一九八九年全国疟疾情况

MALARIA SITUATION IN CHINA, 1989

疟区各省、自治区、直辖市卫生行政部门及广大疟防人员、基层卫生人员,在各级政府的重视和支持下,继续贯彻执行《1986～1990年全国疟疾防治规划》提出的因地制宜、分类指导的原则,克服种种困难。

According to the case reporting system, malaria cases in the whole country (TaiwanProvince not included) in 1989 accounted for 137540, the incidence being 12.56/100000, and lethal cases, 60. All these were close to those (134156, 12.44/100000, and 53) in 1988, while an insidious increase was in view. On the basis of county/city reckoning, about 984.5 million people reside in 2576 counties/cities where malaria incidence was <0.1 per 1000 (including non-endemic areas); 80.2 million people in 174 counties/cities with incidence of 0.1-1.0 per 1000; 29,9 million people in 76 counties/cities with incidence of 1.1-10 per 1000; and 500000 people in 5 counties with an incidence above10 per 1000.Though malaria incidence in the whole nation continued to decline to some extent, informations from 3 provinces, i.e. southern Yunnan, Sichuan and middle Anhui showed an increase of 18.26%, 33.02% and 33.91% respectively, as compared, with the incidence in 1988. This was due to incomplete implementation of malaria intervention strategies and the decrease in mosquito control areas. The general situation could be summarized as foj llows: in endemic areas with Anopheles sinensis as vector, the malaria incidence was steadily decreasing, malaria cases were few and scattered with the proportion of exogenous cases increasing; whereas in areas with A. anthropophagus, A. minimus and A. dims as vectors, the prevalence was unstable and focal outbreaks often occurred. Such places were the main endemic areas of malaria.The endemic areas of falciparum malaria covered 69 counties of 5 provinces/autonomous region, while non-indigenous falciparum cases were reported from 73 counties of 8 provinces/municipality. Hainan and Yunnan provinces in southern China were the principal endemic areas of falciparum malaria, the number of cases accounted for 35.9% and 21.4% of the total number of the parasitologically confirmed cases respectively. Chloroquine resistant Plasmodium falciparum amounted to as high as 84.4% of the total parasite population in Hainan, while resistance at various degrees to piperaquine, pyronaridine, artesunate and amodiaquine was also demonstrated. There was no remarkable alteration in prevalence of falciparum malaria in Guizhou Province and Guangxi Autonomous Region. 166 falciparum malaria patients and parasitemia cases were reported from 3 counties of Anhui Province. No falciparum malaria case was found for 2 consecutive years in Henan and Jiangsu Provinces.Through active and passive case detection with a coverage of a population of 503 million in 17 provinces / autonomous region /, municipality, 83 991 people (mean parasite rate 0.45%) were found to harbour malaria parasites upon microscopical examination of 18.532 million blood slides. Parasitemia cases amounted to 61.1% of the total reported cases, among them 10422(12.4%) were with falciparum malaria (including mixed infection). Surveys on 0.553 million inhabitants at longitudinal investigation in fields and pilot areas in 15 provinces/autonomous region/municipality disclosed 4578 (mean parasite rate 0.83%). 19.38% of plasmodium positive cases were due to falciparum (including mixed infection). Plasmodium malariae infection was found in 20 persons; four of them acquired the infection through blood transfusion, one from Thailand, while other 15 patients or parasite carriers were indigenous cases in Yunnan.