2011年上海市宝山区恶性疟疾病例分析

Case analysis of falciparum malaria in Baoshan District of Shanghai in 2011

目的通过对2011年上海市宝山区恶性疟疾病例进行统计分析,为更好做到"早诊断、早报告、早治疗、早处置",最大可能杜绝死亡病例提供有效防治措施。方法对2011年上海市宝山区7例恶性疟病例资料按时间分布、地区分布、人群分布、感染来源分布、诊断依据、发病类型、个人防护、临床表现与病情程度、治疗及时性进行描述统计分析。结果 7例均有非洲外出史;7例均为实验室诊断病例;7例患者有无使用蚊帐习惯的为4∶3,患者均无露宿习惯;7例病例最高体温达到38.4～41.0℃;均住院治疗,其中3例出现并发症,1例死亡;7例病例回国到发病时间最多12 d,最少0 d,平均6 d,发病时间到初诊时间最长7 d,最短0 d,平均1.71 d,初诊时间到确诊时间最长17 d,最短0 d,平均5.29 d,去私人医院就诊过的2例,被误诊为其他疾病的6例。结论目前,该区疟疾疫情以境外感染的输入性恶性疟为主,应特别加强对恶性疟疾高流行区归国人员的监测、管理、宣教工作,提高医务人员诊断及镜检技术水平。

[Objective]To analyze the cases of falciparum malaria in Baoshan District of Shanghai in 2011,implement the 〝early diagnosis,early report,early treatment and early disposal〞,and provide effective measures for preventing deaths.[Methods]With descriptive method,7 cases of falciparum malaria in Baoshan District of Shanghai in 2011 were analyzed from the temporal distribution,endemic distribution,population distribution,infection source distribution,diagnostic evidence,disease type,personal protection,clinical manifestation and degree,as well as promptness of treatment.[Results]All of 7 cases have had a trip to Africa and were confirmed by laboratory diagnosis.The ratio of using to non-using bed nets was 4∶ 3,and all of them had no bivouac habit.The highest body temperature reached 38.4-41.0 ℃.All cases were treated in hospital,3 cases had complications,and 1 case died.The longest period from returning home to onset was 12 days,and shortest was 0,with the average period of 6 days.The longest time from onset to first visit was 7 days,and shortest was 0,with the average time of 1.71 days.The longest time from first visit to correct diagnosis was 17 days,and shortest was 0,with the average time of 5.29 days.2 cases have visited the private hospital,and 6 cases were misdiagnosed as other diseases.[Conclusion]At present,the epidemic situation of malaria in Baoshan District is mainly imported falciparum malaria cases,and it is important to strengthen the monitoring,management and education among returnees from malaria endemic areas,improve the levels of diagnosis and microscopy techniques in medical personnel.