陕西省消除疟疾基线调查结果分析

Baseline survey of malaria elimination in Shaanxi Province

目的评估陕西省开展消除疟疾初期的疟疾流行与防治能力状况，为陕西省消除疟疾提供基线数据。方法采用回顾性与现况调查相结合的方式，对2005年1月-2010年6月陕西省疟疾病例报告与处置、病原学检测、疟防能力现状及健康教育开展等进行摸底调查。结果调查时段内全省累计报告疟疾病例239例，年发病率为0．11／10万，分布在全省30个县（区），间日疟、恶性疟和未分型疟疾病例构成比分别为38．91％、9．21％和51．88％。输入性病例占全部病例数的59．83％。病例实验室检测率、确诊率和规范治疗率为62．76％、48．12％、80．75％，24h网报及时率、个案调查率和疫点处置率为85．77％、75．31％和36．82％。居民和学生疟疾抗体阳性率为0．13％和0．20％。县级疾控医疗机构均能开展疟原虫显微镜镜检，乡级卫生机构仅45．74％能开展；县级疾控、县级医疗和乡级卫生机构疟防人员近5年培训率分别为40．00％、21．59％和10．07％，县级和乡级临床医生培训率为10．64％和11．86％，镜检人员疟原虫镜检技术培训率为11-31％和5．46％。结论陕西省疟疾流行已处于较低水平，但基层在疟疾诊断，健康教育，疟防能力建设方面还需提高。

Objective To evaluate the status of malaria prevalence and control capability of Malaria Elimination Action at initial stage in Shaanxi Province, and to provide baseline data for Malaria Elimination. Methods The data of malaria case report and disposal, pathogen detection, health education, control work and capabilities were collected by the retrospective and field survey. Results Totally 239 cases were reported in Shaanxi proportion January 2005 to June 2010 with the incidence of 0.11/100 000. These cases were distributed throughout 30 counties, the proption of cases with plasrnodium falciparum malaria, plasmodium vivax malaria and unknown type accounted for 38.91%, 9.21% and 51.88%, respectively. 59.83% of them were imported cases. The rates of laborartory detection,confirmed diagnosis and standard treatment were 62.76%, 48.12% and 80.75%, respectively; the reporting rate within 24 hour, the rate of epidemiological case studies and the rate of treatment of the focus of infection were 85.77%, 75.31% and 36.82%,respectively; The serum antibody positive rates of local residents and students were 0.13% and 0.20%. 100.00% of county-level CDC and medical institutions possessed the ability to microscopically detect plasmodium, but that of township hospitals was 45.74%. The rate of traning of malaria control workers and prevention was 40.00% in county-level CDC, 21.59% in county-level general hospitals, and 10.07% in township hospitals. The rates of the awareness of malaria diagnosis and treatment among the clinicians in county-level medical institutions were 10.64% and 11.86% in township hospitals. The rate of training microscopists in county general hospitals were 11.31% and in township hospitals was 5.46%. Conclusion Malaria prevalence had been at a relatively low level in Shaanxi Province, but the abilii：y of malaria prevention and control of the grassroots in diagnosis, health education, malaria prevention capacity-building be further improved.