浙江省2012—2019年输入性疟疾病例诊断情况

Diagnosis of imported malaria cases in Zhejiang,2012-2019

目的分析2012—2019年浙江省报告疟疾病例诊断情况,防止消除疟疾后再传播,为消除后疟疾工作的防控策略和措施提供依据。方法收集中国疾病预防控制信息系统的寄生虫病防治信息系统中2012—2019年浙江省报告的疟疾病例信息、流行病学调查等资料,对其诊断方式、诊断单位、诊断间隔时间等进行描述和统计学分析。结果2012—2019年浙江省共报告1543例疟疾病例,全部为输入性病例,疟疾类型以恶性疟为主(71.2%)。RDT的使用率从2012年的62.86%(88/140)升高到2019年的88.76%(158/178)。各年间疾控机构诊断比例从2012年的35.7%(50/140)下降至2019年的9.6%(17/178)(P<0.05),医疗机构诊断比例由2012年的55.0%(77/140)上升至2019年的88.2%(157/178),各年间县级医疗机构诊断比例差异有统计学意义(P<0.05)。发病-初诊和初诊-确诊间隔天数的中位数均为1 d,各年份初次就诊-确诊时间间隔差异有统计学意义(P<0.001)。恶性疟的初诊-确诊间隔时间短于其他虫种(P<0.001),县级以下单位较其他层级单位的发病-初诊时间短(P<0.001)。结论消除后阶段需继续加强医务人员业务知识培训,提高疟疾诊断水平和能力,提高群众就诊意识,防止输入性病例继发传播。

Objective To analyze diagnosis of imported malaria in Zhejiang Province duiring 2012-2019,to prevent transmission after elimination of malaria,we provide the foundation for malaria prevention and control.Methods Malaria case information,epidemiological investigation data on imported malaria cases in Zhejiang Province from 2012 to 2019 were collected through Parasitosis Prevention and Control Information System of China Disease Prevention and Control Information System(CISDCP).The diagnostic methods,diagnostic institutions and onset⁃diagnosis time of imported malaria cases were described and analyzed.Results A total of 1543 malaria cases were reported in Zhejiang Province during 2012-2019,and all of which were imported.Majority of the cases were Plasmodium falciparum(71.2%).The utilization rate of RDT increased from 62.86%(88/140)in 2012 to 88.76%(158/178)in 2019.The rate of diagnosis in CDC decreased from 35.7%(50/140)in 2012 to 9.6%(17/178)in 2019(P<0.05),while that in medical institutions increased from 55%(77/140)in 2012 to 88.2%(157/178)in 2019.And the diagnosis rate of county-level medical institutions was statistically significant from 2012 to 2019(P<0.05).The median time from onset to initial diagnosis and from initial diagnosis to confirmation of malaria cases was 1 day,respectively.The time interval from initial diagnosis to confirmation was statistically different in each year(P<0.001).The interval from initial diagnosis to confirmation of Plasmodium falciparum was shorter than that of other species(P<0.001).The interval from onset to initial diagnosis of the institutions below county-level was shorter than that of the institutions at other levels(P<0.001).Conclusions The diagnostic awareness and capabilities of medical institutions should be further strengthened,and health education should be strengthened to increase awareness of medical treatment,to prevent retransmission of imported malaria after elimination.