海南省消除恶性疟的可行性分析

Evaluation of feasibility in elimination of Plasmodium falciparum malaria in Hainan Province.

目的分析在海南省消除恶性疟的可行性。方法对海南省五十年的抗疟工作、防治效果及抗疟经验进行总结,分析目前的形势与条件、存在的困难与问题并提出相关的建议。结果海南省在国家和当地政府的重视和支持下,经过五十年的抗疟工作,已取得许多抗疟经验,如采取控制传染源、保护易感人群和防制蚊媒的综合性措施,建立健全县(市)、乡镇级疟防机构,以市县为单位实行地方与农林场的疟疾联防,重点加强血检站建设和疟疾的经常性管理等,取得了明显的防治效果。且海南省四周环海,所以分布于海南省的疟疾是相对孤立的,这为消除海南岛的恶性疟创造了较好的外部自然环境。另外,目前治疗抗药性恶性疟的药物又有了新的进展,青蒿素类与其他药物配伍,不仅提高了疗效,而且降低了成本,有利于贫困地区大面积使用,快速诊断技术日臻完善,而且价格低廉,为偏远贫困地区早期诊断和及时治疗提供了技术保证。结论有国家和当地政府的重视与投入的加大,又有全球基金和世界卫生组织的支持,加上日臻完善的疟疾防治技术,在海南省消除恶性疟不仅是非常必要的,也是可以实现的。

Objective To evaluate the feasibility of elimination of Plasmoudium falciparum malaria in Hainan Province, Methods To sum up the main achievements and experiences in malaria control in Hainan Province over a period of fifty years and analyse the present situation and conditions as well as the existed problems and proposals. Results With the support of national and local governments many good malaria control experiences and results were achieved in Hainan in the last fifty years, such as using integrated control measures with case - treatment and protecting susceptible inhabitants and vecter control, strengthening the malaria control institutions at county and township levels, combined control system between counties and farms, setting up blood examination station and case - management rule at township hospital, Hainan Island is isolated from the mainland which is the good natural condition for elimination of falciparum malaria. On the other hand, the new drugs as artemisinin - compounds is efficacious for the disease with low cost and is easy for use in poor area. In addition, cheap and rapid diagnostic methods with high sensitivity and specificity are very useful for the control activities in remote mountainous area. Conclusion To eliminate Plasmodium falciparum malaria in this island is not only practical but also can be realized with the support of government, WHO and global fund plus an increasingly improved and perfected prevention and control techniques.