云南省消除疟疾行动计划暨全球基金疟疾项目评估调查

Assessment of the National Malaria Elimination program and projects funded by the Global Malaria Fund in Yunnan Province in 2012

目的了解云南省疟疾流行情况及防治现状,为云南省消除疟疾行动计划的实施和评估提供科学依据。方法根据近2007～2011年的疟疾疫情,采用分层随机不等比例抽样法确定调查点,按照《云南省消除疟疾行动计划暨全球基金疟疾项目专项调查方法》进行调查。结果 2011年抽查县疟疾发病率为4.02/万,其中输入病例占88.12%,间日疟占74.00%,恶性疟占26.00%。发病率超过1/万以上的县有瑞丽市、陇川县和腾冲县；调查县（市）疟疾病例实验室检测率为92.30%,病例确诊率为100.00%,病人规范治疗率为100.00%,病例个案调查率为99.04%,疟疾疫点处置率为100.00%,疫点室内滞留喷洒率为96.30%。发热病人48h内求诊比例为84.92%,疟疾病例确诊后24h内网络直报率为100.00%,发热病人血检阳性率为1.16%；居民长效蚊帐拥有率20.73%,药浸蚊帐拥有率36.35%,至少拥有一顶长效蚊帐/药浸蚊帐的家庭比例为86.88%,调查前一夜睡在长效蚊帐/药浸蚊帐内的目标人群比例为53.01%,重点人群（孕妇）使用长效蚊帐比例为54.55%,目标人群疟疾防治知识知晓率为87.56%；能开展疟原虫镜检的医疗机构数比例为100.00%,镜检人员疟原虫镜检培训率为78.87%,疟防人员、临床医生、村医疟疾防治培训率分别为86.43%、31.77%和96.57%。结论云南省疟疾流行区防治力度的加强和防治能力的提高使全省疟疾得到有效控制。

Objective To provide a scientific basis to effectively implement and evaluate the National Malaria Elimination program and projects funded by the Global Malaria Fund by ascertaining malaria outbreaks and the current state of malaria prevention and control. Methods A survey on the prevalence of malaria was conducted in accordance with the Methods of Studying the National Malaria Elimination program and Projects Funded by the Global Malaria Fund,and survey sites were selected using stratified random disproportionate sampling. Results Counties had a malaria incidence of4.02/10,000 according to a survey in the 2011.Of these cases of malaria,88.12% were imported.Plasmodium vivax accounted for 74.00%of malaria cases while Plasmodium falciparum accounted for 26.00%.Rui Li,Long Chuan,and Teng Chong counties had a malaria incidence greater than 1/10,000.Among the counties surveyed,the rate of laboratory testing was 92.30%,the rate of confirmed diagnosis was 100.00%,the rate of standard treatment was 100.00%,the rate of epidemiological case studies was 99.04%,the rate of treatment of the focus of infection was 100.00%and the rate of indoor residual spraying was 96.30%.The rate of consultation with a physician within 48 hours was 84.92%,and the rate of reporting via the China Information System for Disease Control and Prevention within 24 hours was 100.00%.According to a blood test,1.16%of patients with a fever tested positive for Plasmodium.Residents owned LLITNs at a rate of 20.73%and ITNs at a rate of 36.35%.The proportion of households with at least one LLITN/ITN was 86.88%.Prior to the survey,the proportion of the target population that slept in an LLITN/ITN at night was 53.012%.A key population（pregnant women）used LLITNs at a rate of 54.55%.The rate of awareness of malaria prevention among the target population was 87.56%.The rate of medical facilities with the ability to microscopically detect malaria parasites was 100.00%.The rate of trained microscopists was 78.87%.The rate of training in malaria control and prevention was86.43%for village health workers,31.77%for epidemic prevention staff,and 96.57%for clinicians.Conclusion Malaria prevention and control and the capacity for malaria prevention and control must be enhanced in areas of Yunnan where malaria is endemic in order to effectively control malaria throughout the province.