率分别为97.49%(504/517)、 67.86%(57/84)、90.91%(50/55)和11/12。65例重症病例当日就诊率和首诊确诊率分别为26.15%(17/65)和27.69%(18/65)。按报告地分,全省17个市均有病例报告,其中济宁、泰安、威海、烟台、青岛和济南等6市共报告502例,占全省总报告病例数的74.26%。按现住址分,全省17个市均有输入性病例分布,其中泰安、烟台、威海、济宁和青岛等5市共报告病例401例,占全省总报告病例数的59.32%。病例以青壮年男性为主;年龄最小16岁,最大65岁,年龄中位数为41岁;职业以农民为主(422例, 62.43%)。结论2015-2017年山东省报告的输入性疟疾病例数为676例, 96.75%由非洲输入,当日就诊率和首诊确诊率均较低。
Objective To understand epidemiological characteristics of malaria cases reported in Shandong Province, so as to provide scientific evidence for better prevention and control of malaria. Methods The data of malaria reported in Shandong Province during 2015-2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention, and the clinical manifestations of malaria cases were collected and statistically analyzed by SPSS 18.0. Results Among676 malaria cases reported during 2015-2017, 99.85%(675/676) were imported and most of them were imported from African countries(96.75%, 654/676), mainly from Equatorial Guinea( 143, 21.87%) and Angola( 85, 13.00%).All cases were laboratory confirmed with 76.04% of Plasmodium falciparum infection and 9.76% of P. vivax infection. About 1/4 patients(28.85%, 195/676) went to visit doctor on the first day with symptoms, while 38.17%(258/676) of patients went to visit doctor three or more days after they had symptoms. About 1/3 of patients were diagnosed as malaria at the first doctor visit(37.43%, 253/676) and 1/3 misdiagnosed as other diseases(31.66%,214/676), and another 1/3 were diagnosed as malaria 3 days after the first visit(32.84%, 222/676). The accuracy for diagnoses of P. falciparum, P. vivax, P. ovale and P. malariae infections were 97.49%(504/517), 67.86%(57/84),90.91%(50/55) and 91.67%(11/12), respectively, after being re-confirmed by provincial experts. Among 65 severe malaria patients only 17 went to see doctor on the first day with clinical symptoms(26.15%) and 18 patients were diagnosed as malaria at the first visit(27.69%). 17 cities reported malaria cases during the period(2015-2017) and74.26%(502/676) of the total malaria cases were reported in 6 cities(Jining, Tai 'an, Weihai, Yantai, Qingdao and Jinan). The imported cases were reported in all 17 cities and most of them(59.32%, 401/676) distributed in 5 cities(Tai'an, Yantai, Weihai, Jining and Qingdao). More young and middle-aged men were infected. The minimum age was 16 years old, the maximum age was 65, and the median age was 41 years old. They were mainly peasants( 422, 62.43%). Conclusions Total 676 malaria cases were reported in Shandong Province during 2015-2017 and96.75% of them were imported from Africa. The rates for going to see doctor on the first day with clinical symptoms and the accurate diagnosis with malaria on the first visit were low.
