2012～2017年北京市输入性疟疾疫情分析

Epidemiological analysis on the imported malaria cases in Beijing from 2012 to 2017

目的分析北京市输入性疟疾流行病学特征,为制定疟疾防控措施提供参考依据。方法收集2012~2017年北京市输入性疟疾病例信息和个案流行病学调查资料,采用SPSS20.0统计学软件对疟疾病例流行病学特征和就诊情况进行统计分析。结果2012~2017年北京市共报告输入性疟疾病例505例,全部为境外输入,其中474例(93.86%)来自非洲国家,20例(3.96%)来自亚洲国家,11例(2.18%)来自大洋洲国家。对全部病例的发病时间进行统一分析,发病高峰在6~8月份。所有病例为实验室确诊病例,恶性疟432例(85.55%),间日疟44例(8.71%),卵形疟18例(3.56%),三日疟10例(1.98%),混合感染1例(0.20%)。发病后超过7天就诊的病例有20例(3.96%),就诊后超过7天才确诊的病例有49例(9.70%)。402例首次就诊地在北京的病例中,有83例(20.65%)诊断为其他疾病。北京市医疗机构误诊比例呈下降趋势(Z=5.806,P=0.016)。结论北京市境外输入性疟疾防控形势依然严峻,应继续加强多部门合作,保持高效的疟疾监测体系。

Objective To analyze the epidemiological characteristics of imported malaria in Beijing, so as to provide the evidence for developing interventions for prevention and control of malaria in scientific manner. Methods The data were collected from the registered malaria cases and epidemiological investigation on individual case in Beijing area from 2012 through 2017, and analyzed for the epidemiological characteristics and clinic visits using SPSS 20.0. Results A total of 505 imported malaria cases were reported from 2012 to 2017, in which 474 cases (93.86%) were imported from African countries, 20(3.96%) from Asia, 11(2.18%) from Oceania. Analysis of all cases showed that malaria attack was peaked in between June and August. All cases were confirmed by laboratory studies. The findings indicated P. falciparum malaria in 432 cases(85.55%), P. vivax malaria in 44(8.71%), P.ovale malaria in 18(3.56%), P. malariae malaria in 10(1.98%) and mixed-infection in 1(0.20%). Twenty patients (3.96%) fist visited the doctor after 7 days of the disease attack, and 49(9.70%) were diagnosed beyond 7 days after the first visit. Eighty-three cases(20.63%) were misdiagnosed in the 402 that first visited the clinical institutions in Beijing area, where the misdiagnosis rate was on the decline(Z=5.806, P=0.016). Conclusion Threatening of imported malaria still exists in Beijing area. Multi-sectoral cooperation should be enhanced in order to maintain the malaria monitoring system in higher efficiency.