2010–2017年湖南省郴州市输入性疟疾流行特征分析
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摘要
目的分析湖南省郴州市输入性疟疾流行特征,为巩固消除疟疾成果和制定输入性疟疾防控策略提供科学依据。方法收集2010–2017年郴州市输入性疟疾病例资料,对其流行特征进行统计分析。结果 2010–2017年郴州市报告疟疾病例46例,均为输入性疟疾病例,年均发病率为0.12/10万。报告的疟疾病例以恶性疟为主,占总病例数的60.87%。疟疾病例分布无明显季节性,6月报告病例最多。73.91%的疟疾病例集中在北湖区、苏仙区、桂阳县和资兴市。疟疾病例以中青年为主,69.57%的病例年龄分布在36~60岁,各年龄组疟疾患者分布差异有统计学意义(χ~2=47.80,P <0.01)。病例从发病到确诊间隔中位时间为6 d;病例确诊单位以市级及以上医疗机构为主,占总病例数的52.17%;各级医疗卫生机构确诊病例比例间差异有统计学意义(χ~2=41.96,P <0.01)。结论郴州市输入性疟疾疫情依然严峻。为巩固消除疟疾成果,应强化基层医疗机构疟疾诊治意识、加强发热患者疟原虫血检、加大疟疾防治知识宣传教育。
Objective To study the epidemiological characteristics of imported malaria in Chenzhou City, Hunan Province, so as to provide the reference for consolidating the malaria elimination and formulating the prevention and control strategies of imported malaria. Methods The epidemiological characteristics of imported malaria were statistically analyzed in Chenzhou City from 2010 to 2017. Results Totally 46 malaria cases, which were all imported, were reported in Chenzhou City from 2010 to2017, with an average annual incidence of 0.12/105. The reported malaria cases were mainly falciparum malaria, accounting for60.87% of the total number of cases. There was no obvious seasonal distribution of malaria cases, but the top of reported cases were in June. Totally 73.91% of malaria cases were concentrated in Beihu District, Suxian District, Guiyang County and Zixing City. These cases were mainly the young and middle-aged and 69.57% of the cases were from 36 to 60 years old. There was a statistically significant difference in the distribution of malaria patients among the age groups(χ~2= 47.80, P < 0.01). The median time from onset to diagnosis was 6 days, and the case confirmed institutions were dominated by municipal and above medical institutions, accounting for 52.17% of the total number of cases. There was a statistically significant difference in the proportion of confirmed cases among medical and health institutions at all levels(χ~2= 41.96, P < 0.01). Conclusions The importation of malaria in Chenzhou City is still severe. The awareness of malaria diagnosis and treatment in primary medical institutions, malaria patients' serum tests, and the health education of malaria control and prevention knowledge should be strengthened to consolidate the malaria elimination results.
Objective To study the epidemiological characteristics of imported malaria in Chenzhou City, Hunan Province, so as to provide the reference for consolidating the malaria elimination and formulating the prevention and control strategies of imported malaria. Methods The epidemiological characteristics of imported malaria were statistically analyzed in Chenzhou City from 2010 to 2017. Results Totally 46 malaria cases, which were all imported, were reported in Chenzhou City from 2010 to2017, with an average annual incidence of 0.12/105. The reported malaria cases were mainly falciparum malaria, accounting for60.87% of the total number of cases. There was no obvious seasonal distribution of malaria cases, but the top of reported cases were in June. Totally 73.91% of malaria cases were concentrated in Beihu District, Suxian District, Guiyang County and Zixing City. These cases were mainly the young and middle-aged and 69.57% of the cases were from 36 to 60 years old. There was a statistically significant difference in the distribution of malaria patients among the age groups(χ~2= 47.80, P < 0.01). The median time from onset to diagnosis was 6 days, and the case confirmed institutions were dominated by municipal and above medical institutions, accounting for 52.17% of the total number of cases. There was a statistically significant difference in the proportion of confirmed cases among medical and health institutions at all levels(χ~2= 41.96, P < 0.01). Conclusions The importation of malaria in Chenzhou City is still severe. The awareness of malaria diagnosis and treatment in primary medical institutions, malaria patients' serum tests, and the health education of malaria control and prevention knowledge should be strengthened to consolidate the malaria elimination results.
引文
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[10]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.
[11]王伟明,周华云,朱国鼎,等.江苏省疟疾疫情预警系统的建立VII消除疟疾哨点监测[J].中国血吸虫病防治杂志,2015,27(6):586-590.
[12]王伟明,周华云,刘耀宝,等.江苏省疟疾疫情预警系统的建立V输入性恶性疟防控体系的构建[J].中国血吸虫病防治杂志,2015,27(4):359-361.184
[13]Thwaites GE,Day NP.Approach to fever in the returning traveler[J].N Engl J Med,2017,376(6):548-560.
[14]朱东山,葛军,朱刚,等.疟区发热病人易患疟疾的危险因素分析[J].中国热带医学,2012,12(4):452-455.
[15]曹俊,周水森,周华云,等.中国疟疾从控制走向消除——消除阶段的目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):439-443.
[16]汤林华.我国消除疟疾的关键策略:线索追踪,清点拨源[J].中国热带医学,2017,17(5):431-434.
[2]朱韩武,李灯华,朱维明,等.湖南省郴州市2003-2012年疟疾流行特征及监测效果研究[J].中国媒介生物学及控制杂志,2014,25(2):139-141.
[3]庄世锋,何卓,李正祥,等.湖南省2011-2013年疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2014,32(6):483-484.
[4]张滔,许娴,姜静静,等.安徽省输入性疟疾疫情流行特征及重症病例影响因素分析[J].中国血吸虫病防治杂志,2017,29(6):704-709.
[5]张学艳,孙伯超.2011-2015年盐城市输入性疟疾疫情分析[J].中国血吸虫病防治杂志,2017,29(6):746-748.
[6]鲁琴宝,吴晨,吴昊澄,等.2007-2016年浙江省境外输入性疟疾流行特征分析[J].中华地方病学杂志,2017,36(12):902-906.
[7]贾从英,王伟明,杨文洲,等.淮安市输入性恶性疟流行现状与特征分析[J].中国血吸虫病防治杂志,2017,29(5):632-634.196
[8]朱韩武,李成华,段良松,等.2013-2014年郴州市传疟媒介按蚊种群和密度调查分析[J].社区医学杂志,2015,13(17):25-27.
[9]高琪.我国消除疟疾面临的机遇与挑战[J].中国血吸虫病防治杂志,2011,23(4):347-349.
[10]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.
[11]王伟明,周华云,朱国鼎,等.江苏省疟疾疫情预警系统的建立VII消除疟疾哨点监测[J].中国血吸虫病防治杂志,2015,27(6):586-590.
[12]王伟明,周华云,刘耀宝,等.江苏省疟疾疫情预警系统的建立V输入性恶性疟防控体系的构建[J].中国血吸虫病防治杂志,2015,27(4):359-361.184
[13]Thwaites GE,Day NP.Approach to fever in the returning traveler[J].N Engl J Med,2017,376(6):548-560.
[14]朱东山,葛军,朱刚,等.疟区发热病人易患疟疾的危险因素分析[J].中国热带医学,2012,12(4):452-455.
[15]曹俊,周水森,周华云,等.中国疟疾从控制走向消除——消除阶段的目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):439-443.
[16]汤林华.我国消除疟疾的关键策略:线索追踪,清点拨源[J].中国热带医学,2017,17(5):431-434.