1950-2015年江西省南昌市疟疾疫情分析

Epidemiological analysis of malaria in Nanchang City, Jiangxi Province from 1950 to 2015

目的分析南昌市1950-2015年疟疾流行趋势，探讨疟疾发病规律，为制订消除疟疾达标后的防制策略提供依据。方法收集南昌市1950-2015年疟疾防治疫情相关数据、报表、工作总结等资料，采用描述流行病学方法分析南昌市1950—2015年的疟疾流行特征。结果1950-2015年南昌市共发生疟疾1449878例；20世纪50～70年代出现了3次发病高峰，分别为1954、1970、1977年，其中1970年发病率最高，达6948．75／10万。1950-1999年共报告本地病例1449739例，其中1970-1981年报告703911例，5-8月为疟疾流行季节，共发病484292例，占总发病数的68．80％；1980-1989年南昌市发生的109293例病例，发病地区前4位依次是南昌县、新建县、进贤县和青山湖区，分别为44931、25684、22614和5842例，合计古南昌市的90．65％（99071／109293）；1972-1985年3个县区发生的13245例病例中，男性8513例，女件4732例。2005-2015年全市报告疟疾病例126例中，输入性病例为122例（以境外劳务输出的回国人员为主），恶性疟57例且有逐年增加趋势，病例无明显的季节性分布。结论文施以消灭传染源为主的综合防治措施，已经有效控制了疟疾的流行。南昌市经过65年的疟疾防治，本地疟疾病例的流行特征已消失，输入性疟疾病例尤其是恶性疟的监控应作为后期防治工作重点。

Objective To analyze the epidemiological characteristics of malaria and to discover the regularity of malaria outbreaks in Nanchang City from 1950 to 2015, so as to provide a scientific basis for developing control strategies after the goal of malaria elimination has been achieved. Method Malaria related data, report forms and work summary in Nanchang from 1950 to 2015 were collected and analyzed to indicate malaria distribution eharaeteristics via the descriptive epidemiological methods. Results The total number of malaria cases reported in Nanchang City was 1 449 878 from 1950 to 2015. The particular years with the three peaks of malaria epidemic from 1950s to 1970s were 1954, 1970 and 1977. The climax of annual mean incidence rate of malaria （6 948.75 per 100 thousand） was reached in 1970. Totally 1 449 739 local recurrence cases were reported between 1950 and 1999. There were 484 292 local reemxence cases （accounting for 68.80%, 484 292/703 911） that were diagnosed in the malaria epidemic seasons, May to August. There were 44 931, 25 684, 22 614 and 5 842 cases reported in Nanchang County, Xinjian County, Jinxian County and Qingshanhu District, which ranked the top 4 of epidemic focus areas （accounting for 90.65%, 99 071/109 293） between 1980 and 1989. The 13 245 cases reported between 1972 and 1985 in the three county/districts （Jinxian County, Xihu District and Wanli District）, included 8 513 cases of male and 4 732 cases of female. The 126 cases reported between 2005 and 2015, included 122 imported cases who were mostly returnees after overseas labor output and 57 falciparum malaria cases with a increasing trend year by year. There was no correlation between the seasonal change and the occurrence of malaria. Conclusions The comprehensive prevention and control measures based on eliminating the source of infeetion can effectively control the epidemic of malaria. It is suggested that the surveillance on imported falciparum malaria casesshould be the focus in prevention and control of the disease at the late-stage because the epidemiological characteristics of local malaria cases have died out completely.