江苏省巩固消除疟疾成果面临的挑战

Challenges for maintaining achievements of malaria elimination in Jiangsu Province,China

目的分析江苏省当前消除疟疾形势,明确该省巩固消除疟疾成果面临的主要挑战和困难,并寻找可行的解决方案。方法召集江苏省13个设区市疾病预防控制中心疟疾防治负责人和江苏省寄生虫病防治研究所疟疾团队成员,随机分组后围绕"管理保障、病例诊治、现场流行病学调查(流调)和其他"等主题进行讨论;通过问卷调查的方式搜集相关信息,并对研讨会效果进行评估。结果专家组27人分为3个小组进行讨论,参与问卷调查者27人,回收有效问卷24份。问卷调查有效参与者中79.1%(19/24)为中高级职称,66.7%(16/24)有10年以上工作经验。讨论前,仅有16.7%(4/24)的参与者非常了解当前全省疟疾防控面临的挑战和困难;讨论后,有87.5%(21/24)的参与者认为此次研讨会增进了对消除疟疾后面临挑战和困难的了解。通过主题讨论,专家组对疟防工作的管理保障、病例诊治、现场流调、其他等4个方面所存在的困难或挑战及解决方案进行了归纳总结,并形成框架。结论当前江苏省巩固消除疟疾成果在管理保障、病例诊治、现场流调和疫点处置、消除后监测工作的可持续性等方面仍面临许多挑战和困难,探索可行的解决方案可为正在进行疟疾消除或已达到疟疾消除的地区提供借鉴。

Objective To analyze the situation of malaria elimination,identify the current main challenges and difficulties of maintaining the achievements of malaria elimination,and find out feasible solutions in Jiangsu Province. Methods Through randomized grouping,the subject discussion and questionnaires were conducted by malaria control staffs from centers for diseas.es control and prevention of 13 cities of Jiangsu Province and Jiangsu Institute of Parasitic Diseases. The basic characteristics of participants and the effect of the discussion were analyzed through questionnaires. Results Twenty.seven professional partici.pants were randomly divided into 3 groups. Totally 27 questionnaires were released and 24 valid questionnaires were retrieved.Among the 24 participants,79.1%（19/24）of them were with mid.level and senior professional titles,and 66.7%（16/24）of them had worked for more than 10 years. Before the group discussion,only 16.7%（4/24）of the participants were aware of the current main challenges and difficulties in Jiangsu Province. After the discussion,87.5%（21/24）of them thought the discussion increased their understanding of the challenges and difficulties. Through the subject discussion,the expert group summarized the current challenges and difficulties as well as the solutions in malaria prevention in Jiangsu Province in 4 aspects,namely the management guarantee of prevention work,diagnosis and treatment of the cases,field epidemiological investigation and others.Finally,a framework about these discussion results was established. Conclusions During the post.stage of malaria elimina.tion,Jiangsu Province still faced many challenges and difficulties,such as management guarantee,case diagnosis and treat.ment,epidemiology survey and focus disposals,and malaria surveillance sustainability. The feasible solutions of these challeng.es may provide examples for other provinces and regions which are undergoing malaria elimination or in post.stage of malaria elimination.