2011—2021年河南省输入性三日疟流行病学特征分析

Analysis on epidemiological characteristics of imported quartan malaria in Henan Province from 2011 to 2021

通过国家传染病报告信息管理系统和寄生虫病防治信息管理系统收集2011—2021年河南省输入性三日疟病例疫情数据和流行病学个案信息,采用描述性流行病学方法对疟疾疫情特征进行分析。结果显示,2011—2021年河南省共报告输入性三日疟60例,其中男性占96.7%(58/60)、女性占3.3%(2/60);多数病例集中在24~47岁年龄组(80.0%, 48/60);病例职业以农民居多(53.3%, 32/60)。输入性三日疟病例来自非洲17个国家,来自西非、中非、南非和北非的输入性三日疟病例分别占41.7%(25/60)、 26.7%(16/60)、 30.0%(18/60)和1.7%(1/60);输入病例数较多的来源国家为安哥拉(25.0%, 15/60)、刚果(金)(13.3%, 8/60)、几内亚(10.0%, 6/60)、尼日利亚(10.0%, 6/60)和加纳(8.3%, 5/60)。2021年三日疟病例报告数占当年输入性疟疾总数比例最高(13.3%, 4/30)。60例输入性三日疟病例分布于全省12个市和1个直管县,其中郑州、洛阳、濮阳、许昌和焦作市报告的病例数占全省总报告病例数的73.3%(44/60)。由地(市)级医疗单位、疾病预防控制中心(疾控中心)诊断的病例分别占63.3%(38/60)、 11.7%(7/60),由县级医疗单位、疾控中心诊断的病例分别占比3.3%(2/60)、 20.0%(12/60),由乡(镇)卫生院诊断的病例占1.7%(1/60)。各级机构诊断疟疾病例数差异有统计学意义(χ^(2)=96.042, P <0.05)。病例从发病到确诊的时间间隔中位数为10.5 d,最短为0 d,最长为142 d。其中38例(63.3%)从发病到确诊的时间间隔≤7 d (23例≤3 d, 15例4~7 d), 22例(36.7%)> 7 d。提示河南省在消除疟疾后阶段,应加强对输入性三日疟监测,提高输入性三日疟诊断能力,巩固消除疟疾成果。

The epidemiological data and information on imported quartan malaria cases in Henan Province from 2011 to 2021 were collected through the Chinese Information System for Infectious Diseases Control and Prevention and the Parasitic Diseases Information Reporting Management System (PDIRMS) of the Chinese Center for Disease Control and Prevention and analyzed using descriptive epidemiological methods.A total of 60 imported quartan malaria cases were reported in Henan Province from 2011 to 2021,of which 96.7%(58/60) were males and 3.3%(2/60) were female.Seventy-eight cases (80.0%) were found in the 24-47 age groups.Most of the cases were farmers (53.3%).All imported cases returned from 17 African countries.The imported cases from West Africa Central Africa,South Africa and North Africa accounted for 41.7%(25/60),26.7%(16/60),30.0%(18/60) and1.7%(1/60),respectively.The countries where most imported cases returned from are Angola (25.0%,15/60)Congo (DRC)(13.3%,8/60),Guinea (10.0%,6/60),Nigeria (10.0%,6/60) and Ghana (8.3%,5/60).The proportion of the quartan malaria cases reported in 2021 to the total number of imported malaria cases in that year was the highest (13.3%,4/30).The 60 imported quartan malaria cases were distributed in 12 cities and 1provincial-controlled division.The number of reported cases from Zhengzhou,Luoyang,Puyang,Xuchang and Jiaozuo,accounted for 73.3%(44/60) of the total reported cases in the province.A total of 63.3%(38/60) and 11.7%(7/60)of the imported quartan malaria cases were diagnosed by prefecture (city) level medical units and Centers for Disease Control and Prevention (CDC),respectively,and 1.7%(1/60) cases were diagnosed by township (town)hospitals.There was a statistically significant difference in the number of malaria cases diagnosed by diagnostic institutions at all levels (χ^(2)=96.042,P<0.05).The median time interval between the onset and the diagnosis was10.5 days,the shortest was 0 days,and the longest was 142 days.The time interval from onset to diagnosis was≤7days in 38 cases (63.3%,38/60)(23 cases≤3 days,15 cases 4-7 days),and 22 cases (36.7%,22/60)>7 days.It is suggested that the surveillance of imported quartan malaria should be strengthened,and the diagnostic ability should be improved to consolidate the elimination achievements in the post-elimination stage in Henan Province.