摘要
目的 对2003-2013年杭州市境外输入性疟疾报告病例流行病学特征进行分析,为制定防治措施提供依据。方法 根据《疟疾诊断标准》（WS259-2006）,以血片镜检找到疟原虫为实验室确诊依据,收集确诊病例个案调查表,结合年报表和网络报告等资料,对病例的人群、地区、时间分布,感染来源及诊治情况进行描述性分析,并比较间日疟和恶性疟患者在人群、时间分布上的差异。结果 杭州市2003-2013年共报告境外输入性疟疾病例147例,其中,恶性疟108例,占73.47%,间日疟39例,占26.53%;患者平均年龄为（37.6±11.5）岁,以20~49岁青壮年为主,占81.63%（120/147）;发病人群主要为男性,占91.84%（135/147）,且男性恶性疟的感染率（95.40%）显著高于间日疟（82.10%）（χ2=5.120,P=0.024）;发病人群主要为劳务输出人员,占42.18%（62/147）,恶性疟和间日疟在职业构成上差异有统计学意义（χ2=14.468,P=0.006）;感染地为非洲的占76.87%（113/147）,东南亚的占23.13%（34/147）;全年各月均有病例发生,5月份和8~10月份出现2个发病高峰,占全年发病数的41.50%（61/147）,恶性疟与间日疟患者在发病时间分布上差异无统计学意义（χ2=7.724,P=0.738）;间日疟从发病到确诊的时间明显高于恶性疟（t=2.23,P=0.03）,外地转入杭州诊治恶性疟的患者数明显高于间日疟（χ2=4.69,P=0.03）;省级医疗单位的检出率为94.0%,县级及以下医疗单位的检出率仅为26.7%。结论杭州市境外输入疟疾病例以来自非洲的境外劳务输出人员为主,基层人员恶性疟镜检能力薄弱,因此应加强多部门合作,积极开展境外劳务输出人员的主动监测及健康教育,提高基层医疗单位人员疟疾诊治能力,这是实现杭州市消除疟疾目标的关键。
Objective To analyze the epidemiological features of imported malaria cases reported from 2003 to 2013 in Hangzhou, so as to provide evidence for disease prevention and control. Methods Data of laboratory-confirmed cases of malaria imported overseas were collected and analyzed in terms of epidemiological features from 2003 to 2013. Results A total of 147 imported cases of malaria were reported during the ten year period, 108 （73.47%） were P. falciparum infected cases and 39 （26.53%） were P. vivax infected ones. The average age was 37.6 ± 11.5 years old and majority of cases were young adults, accounting for 81.63% （120/147）. 91.84% （135/147） cases were males. The infection rate of P. falciparum （95.40%） was significantly higher than that of P. vivax （82.10%） among male cases （X2=5. 120, P = 0. 024）. Almost half （42.18%） of malaria cases were those previously exported for labor services. There was significant difference of occupational structure between cases with P. falciparurn and P. vivax （X2 = 14. 468, P=0. 006）. 76.87 （113/147） of cases were imported from Africa, and 23.13% （34/147） were from Southeast Asia. 41.50% of cases appeared in May and August to October. The median time from disease onset to diagnosis of P. vivax was obviously longer than that of P. falciparurn （t= 2.23, P= 0. 03）. The number of cases with P. falciparum who were transferred to Hangzhou for diagnosis and treatment were higher than those of Plasmodiurn vivax cases （？（2= 4.69, P= 0.03）. The detection rate was 94.0% in provincial level health centers, while it was only 26.70% in health institutes with lower levels. Conclusions Majority of imported cases of malaria in Hangzhou are individuals exported to Africa for labor services. Multi-department cooperation, active monitoring of exported individuals and health education as well as improving diagnostic ability of medical stuff are important ways to eradicate malaria in Hangzhou.
出处
《中国预防医学杂志》
CAS
2015年第4期279-282,共4页
Chinese Preventive Medicine
基金
杭州市医学重点学科项目
关键词
疟疾
境外输入性
防控
Malaria
Imported
Prevention and control
作者简介
金行一，大专，主任技师，主要从事疟疾实验室诊断与防治研究
通讯作者：朱素娟，E-mail：zsj064@163．com
