广西凌云县1951—2015年疟疾流行分析

Analysis of malaria prevalence in Lingyun County,Guangxi,1951-2015

目的了解凌云县疟疾流行趋势,为消除疟疾后继续巩固成果提供建议。方法收集凌云县1951—2015年疟疾发病数、发热血检及居民普查血检调查、媒介调查、疟疾病人等资料,采用描述性方法进行分析。结果 1951—2015年凌云县共报告疟疾病例数57 619例病例,平均年发病率为57.5/万,占传染病发病数的22.42%;死亡52人,病死率0.09%。1980—2015年居民发热病人血检405 854人,阳性753例,其中间日疟占77.42%(583/753),恶性疟占22.44%(169/753);荧光抗体阳性率由1988年的1.4%(7/500)降至2000—2009年的0.62%(23/3 725);中华按蚊为主要传疟蚊种。通过几十年来的综合防治,疟疾发病率从1958年的316.05/万下降到1985年的1/万以下,于2000年10月份达到了基本消除疟疾目标。从2005年起已无本地疟疾病例,所报告的病例均为输入性病例,2014年12月通过百色市级消除疟疾考核。结论落实疟疾综合防治措施效果显著,将继续加强"三热"病人血检监测和输入性疟疾病例监测,巩固消除疟疾成果。

Objective To understand the malaria prevalence in Lingyun County,so as to provide the evidence for offering the suggestion to consolidate the control achievements after reaching the goal of malaria elimination. Methods The data of malaria incidence,the ratio of malaria in the whole infectious diseases,blood tests of feverish patients and resident census survey,media survey and malaria patients were collected and analyzed with the descriptive method in Lingyun County,Guangxi,1951-2015. Results A total of 57 619 malaria cases were reported in Lingyun County,1951-2015,with the average annual incidence of 57.5/10 000,accounting for 22.42% of the whole number of infectious diseases of the county. There were 52 death cases,and the mortality was 0.09%. From 1980 to 2015,405 854 feverish inhabitants received blood tests with 753 positives,in which Plasmodium vivax accounted for 77.42%（583/753）,P. falciparum accounted for 22.44%（169/753）. The fluorescent antibody positive rate dropped from 1.4%（7/500）in 1988 to 0.62%（23/3 725）from 2000 to 2009. Anopheles sinensis was the main vector. Through the comprehensive prevention and control interventions for decades,the malaria incidence decreased from 316.05/10 000 in 1958 to below 1/10 000 in 1985,reaching the goal of basic malaria elimination in October 2000. From 2005,there was no local malaria cases and the malaria cases reported were all imported. In December 2014,Lingyun County passed the Baise municipal malaria elimination assessment. Conclusion The implementation of the interventions of malaria prevention and control is significantly effective. Howecer,the blood tests of feverish patients and monitoring of imported malaria cases still should be strengthened in order to consolidate the achievements of malaria elimination.