云南省玉溪市1954-2015年消除疟疾措施实施情况和评价

Evaluation of the implementation of malaria elimination measures in Yuxi City,Yunnan during 1954-2015

目的科学评价玉溪市消除疟疾项目工作,为巩固消除疟疾成果提供依据。方法对全市1954—2015年疟疾疫情数据、各类工作报表、文件、监测数据、防治措施和消除疟疾方案等资料进行全面总结和分析,根据国家卫生计生委《消除疟疾考核评估方案(2014年版)》,从保障措施、技术措施、防控效果3个方面对消除疟疾工作进行评估。结果防治工作经历疟疾高发和大流行期、发病基本遏制期、疫情基本控制期、全球基金暨消除疟疾项目行动计划期4大阶段。在2010—2015年消除疟疾阶段,全市建立多部门联防联控工作机制,科学管理工作机制,各级经费到位,各项措施得到落实,规范项目考核评估验收模式,建立健全县、乡、村三级疟疾防治网络,2010—2015年"三热病人"血检92 921人,疟原虫阳性率0.03%,RDT检测21 100人,阳性率0.15%,流行季节发热病人血检数占全年血检数的84.63%,1953—2015年期间发病率最高是1954年,发病率2 891.6/10万,项目实施后疟疾发病率均控制在1.0/10万以下,2011—2015年仅发现输入性病例,媒介监测未发现微小按蚊,全市通过了省级考评验收。结论全市建立健全了项目各项工作机制,疟疾疫情网络报告系统,各项消除措施得到认真落实,圆满完成了各项工作任务指标,连续4年无本地疟疾病例,县(区)市提前通过考评认证,实现了消除疟疾目标。

Objective To scientifically evaluate the malaria elimination program in Yuxi City to provide the basis to maintain post-elimination control. Methods The malaria epidemic data, work reports, documents, monitoring data, control measures and malaria elimination program of the city from 1954 to 2015 were comprehensively collected, analyzed and summarized. According to ＂Malaria Elimination Evaluation Scheme（2014 Version）＂ of the National Health and Family Planning Commission, Yuxi Malaria Elimination Program was evaluated from three aspects, including safeguard measures,technical measures and control effect. Results The control work experienced 4 stages, including malaria outbreak period,incidence containment period, epidemic control period and action plan period of global fund and malaria elimination project.During the malaria elimination period from 2010 to 2015, multi- sectoral malaria joint control and scientific management mechanisms were established in the city. Funds were distributed to all levels, various measures were implemented, assessment and acceptance model was standardized and three levels of county, township and village malaria control network was established and maintained. From 2010 to 2015, malaria blood tests were performed in a total of 92 921 fever patients with a positive rate of 0.03%. Among them, 21 100 fever patients were examined by rapid diagnostic test, and the positive rate was0.15%. Blood tests of fever patients in the epidemic season accounted for 84.63% of total blood tests in the whole year. The incidence of malaria was 2 891.6 / one hundred thousand in 1954, which was the highest between 1953 and 2015. The incidence remained steadily below 1.0 / one hundred thousand after the project was implemented. From 2011 to 2015, only imported cases were found with no Anopheles mininus observed by vector monitoring, and the city passed the provincial evaluation and acceptance. Conclusion Working mechanism of the project, and malaria network reporting system were established and improved in the city. All elimination measures were seriously implemented, and all work targets were successfully completed. There had been no local malaria cases for four consecutive years. County（District） City passed the evaluation and certification in advance, and achieved the goal of malaria elimination.