广州市白云区基本消除疟疾地区疟疾监测与防治对策研究

Surveillance and control strategies in malaria basically eliminated areas

目的评价广州白云区基本消除疟疾后监测效果与防治对策，为调整疟防措施提供依据。方法白云区达到基本消除疟疾后，在全区范围内设专职或兼职镜检站22处，开展疟疾传染源搜索，及时发现和治疗现症病人，对病例进行流行病学调查和疫点处理，加强流动人口疟疾管理，定时对各镜检站的工作进行检查、督导，并对本地区小学生进行疟疾抗体检测及进行按蚊密度监测。结果2005∽2013年共报告全区疟疾病例69例，其中间日疟19例，恶性疟40例，未分型10例，均为输入性病例。69例病例中确定外籍病例26例，其中非洲籍22例，东南亚籍4例；本地居民外出非洲感染34例，外出东南亚感染9例。2010—2013年辖区医疗机构共血检“三热病人”19958人次，发现疟原虫阳性3例。连续2年对学龄儿童疟疾抗体监测1013人次，未发现阳性者。在2011-2013年按蚊监测中，只有2013年在自云区郊区捕获1只中华按蚊，其它均为致倦库蚊，表明本地区中华按蚊密度维持在极低水平。结论输入性疟疾病例为现阶段病例的主要来源，基本消除疟疾后的防治成果得到了巩固，现行疟防措施可以适当简化。加强非洲及东南亚等地流动人口的疟疾监测及管理是巩固疟防成果的关键。

Objective To evaluate the effect of consolidation measures after malaria was basically eliminated. Methods Twenty-two malaria microscopy stations were set up after malaria was basically eliminated in Baiyun district of Guangzhou, malaria sources of infections, imported cases and epidemiological survey were carried out to detect malaria cases and timely treawment of the cases. Malaria management of mobile populations, monitoring and guidance of staffs, malaria antibody level survey of children and monitoring of vector density were conducted. Results From 2005 to 2013,the 69 imported malaria patients were reported in Baiyun district included 19 vivax malaria cases, 40 falciparum malaria eases and 10 unidentified infections, There 26 cases infected abroad including 22 from Africa and 4 from Southeast Asia. Out of the 63 local residents 34 were infected in Africa and 39 in Southeast Asia. Between 2010 and 2013, 19 958 blood samples of patients were examined, three positives samples positive ,of which were imported.Anti- malaria antibodies among 1013 elementary were detected.An sinensis was seized in vector anopheles surveillance in rural district in 2013, the dentisy of anopheles kept in very low level. Conclusion The consolidation measures of prevention and cure in area where Malaria was basically eliminated is effective. Prevention measures of malaria should be simplified .Enhancing malaria surveillance and control in the migrant population from Africa and southeast Asia is key to ensuring that Malaria is controlled.