海南疟疾70年——从肆虐走向消除

The seventy years of malaria from hyperendemicity to elimination in Hainan

海南地处热带地区,曾是全国疟疾流行严重的地区之一,也是历史上有名的"瘴疬之地",解放后,在党和政府的重视和领导下,海南的疟疾经历了调查研究、重点防治、大规模抗疟、试点防治等阶段,疟疾发病得到有效控制,疟疾流行区大幅减少,特别是建省后,在省委省政府的重视和支持下,在省卫生厅的直接领导下,经过全省几代疾控人员的艰苦努力和几十年的科学防治,取得了显著的成绩,海南疟疾流行面积大幅缩小,高度疟区、超高度疟区已不存在,疟疾流行只局限分布在岛中南部个别市县的偏僻山林区。为切实保障全省广大人民群众身体健康,促进国际旅游岛的建设和经济与社会协调发展,海南省从2010年开始全面开展消除疟疾行动,海南的疟疾从此走上消除阶段,各级医疗卫生机构按照要求开展发热病人血检工作,血检发现的疟疾病例均及时通过传染病报告信息管理系统上报,病例诊断后24 h网络直报率达到100%;所有病例均进行了抗疟疾治疗,疟疾病例规范治疗率为100%。对所有报告的疟疾病例开展了3 d内病原学确认和流行病学个案调查和病例分类,特别是对输入性病例进行甄别,并以此为线索,在7 d内对疫点进行传染源与传播媒介调查和疫点分类,并根据疫点分类,科学采取包括传染源控制、传播媒介控制和健康教育等措施。另外加强了媒介的监测工作。全省疟疾从有较全面疫情报告的1955年82 447例,死亡47例,到2005年4 512例,死亡0,从此再无本地疟疾死亡病例,到2010年实现了无本地感染恶性疟目标,至2012年实现了无本地感染间日疟病例的目标,海南省历史上第一次呈现无本地感染疟疾病例情况,除了2015年有几例来源不明的三日疟病例外,海南省已连续7年无本地感染的恶性疟和间日疟病例,实现了消除疟疾的目标。建国70年来,海南的疟疾从肆虐走向消除,这一伟大成绩的取得,主要得益于党和政府的重视,得益于几代疟疾防治工作者的不懈努力和无私奉献。

Hainan is located in the tropics,was one of the areas hit hardest by the national malaria endemic,and also in the history of the famous "land of pernicious",after the liberation,under the leadership of the party and the government,the malaria in Hainan has gone through several stages,such as investigation and research,focus on the prevention and treatment,large-scale anti-malaria,and pilot control.Malaria is under effective control,malaria endemic areas dropped sharply,especially after the province construction,under the provincial government attention and support,and the direct leadership of the provincial Bureau of Health,through the provincial CDC researchers several generations of hard work and scientific prevention and control for decades,it has obtained the remarkable result,malaria endemic area of Hainan significantly declined,high-grade and ultra-high-grade malaria areas were no longer existed,and malaria epidemics are only confined to remote mountain forests in some cities and counties in the south central part of the island.To ensure the health of people in the province,promote the construction and coordinated development of economy and society of international tourism island,Hainan Province began to eradicate malaria in 2010 and then in the elimination stage.As requested,medical and health institutions at all levels carry out blood tests of the fever patients,tests found that malaria cases will be reported in a timely manner through the infectious disease report information management system(hereinafter referred to as the network straight newspaper).The direct reporting rate of 24 hours after diagnosis reached 100%.All cases received anti-malaria treatment,and the standard treatment rate of malaria cases was 100%.The malaria cases will be all reported etiology identification,epidemiological case study,and case classification in the 3 days,especially for imported cases,as clues,carried out infection and transmission vector investigation and foci of classification,within 7 days,and according to the foci classification,to source control,health education and vector control measures.Vector monitoring has also been strengthened.There would be more comprehensive with the report of 82 447 cases,47 cases died from 1955,to 4 512 cases,die 0 in 2005,and then no local malaria deaths,again to achieve without local infected with P.falciparum in 2010,realize the goal of no local infection with Plasmodium vivax malaria cases in 2012,Hainan Province was the first time in history without local infection of malaria cases,in addition to a few unknown source of malaria cases in 2015,Hainan has 7 years without local falciparum and Plasmodium vivax malaria cases of infection,to achieve the goal of eliminating malaria.The 70-year history of the founding of the People’s Republic of China has witnessed the history of malaria elimination in Hainan.The great achievement is mainly attributed to the attention of the party and the government and the unremitting efforts and selfless dedication of several generations of malaria prevention and control workers.