杭州市1990-2009前后十年疟疾流行病学特征比较分析

The comparison of malaria epidemiological characteristics in Hangzhou from the previous decade to the last decade during 1990-2009

目的对杭州市达到基本消灭疟疾标准后,1990-1999年与2000-2009年前后十年疟疾疫情的流行特点进行比较分析,为制定今后的疟疾防治策略提供依据。方法对1990-2009年血检阳性确诊疟疾病例的个案调查资料进行统计分析,采用SPSS 11.5统计软件,采用χ^2检验对1990-1999年和2000-2009年的流行特点进行比较分析,P〈0.05为差异有统计学意义。结果 1990-2009年平均年发病率0.2/10万,1990-1999年疟疾发病呈高度散发,2000-2009年出现疟疾局部暴发疫情;前后十年疟疾病人在不同性别、职业及年龄组中的构成比差异均有统计学意义（P均〈0.05）;前后十年本地、外出感染、外来患者在构成上差异有统计学意义（χ^2=47.74,P〈0.05）;2000-2009年本地病人发病高峰（8-10月份）明显滞后外来病人（6-9月份）;1990-2009年疟疾病人627例,其中共检出间日疟598例,恶性疟29例,分别占95.37%和4.63%,前后十年间日疟和恶性疟构成比差异无统计学意义（χ^2=3.54,P=0.06）。结论 2000-2009年大量外来病人的输入使杭州市疟疾发病总人数明显上升,出现局部暴发疫情,不断加强对来自高疟区流动人口的监测,提高医疗单位疟疾诊治和镜检能力,从源头上控制传染源,是今后杭州市疟疾防治工作的重点。

Objective To provide the scientific evidence for further prevention and control of malaria in Hangzhou by comparing and analyzing the epidemic feature of infection characteristic between the previous decade and the last decade after achieving the basic standard of malaria elimination.Methods To analyze infection cases of malaria confirmed by blood examination during 1990-2009 with SPSS 11.5 software.Chi-square test was performed to compare the epidemic features of the two decades（α=0.05）.Results The annual mean incidence rate from 1990 to 2009 was 0.2 per 100 000.The distribution of the cases showed highly diverging in the first decade and appeared partly epidemic outbreak in the last decade.There were significant difference with the sex,occupation and ages between two decades（P0.05 to every）.It were significantly different within the local/outside infection and non-native patients between two decades（χ^2=47.74,P0.05）.In the last decade native patients mainly appeared from August to October,which was significantly different compared with that of non-native patients which mainly appeared from June to September.During 1990-2009 the total patients of Plasmodium vivax and Plasmodium falciparum were 598 and 29 cases,and the constituent ratio was 95.37% and 4.63% respectively.There was no significant difference with P.vivax and P.falciparum between the two decades（χ^2=3.54,P=0.06）.Conclusion The incidence rate of malaria was notably rising in the last decade which was mainly affected by no-native patients.Epidemic outbreak of the disease occurred locally in some area.The results suggests that prevention and control of malaria in Hangzhou should lay more emphasis on infection sources control by monitoring the non-native population from area with high incidence rate of malaria and improving diagnosis techniques as well as blood examination in local clinics.