Objective To understand epidemiological characteristics of malaria cases reported in Shandong Province, so as to provide scientific evidence for better prevention and control of malaria. Methods The data of malaria reported in Shandong Province during 2015-2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention, and the clinical manifestations of malaria cases were collected and statistically analyzed by SPSS 18.0. Results Among676 malaria cases reported during 2015-2017, 99.85%(675/676) were imported and most of them were imported from African countries(96.75%, 654/676), mainly from Equatorial Guinea( 143, 21.87%) and Angola( 85, 13.00%).All cases were laboratory confirmed with 76.04% of Plasmodium falciparum infection and 9.76% of P. vivax infection. About 1/4 patients(28.85%, 195/676) went to visit doctor on the first day with symptoms, while 38.17%(258/676) of patients went to visit doctor three or more days after they had symptoms. About 1/3 of patients were diagnosed as malaria at the first doctor visit(37.43%, 253/676) and 1/3 misdiagnosed as other diseases(31.66%,214/676), and another 1/3 were diagnosed as malaria 3 days after the first visit(32.84%, 222/676). The accuracy for diagnoses of P. falciparum, P. vivax, P. ovale and P. malariae infections were 97.49%(504/517), 67.86%(57/84),90.91%(50/55) and 91.67%(11/12), respectively, after being re-confirmed by provincial experts. Among 65 severe malaria patients only 17 went to see doctor on the first day with clinical symptoms(26.15%) and 18 patients were diagnosed as malaria at the first visit(27.69%). 17 cities reported malaria cases during the period(2015-2017) and74.26%(502/676) of the total malaria cases were reported in 6 cities(Jining, Tai 'an, Weihai, Yantai, Qingdao and Jinan). The imported cases were reported in all 17 cities and most of them(59.32%, 401/676) distributed in 5 cities(Tai'an, Yantai, Weihai, Jining and Qingdao). More young and middle-aged men were infected. The minimum age was 16 years old, the maximum age was 65, and the median age was 41 years old. They were mainly peasants( 422, 62.43%). Conclusions Total 676 malaria cases were reported in Shandong Province during 2015-2017 and96.75% of them were imported from Africa. The rates for going to see doctor on the first day with clinical symptoms and the accurate diagnosis with malaria on the first visit were low.
引文
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[18]Feng J,Xiao H,Zhang L,et al.The Plasmodium vivax in China:decreased in local cases but increased imported cases from Shoutheast Asia and Africa[J].Sci Rep,2015,5:8847.
[2]王用斌,孔祥礼,张本光,等.2012年山东省疟疾疫情流行病学特征分析[J].中国血吸虫病防治杂志,2013,25(6):618-622.
[3]孔祥礼,赵长磊,卜秀芹,等.2013年山东省疟疾疫情分析及防控策略探讨[J].中国血吸虫病防治杂志,2014,26(4):387-390,398.
[4]许艳,孔祥礼,赵长磊,等.2014年山东省疟疾疫情流行病学分析[J].中国血吸虫病防治杂志,2016,28(1):30-33.
[5]孔祥礼,赵长磊,王用斌,等.山东省消除疟疾行动计划中期评估报告[J].中国热带医学,2016,16(4):311-316.
[6]Kong XL,Liu X,Tu H,et al.Malaria control and prevention towards elimination:data from an eleven-year surveillance in Shandong Province,China[J].Malar J,2017,16:55.
[7]张丽,丰俊,张少森,等.2015年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2016,34(6):477-481.
[8]张丽,丰俊,张少森,等.2016年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2017,35(6):515-519.
[9]Cao J,Sturrock HJ,Cotter C,et al.Communicating and monitoring surveillance and response activitise for malaria elimination:China’s“1-3-7”strategy[J].PLoS Med,2014,11(5):e1001642.
[10]夏志贵,丰俊,周水森.2012年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2013,31(6):413-318.
[11]张丽,丰俊,张少森,等.2017年全国消除疟疾进展及疫情特征分析[J].中国寄生虫学与寄生虫病杂志,2018,36(3):201-209.
[12]Liu Y,Sturrock HJW,Yang H,et al.The challenge of imported malaria to eliminating countries[J].Lancet Infect Dis,2017,17(2):141.
[13]杨维中,周晓农.中国在疟疾消除阶段面临的新挑战[J].中华预防医学杂志,2016,50(4):289-291.
[14]曹俊,刘耀宝,曹园园,等.中国消除疟疾的持续挑战:输入性疟疾[J].中国寄生虫学与寄生虫病杂志,2018,36(2):93-96.
[15]曹园园,王伟明,周华云,等.江苏省2014-2016年境外输入性疟疾病例诊断情况分析[J].中华流行病学杂志,2018,39(2):218-221.
[16]李忠杰.我国输入性疟疾流行特征与传播风险研究[D].北京:中国疾病预防控制中心,2016.
[17]周晓农,张少森,徐俊芳,等.我国消除疟疾风险评估分析[J].中国寄生虫学与寄生虫病杂志,2014,32(6):414-418.
[18]Feng J,Xiao H,Zhang L,et al.The Plasmodium vivax in China:decreased in local cases but increased imported cases from Shoutheast Asia and Africa[J].Sci Rep,2015,5:8847.
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