长沙市2017—2018年疟疾诊治情况分析

Diagnosis and treatment analysis of malaria in Changsha, 2017-2018

目的了解疟疾病例诊治基本情况,为提出针对性疟疾防控措施提供科学依据。方法对2017—2018年长沙市报告的疟疾病例进行普查,采取电话回访病例及查阅病例资料的方式开展。结果共调查70例疟疾病例,病例在县级以上医疗机构初诊正确率(88%)显著高于县级以下医疗机构(5%);病例就诊-确诊时间间隔基本与全国水平持平,对就诊-确诊时间间隔影响因素进行单因素分析,结果显示"就诊前咨询疾控机构"、"就诊时医生询问流行病学史"及"病例有疟疾认知"差异有统计学意义(P<0.05),进一步开展Logistic回归分析显示,"就诊时医生询问流行病学史"差异有统计学意义(P<0.05);病例抗疟药使用规范率为74.29%,不同年度、不同疟疾类型及不同用药方式(口服或注射)抗疟药使用规范率差异有统计学意义(P<0.05)。结论今后应提高重点人群自我防护意识,提高医疗机构尤其是基层医疗机构疟疾诊治意识及能力。

Objective To understand the basic situation of diagnosis and treatment of malaria cases,so as to provide scientific basis for the prevention and control of malaria.Methods Investigations were conducted on telephone surveys and clinical data review for malaria cases reported in Changsha in 2017-2018.Results A total of 70 malaria cases were investigated,and the diagnostic accuracy of the first time to the hospital was significantly higher in the medical institutions above the county level(88%) than below(5%).Time interval between initial visit and diagnosis was in line with the national level.Univariate analysis revealed that the factors impacting the time interval were Consulting the CDC staffs’,’Whether the doctor asked the epidemiological history’ and ’the patients’ knowledge of malaria’(P<0.05).Logistic regression analysis indicated that the time interval was correlated to ’ Whether the doctor asked the epidemiological history ’,and the difference has statistical significance(P<0.05).The rate of appropriate use of antimalarial drugs was 74.29%,statistic difference(P<0.05) was found at different years,types of malaria and methods of medication(oral or injection).Conclusion We should enhance the self-protection awareness of key groups,strengthen the awareness and ability of malaria diagnosis and treatment in medical institutions,especially primary medical institutions.