韶关市消除疟疾后监测结果分析

Monitoring results of post-malaria elimination in Shaoguan

目的分析2015—2016年韶关市疟疾疫情监测情况,评价疟疾防控效果,为制定巩固消除疟疾成果的防治策略和措施提供科学依据。方法收集韶关市2015—2016年"三热"病人监测、蚊媒监测及病例治疗处置资料,采用Excel2003统计软件进行数据处理。结果 2015—2016年,韶关市共监测检查"三热"病人5 033例,发现疟疾病例4例,平均阳性率0.08%,均为境外输入病例。2015—2016年的血检效率1 258.25∶1。临床初诊为疟疾和疑似疟疾病人的血检效率25.75∶1,而临床初诊为感冒和不明原因发热病人血检效率为0,工作量却是临床初诊为疟疾和疑似疟疾病人的48倍。随着疟疾发病率的下降,发热病人血检阳性率也在下降,导致血检效率的低下,如何提高血检效率是消除疟疾后阶段需要解决的关键问题。对病例正规治疗及对疫点规范处置,未出现本地感染二代病例。蚊媒监测均为中华按蚊。结论在消除疟疾后阶段,由于仍有个别输入性病例,应加强诊治及疫情处置能力的建设,简化血检对象开展有效监测,建议血检对象为流动人口中的疟疾和疑似疟疾病例。

Objective To analyze the monitoring situation of malaria epidemic and evaluate the malaria control effect inShaoguan City from 2015 to 2016, so as to provides the evidence for the formulation of prevention strategies and measures toconsolidate the achievements of malaria elimination. Methods In Shaoguan City from 2015 to 2016, the data of the patientmonitoring, mosquito vector surveillance, case treatment, and the treatment of the＂three hot＂patients（febrile patients） werecollected and analyzed by using the Excel 2003 software. Results From 2015 to 2016, 5 033 cases of the＂three hot＂patientswere checked, and 4 cases of malaria were found, with an average positive rate of 0.08%, and all the malaria patients wereimported from abroad. The blood test efficiency was 1 258.25∶1. The blood test efficiency of the clinical first diagnosis ofmalaria or suspected malaria was 25.75∶1 and the blood test efficiency of the clinical first diagnosis for cold and unexplainedfever was 0, and the workload of the latter was 48 times of the former. With the decline of malaria incidence, the blood testpositive rate in the febrile patients was declining, which resulted in the low blood test efficiency. There were no secondgeneration of malaria cases of local infection for the formal treatment of cases and the treatment of epidemic foci. The mosquitovector surveillance showed that the mosquito vector was Anopheles sinensis. Conclusion In the post-malaria eliminationstage, because there are still individual imported malaria cases, the diagnosis and treatment of malaria patients and epidemicdisposal ability construction still should be strengthened. However, it is necessary to simplify the blood test objects, whichmeans that the blood test objects should be focused on the malaria and suspected malaria cases in migrating population.