云南陇川县疟疾流行基线调查分析

Baseline investigation of malaria prevalence in Longchuan County, Yunnan Province

目的 了解掌握陇川县疟疾流行程度与防治状况,为全球基金疟疾控制项目实施的效果评价提供依据。 方法 按《全球艾滋病、结核病和疟疾基金中国高传播区疟疾控制项目管理与技术方案》中的"疟疾基线调查技术方案"对陇川县的赛号乡、姐乌乡、城子镇进行疟疾流行程度、防治措施、居民疟疾防治知识等调查。 结果 陇川县、乡、村三级网络基本健全,基本能够开展疟疾病源监测工作。发热病人疟原虫血片镜检阳性率县级、乡级分别为11.58％、2.90％;疟疾病人规范化治疗率乡级59.85％,村级62.16％。当地居民疟疾知识知晓率仅为15.44％,中小学生疟疾知识知晓率29.67％。3个乡发热血检、处方和走访的实际疟疾发病数估算分别是255例、2445例、955例,是原疫情报告数的1.67倍、16倍、6.24倍。疫情漏报率估算分别为43.50％、93.75％、84.93％。 结论 陇川县疟疾流行势态仍然严重,必须进一步加强乡村防保人员疟疾技术培训和乡卫生院显微镜镜检设备,增强当地居民疟疾防治知识意识,规范疫情管理制度和疟疾正规治疗方案。

Objective To understand the situation of malaria transmission and control in Longchuan County, provide evidences for effective evaluations of the global fund for malaria control program and reduce malaria incidence rate in Longchuan County. Methods According to the technique procedures of malaria basis-line investigation from the malaria control program management and technique procedures in the high endemic areas of China for the global fund to fight AIDS, tuberculosis and malaria, a large scale investigations or local malaria tranismision,control measures and resident knowledge of malaria control were carried out in Saihao,Jiewu and Chengzi towns of Longchuan county. Results The three-level health-nets for county, town and village in Longchuan were almost sound, and could carry out the monitor work on malaria parasite. The malaria postitive rates of blood slides microscopy examination of febrile patients in the county-and town-level were 11.58% and 2.90% respectively; the normalized treatment rate of malaria patient in town-level was 59.85% and 62.16% for village-level.The rate of local resident for malaria knowledge was only 15.44% and 29.67% for the middle and primary school students.The estimate number of actual malaria infections from the febrile blood microscopy , prescription and visiting surveys in three selective towns were 255,2 445 and 955 respectively; the estimated missing report rates of cases were 43.50 % , 93.75 % and 84.93 % respectively; and 1.67,16 and 6.24 times for the original epidmic report number. Conclusion Malaria is still prevalent in Longchuan County. The techniqnes in diagnosis and treatment of malaria at township and village level be enhanced through training and microscopy equiqment be supplied, malaria knowledge be spread and management of infections be standardized.