上海市2003-2012年疟疾疫情流行特征分析

Epidemiological analysis on malaria prevalence in Shanghai from 2003 to 2012

目的 了解2003-2012年上海市疟疾流行特征.方法 收集2003-2012年上海市疟疾疫情资料,对疟疾病例开展流行病学个案调查,分析消除疟疾启动前（2003-2008年）、试点阶段（2009-2010年）和消除阶段（2011-2012年）的疟疾流行特征.结果 2003-2012年上海市共有疟疾936例,其中间日疟616例,恶性疟110例,其他疟疾210例,年发病率均低于1/10万,2010年以来疟疾年发病率逐年降低,但恶性疟病例数逐渐增多.消除疟疾启动前疟疾发病有明显的季节高峰,消除疟疾试点阶段发病高峰期缩短、峰值降低,消除疟疾阶段疟疾发病无明显的季节高峰期（x2=37.36,P＜0.001）.在所有的疟疾病例中输入性病例占82.80％,本地感染病例占11.43％,感染地不详者占5.77％.随着消除疟疾工作的启动和推进,上海市疟疾疫情由国外输入比例增加、国内输入比例减少,感染地不详和本地感染病例逐步消除,至2012年上海市疟疾疫情均为国外输入,2011年起无感染地不详病例,2009年起上海市未发现本地感染病例.结论 上海市疟疾年发病率逐年降低,已连续4年实现无本地感染病例,但国外输入性疟疾疫情不容忽视.

Objective To understand the epidemiological characteristics of malaria in Shanghai.Methods Data related to malaria cases during 2003 to 2012 year in Shanghai was collected and analyzed according to the 3 stages as malaria pre-elimination （2003-2008）,pilot malaria elimination （2009-2010） and malaria elimination （2011-2012）,respectively.Results A total number of 936 malaria cases were collected,including 616 cases of Plasmodium （P.）vivax,110 cases of P.falciparum and 210 cases of unidentified plasmodium.The overall annual incidence rate of malaria was lower than 1 per one hundred thousand and showing a gradual downward trend after 2008.P.vivax was mostly seen during 2003-2008 while the proportion of P.falciparum increased gradually during 2009-2010 and the case of P.falciparum occupied the most during 2011-2012.During 2003-2008,most malaria cases were infected in other provinces but diagnosed in Shanghai.However,between 2008 and 2012,malaria cases were mainly imported from overseas which accounted for 82.80％ of the total identified cases,particularly in 2012 that all the malaria cases were imported from Africa and South-East Asia.No indigenous malaria case had been identified since 2009.Conclusion The annual incidence rate of malaria in Shanghai showed a gradual downward trend.Not a single indigenous malaria case had been found for the last 4 years.However,the fact that the situation of importation called for special attention.