2012—2021年福州市输入性疟疾流行特征分析

Epidemiological characteristics of imported malaria in Fuzhou from 2012 to 2021

目的分析福州市输入性疟疾病例的流行特征,为制定防控措施提供依据。方法收集2012—2021年中国疾病预防控制信息系统中传染病监测系统和寄生虫病防治信息管理系统福州市上报的疟疾病例资料,以及个案调查资料,对疟疾的流行概况、三间分布、诊断层级、确诊时间等进行分析。结果2012—2021年福州市共报告输入性疟疾病例629例,其中境外输入性病例627例,省外输入性病例2例。报告病例以恶性疟为主,共463例(占73.61%);间日疟次之,为103例(占16.38%)。男性556例,女性73例,性别比为7.62:1;年龄中位数为39(30,46)岁,40~49岁年龄段病例数最多,占32.59%(205/629)。每月均有输入性疟疾病例报告,其中1月份报告病例数最多,为80例。输入来源地以非洲为主,占89.79%(563/627),主要来自尼日利亚(80例)、喀麦隆(68例)、刚果(金)(62例)。发病-确诊时间间隔中位数为3.00(1.00,6.00)d,各年份发病-确诊时间差异无统计学意义(χ^(2)=14.047,P=0.121)。报告病例首次就诊单位主要为地市级医疗机构,占58.03%(365/629);首次就诊结果为疟疾的病例占73.93%(465/629),复核与初诊结果不符的占31.00%(195/629)。结论福州市应加强对重点地区入境人员的筛查和疟疾防治知识的宣传,提高基层医疗机构诊疗水平,降低由输入性疟疾引发本地传播的风险。

Objective To analyze the epidemiological characteristics of imported malaria cases in Fuzhou,so as to provide scientific basis for formulating prevention and control measures.Methods The data on malaria,together with the case investigation data,were collected from the Infectious Diseases Surveillance System and the Parasitic Disease Prevention and Control Information Management System under the China Disease Prevention and Control Information System reported in Fuzhou area from 2012 to 2021,and then analyzed regarding the prevalence situation,distribution in time,region and population,diagnosis of the infection at the medical institution and the time to confirm the diagnosis.Results A total of 627 overseas imported malaria cases and 2 cases imported from another province were reported in Fuzhou from 2012 to 2021.Plasmodium falciparum malaria was predominant,accounting for(n=463 cases,73.61%),followed by Plasmodium vivax malaria(n=103 cases,16.38%).Five hundred and fifty-six were males,and 73 females,with a male to female ratio of 7.62:1.The median age was 39(30,46)years,and the infection was most seen in patients aged 40-49 years(32.59%,205/629).The imported cases occurred every month,yet were most reported in January(n=80 cases).The source of import was mainly from African countries,accounting for 89.79%(563/627),as primarily involved in Nigeria(n=80 cases),Cameroon(n=68 cases)and the Democratic Republic of the Congo(n=62 cases).The median time interval between onset and diagnosis was 3.00(1.00,6.00)days,and there was no statistical difference in the time interval between onset and diagnosis among years(χ^(2)=14.047,P=0.121).The first visit at the medical institution for the reported cases mainly occurred at municipal medical institutions,which accounted for 58.03%(365/629)of the total.73.93%(465/629)of the cases were diagnosed as malaria upon first visit,and 31.00%(195/629)of cases in re-diagnosis were inconsistent with the original diagnosis.Conclusion The population returned from the key areas in foreign countries should be strictly screened and provided with education on malaria prevention and control.In addition,the diagnosis and treatment level at grassroots medical institutions should be strengthened in order to reduce the risks of local transmission caused by imported malaria.