海南省消除疟疾行动计划中期评估报告

Mid-term assessment report of Malaria Elimination Action Plan in Hainan

疟疾是危害海南人民群众健康的重要寄生虫病之一,且因气温全年皆适宜按蚊生长和疟原虫子孢子在蚊体内的发育和繁殖,故当地疟疾终年传播无休止期。1956年全省疟疾调查显示,居民疟原虫带虫率及脾肿率分别为40.3%及69.6%。自1959年开始在全岛开展大规模抗疟,1969年,海南省疟疾发病率为159.2/万,此后发病率持续下降,至1977年下降至30.5/万,1978年发病率上升1倍多,为63.44/万,此后虽个别年份发病率有所上升,但总体呈下降趋势,至1999年,疟疾年发病率降至4.57/万。2010年,海南省按照国家的《中国消除疟疾行动计划（2010—2020）》开展消除疟疾工作,病例数持续减少,并在2012年首次实现无本地报告疟疾病例,至2014年,海南省连续3年无本地疟疾病例报告。2014年屯昌县、文昌市陆续通过了省级消除疟疾考核。2010—2014年,市县级政府合计拨付1 403.39万元用于开展消除疟疾工作。近几年海南省开展消除疟疾的主要工作内容是：1发热病人血检;2病例报告、治疗、个案调查及疫点处置;3技能培训;4健康教育等。2010—2014年,每年血检率达1.28%~2.05%。所有网报病例均严格按照1-3-7模式开展防控措施,防止二代病例出现。足够的经费投入保障了大规模培训专业人员及群众健康教育措施的实施,2010—2014年培训疟疾防治管理人员、临床医生及检验人员共16 854人次,发放各式健康教育资料共170多万份。虽已取得阶段性的成果,但在消除疟疾过程中我们仍然面临很多的困难与挑战。首先是部门间合作机制有待加强;第二是输入性病例造成的威胁;第三是一些关键性技术难题尚未解决;第四是基层疟防人员有所削弱;第五是宣传力度仍然不够。

Malaria is one of the parasitic diseases which were most harmful to people＇s health in Hainan. Malaria transmitsthroughout the year with no telogen in Hainan due to optimal temperature which permits growth, development and reproductionof Anopheline mosquitoes and Plasmodium sporozoite all year round. A survey on malaria in 1956 showed that rates of malariaparasite carrying and splenomegaly in residents were 40.3% and 69.6% respectively in Hainan. Since 1959, the large-scale ofanti-malarial action was performed, the incidence of malaria was 159.2/10 000 in Hainan Province in 1969, then the incidencecontinued to decline, to 30.5/10 000 in 1977, then up to more than 1 time, to 63.44/10 000 in 1978, since then, although theincidence has increased in some years, but overall kept a downward trend to 1999, with the incidence of malaria in 4.57 /10 000.Since 2010, Hainan had carried out malaria elimination according to the Malaria Elimination Action Plan（2010-2020）（PAEM）,the number of malaria cases continued to decline, and realized＂No local malaria cases reported＂in 2012. By the end of 2014,there had been free of local malaria cases for 3 consecutive years. In 2014, Tunchang county and Wenchang city passed theprovincial appraisal of malaria elimination. From 2010 to 2014, city and county governments allocated 14.03 million Yuan formalaria elimination. In recent years, the main content of malaria elimination work include： 1. blood test on fever cases; 2. casereporting, treatment, survey and disposal; 3. technical training; 4. health education. From 2010 to 2014, annual rate of malariablood test was 1.28%- 2.05%. All reported malaria cases were treated in strict accordance with 1- 3- 7 model to preventsecondary cases from occurring. Sufficient funding ensured the large-scale training of professionals, and the implementation ofpublic health education. From 2010 to 2014, a total of 16 854 person-times（including manager, clinician and inspector） weretrained, and more than 1.7 million health educational materials were distributed. Although substantive results have beenachieved, many difficulties and challenges are still in front of us in the process of malaria elimination. First, cooperation amongdepartments should be enhanced. Second, imported malaria becomes a potential threat. Third, several key technical problemsheve not been resolved. Fourth, front line malaria control personnel are decreasing. Fifth, publicity of malaria elimination needsto be further strengthened.