上海市消除疟疾后输入性疟疾监测响应系统实施与成效分析

Analysis on implementation and effectiveness of imported malaria surveillance⁃response system post⁃elimination in Shanghai

目的分析上海市消除疟疾后输入性疟疾监测响应系统的实施和工作成效,为持续维持消除疟疾状态、巩固消除疟疾成果提供科学依据。方法系统收集上海市疟疾监测响应相关的活动方案及其记录,基于国家传染病报告信息管理系统和寄生虫病防治信息管理系统中2017—2022年疟疾病例个案信息,使用SPSS 25.0软件进行统计学分析。结果2017—2022年上海市共报告疟疾病例281例,包括上海市户籍47例(16.7%,47/281)、外省籍215例(76.5%,215/281)和外籍病例19例(6.8%,19/281),均有境外疟疾流行区旅居史。报告病例均为境外输入性病例,主要来自几内亚(17.4%,49/281)、尼日利亚(14.2%,40/281)、刚果民主共和国(12.1%,34/281)等非洲国家。报告病例以恶性疟(83.3%,234/281)为主,报告地区主要为金山区(15.7%,44/281)、浦东新区(14.9%,42/281)和闵行区(11.7%,33/281)。2017—2022年上海市共血检106361人次,血检阳性率为3.3‰(353/106361),被动监测、人群主动侦查和病例线索追踪的阳性率分别为3.6‰(350/97917)、0.4‰(3/7828)和0(0/616)。病例1 d内网络报告率和1 d内复核率均为100%(281/281),2 d内流行病学调查率为90.0%(253/281),3 d内疫点调查处置率为100%(179/179),1个月内风险评估率为100%(281/281)。病例从发病到确诊时间间隔中位数为2 d(四分位数P25,P75:1 d,4 d)。共捕获传疟媒介按蚊2126只,均为中华按蚊,主要分布于嘉定区(31.6%,672/2126)、崇明区(24.9%,529/2126)等郊区。结论消除疟疾后上海市输入性疟疾监测响应系统运行良好,疫情处理规范、及时。

Objective To analyze the implementation and effectiveness of imported malaria surveillanceresponse system in Shanghai after malaria elimination,and to provide scientific basis for maintaining malaria postelimination status and consolidating the achievements of malaria elimination.Methods The activity plan and records related to malaria surveillanceresponse in Shanghai were systematically collected and sorted.The data of individual malaria case in 2017—2022 from webbased National Information System for Infectious Disease surveillance and National Information System for Parasitic Diseases Control and Prevention were analyzed using SPSS 25.0.Results From 2017 to 2022,a total of 281 malaria cases were reported in Shanghai,including Shanghai nationality(16.7%,47/281),other province nationality(76.5%,215/281)and foreign nationality(6.8%,19/281),all of them have the malariaendemic areas traveling experiences.All reported cases were imported from abroad,the mainly infection sources were African countries,such as Guinea(17.4%,49/281),Nigeria(14.2%,40/281)and the Democratic Republic of the Congo(12.1%,34/281).The reported cases were mainly falciparum malaria(83.3%,234/281)and mainly reported from Jinshan District(15.7%,44/281),Pudong New Area(14.9%,42/281)and Minhang District(11.7%,33/281).A total of 106361 blood tests were performed in Shanghai from 2017 to 2022,with a positive rate of 3.3‰(353/106361).The positive rates of passive case detection,proactive case detection and reactive case detection were 3.6‰(350/97917),0.4‰(3/7828)and 0(0/616),respectively.Malaria reported cases were mainly detected by passive monitoring(98.9%,278/281).All cases were reported in 24 hours after diagnosis and checked in 1 day after reporting,the rate of individual cases epidemiological investigation within 2 days was 90.0%(253/281),all foci were investigated and disposed within 3 days,and all cases were assessed in one month without transmission risks.The median time from the illness onset to confirmed diagnosis was 2 d(P25,P75:1 d,4 d).A total of 2126 Anopheles were captured,all of which were Anopheles sinensis.The mainly distribution areas were suburban districts such as Jiading District(31.6%,672/2126)and Chongming District(24.9%,529/2126).Conclusion The surveillanceresponse system of imported malaria was operated well in Shanghai after malaria elimination and the epidemic handling was standardized and timely.