2005-2012年上海市疟疾监测结果分析

Malaria surveillance in Shanghai from 2005 to 2012

目的了解上海市疟疾监测和疫情变化情况,为评价和推进消除疟疾工作提供科学依据。方法收集2005-2012年上海市疟疾监测年报、疟疾疫情数据和人口资料,分析该市发热病人疟原虫血检情况、血检阳性率、人群疟原虫带虫率、人群疟疾抗体水平,以及传疟蚊媒的种群和密度等。结果 2005-2012年,上海市累计血检发热病人400 177人次,血检率为0.36%,各年份的血检率在0.15%~0.83%,其中2010年前的年血检率均低于0.20%,之后血检率明显升高。8年间共发现疟原虫阳性者604例,血检阳性率为0.15%,其中阳性者以2006-2008年为多,2009年后逐年减少,2012年仅有26例,2011年后的所有病例均为国外感染。各年份的血检阳性率从0.61%逐渐降低至0.03%。血检对象中本市居民占79.02%,而血检阳性者中外来流动人员占83.44%。8年期间主动病例筛查15 759人次,分别于2007年和2008年发现5例疟原虫带虫者。对1 239 440人次的流动人员进行疟疾抗体检测,阳性率为0.04%,抗体阳性者均未查出疟原虫;对7 065人次的本地小学生进行疟疾抗体检测,未发现抗体阳性者。2005-2011年开展蚊媒监测216点次,在城区观察点未发现按蚊,郊区观察点监测到按蚊蚊种为中华按蚊。按蚊叮人率季节高峰为7月底至8月底,郊区、近郊区和远郊区的按蚊叮人率未发现地区分布差异。结论上海市已全方位地开展了疟疾监测工作,并已进入消除疟疾阶段,今后的疟疾监测以有境外疟疾流行病学史的人群为重点监测对象,维持并提高二、三级医疗机构的疟疾血检能力,确保能及时、准确发现疟疾病例。

Objective To understand the status of malaria prevalence in Shanghai, so as to provide the evidence for evaluat ing and promoting malaria elimination. Methods The data of population, malaria endemic and monitoring in Shanghai from 2005 to 2012 were collected and analyzed. The malaria positive rates in febrile patients and normal population, the malaria antibody lev els of the floating population and location pupils, and the species and density of mosquitoes were investigated and the results were analyzed. Results The blood examples from 400 177 febrile patients with 0.36% of the total population were examined for malar ia, and the annual rates of blood examination varied from 0.15% to 0.83% in the period of 2005 to 2012. Before 2010, the annual blood examination rate was lower than 0.20%, but increased significantly since 2010 because of the implementation of the Action of Malaria Elimination in Shanghai from 2010 to 2020. Totally 604 malaria cases were found and the positive rate of blood examina tion was 0.15%. During the period of 2006 to 2008, more than 100 malaria cases were found every year, but the number of malaria cases decreased since 2009, and only 26 cases was found in 2012. Since 20l 1, all the malaria cases have been found infected out of China according to the questionnaire investigation. The malaria positive rate of blood examinations decreased from 0.61% to 0.03% yearly. The proportion of local residents who had the blood examination was 79.02%, but that of the malaria positive in tloat ing population was 83.44%. The active ease detection was carried out in 15 759 persons and five cases were found in 2007 and 2008, respectively. The level of malaria antibody was tested in 1 239 440 floating population with the average positive rate of 0.04%. The level of malaria antibody was also tested in 7 065 local pupils but there was no positive h^r malaria. Only Anopheles si nensis was found in Shanghai sutmrb, but no other Anopheles mosquitoes were tound at the city or towns. The peak of Anopheles density was from the end of July to August. Conclusions Malaria surveillance is carried out efficiently in Shanghai, and the result shows Shanghai is in the phase of malaria elimination. The more attention should be paid to persons coming from malaria endemic areas for the malaria blood examination and the general and advanced hospital should maintain the ability of malaria blood exami nations simultaneously.