1950—2019年河南省疟疾流行特征

Epidemiological characteristics of malaria in Henan Province from 1950 to 2019

目的分析1950—2019年河南省疟疾流行特征,为巩固河南省消除疟疾成果提供科学依据。方法收集1950—2019年河南省疟疾疫情资料和人口数据,采用描述性流行病学方法进行统计分析,应用Arc GIS 10.3软件探讨疟疾病例空间分布特征。结果1950—2019年,河南省疟疾消除历程可分为摸底调查和重点防治、控制流行和降低发病率、实现基本消灭和巩固成果、实现消除疟疾4个阶段。疟疾病例空间分布经历了由淮河以南地区和黄河、太行山间的平原地区向黄淮海平原和南阳盆地转移,后又集中在淮河以南东部嗜人按蚊分布区,最后在豫东平原暴发后逐渐得到控制的变化。疟原虫种类由间日疟、恶性疟、三日疟原虫混合流行转为单一间日疟原虫流行,再到5种输入性疟原虫混合流行;传播媒介经历了中华按蚊、嗜人按蚊复合媒介向中华按蚊单一媒介变化。结论1950—2019年河南省疟疾流行特征发生了较大变化。目前河南省虽已实现消除疟疾,但境外输入性疟疾防控形势严峻,巩固消除疟疾成果任重道远。

Objective To analyze the epidemiological characteristics of malaria in Henan Province from 1950 to 2019,so as to provide the scientific evidence for consolidating malaria elimination achievements in the province.Methods The epidemiological situation of malaria and demographic data in Henan Province from 1950 to 2019 were collected,and the statistical analyses were performed using a descriptive epidemiological method.The spatial temporal distribution of malaria cases was identified using the software ArcGIS version 10.3.Results During the period from 1950 through 2019,the progress of malaria elimination was divided into 4 stages in Henan Province,including the baseline-survey and key-control stage,morbidity-control and incidence-reduction stage,basic-eradication and achievement-consolidation stage and elimination stage.The spatial distribution of malaria cases shifted from south of the Huai River and the plain regions between the Yellow River and Taihang Mountain to the Huang-Huai-Hai Plain and Nanyang Basin,then was concentrated in eastern part of southern Huai River where Anopheles anthropophagus was distributed,and finally was gradually under control following malaria outbreak in Eastern Henan Plain.In addition,the species of Plasmodium changed from P.vivax,P.falciparum and P.malariae co-endemics to a single P.vivax infection,and the current co-endemics of 5 invasive malaria parasites,and the malaria vectors shifted from co-existence of Anopheles sinensis and An.anthropophagus to An.sinensis alone.Conclusions There has been a large change in the epidemiological characteristics of malaria in Henan Province from 1950 to 2019.Although malaria has been eliminated in Henan Province,the consolidation of the malaria elimination achievements remain a great challenge due to overseas imported malaria.