云南省疟疾流行现状与防制对策

The Malaria Condition of Current Prevalence and Strategy for Control in Yunnan Province

近年云南省报告疟疾病例的县（市）达110个，年病例数在1．2～1．6万，而漏报率高达8倍左右。N22°～24°及高黎贡山西侧是主要流行区，海拔1500米以下发病率高、恶性疟比重大。每年均有以自然村为单位的点状暴发流行。6～10月是疟疾流行高峰期，1990～1994年，年均发病率为43．69／10万，平均死亡率为0．08／10万，病死率为13．64％，发热病人血检阳性率为3．17％，居民带虫率为正．28％，IFA阳性率为6．13％。10年恶性疟抗药性监测证实。恶性疟对4-氨基喹啉类及S／P普遍产生了抗性。防治对策应以疟疾联防片为依托，针对不同传疟媒介区开展不同防制策略的防治工作，已达标县应继续坚持病原监测，发病重的地区应适度开展一些科研工作，重视疟防人才培养，年度目标除考核发病率外，应增加疫情漏报率的内容。

Every year there are 12 000- 16 000 malaria cases distributing in 110 counties of Yunnan.However, the estimated missing-reported is 8 times than the number of reported cases. The aresa of 22degree to 24 degree north lantitude and west of the Gaoligong Mountain are the mainly endemic areas. Themalaria incidence is higher and more falciparum malaria cases are found below the elevation of 1 500 M.Every year there are always outbreak spots in some natural villages. The prevalent peak of malaria is from Juneto October every year. The incidence rate was 43. 69 per ten thousand during 1990 to 1994. The averagemortality was 0. 08 per ten thousand. The malaria case-fatality rate was 13. 64 percent. The positive rate of bloodfilm examination was 3. 17 percent in febrile patients. The carrier rate of local inhabitant was 1. 28 percent.The positive rate of IFTA was 6. 13 percent. It was covinced that the resistant to 4-aminoquinolines and s/pexists commonly in plasmodium falciparum. .Based on malaria collaboration,the strategy for control shouldbe varied from different areas of malaria transmission vector. Surveillance on disease infectious should betaken in these counties whose incidence have been controlled below the standards. Some proper studies should betaken in the areas with serious prevalence and closely attention be pard to training technicals on malariacontrol. Thte fectors of assessment should consider the missing reported rate besides incidence rate.