国境口岸输入性恶性疟的现状与预防控制

Imported falciparum malaria situation and its prevention and control at frontier ports

目的了解近年来我国境外输入性恶性疟疫情,探讨现阶段恶性疟预防与控制措施。方法查阅了2006年以来所有详细报道我国国境口岸输入性恶性疟的文献,对有关感染地区、诊疗状况等相关资料进行分析。结果输入性恶性疟最主要的感染地为非洲和东南亚地区,其中非洲地区的尼日利亚、安哥拉、几内亚、赤道几内亚,东南亚的缅甸是我国输入性恶性疟来源最多的国家。恶性疟易引起误诊,感染者常因未得到及时有效的抗疟治疗而死亡。疟疾病人的实验室诊断率有待提高,采用疟原虫抗原快速检测法和PCR法等疟疾诊断新技术作为镜检的补充,有助于提高疟疾诊断水平。赴非洲等恶性疟高发区的归国劳务人员,恶性疟发病率高、复燃比例高,采用以青蒿素类药物为主的联合疗法可提高疗效和阻止疾病传播。结论我国国境口岸输入性恶性疟防治重点是加强境外输入性疟疾监测与管理,提升恶性疟的诊疗水平,提高出国人员疟疾的自我防护能力。

Objective To explore the focus of its prevention and control on Chinese imported falciparum malaria. Methods All literatures on imported falciparum malaria in the last six years were searched and analyzed. Results The imported patients mostly returned from Africa and Southeast Asia. The countries of most infection of falciparum malaria were Nigeria, Angola, Guinea and Equatorial Guinea from Africa, and Burma from Southeast Asia. Falciparum malaria was easy to misdiagnosis, the patients often died of delayed treatment. Microscopic examinations as the laboratory confirmation of diagnosis need to be combined with those new technologies such as plasmodial antigen rapid test and PCR. Those who returned from the high plasmodium falciparum transmission areas had a high falciparum malaria incidence and a high recurrence rate. Dihydroartemisinin based treatments could improve effect and prevent transmission of the disease. Conclusion Focus of prevention and control of the imported falciparum malaria should be paid on its surveillance and management, its early diagnosis and prompt treatment, and capacity building of self protection of the international travelers.