当前疟疾形势与我国消除疟疾后的再传播风险与对策

Risk and countermeasures of re-establishment after malaria elimination in China

疟疾曾是我国流行严重的传染病之一,在几代人不懈努力下,我国疟疾防控从控制到消除取得了显著成效,特别是经过10年国家消除疟疾行动,成功阻断了本地传播,实现了年发病数从3000万到0。尽管我国成功消除疟疾,但全球疟疾流行依然严重,我国原疟疾流行区仍存在传疟按蚊,每年有数千例境外输入病例,跨境阳性按蚊对边境地区再传播造成新的风险。防止输入再传播将成为我国消除疟疾后长期工作任务。本文总结了我国消除疟疾5项支柱和“1-3-7”策略,分析了全球疟疾形势和我国消除疟疾后的再传播风险新特点,提出了加强对防止疟疾输入再传播工作的支持、适时调整再传播风险分层、加强医疗机构对输入性疟疾的诊治能力和疾控机构再传播风险监测预警及应急处置能力、重视特殊抗疟产品生产/供应和创新研究等对策、措施的建议,以期为我国防止输入再传播工作提供参考。

Malaria used to be one of the most prevalent infectious diseases in China.With the unremitting efforts of several generations,China has achieved remarkable achievements from malaria control to elimination.In particular,after 10 years of national malaria elimination action,local transmission has been successfully interrupted,and the indigenous cases reduced from 30 million to zero.Despite the successful malaria elimination in China,the global malaria epidemic is still serious and Anopheles mosquitos are still existing in the original malaria-endemic areas in China.With the risks of thousands of imported cases every year and cross-border positive Anopheles mosquitoes give rise to new challenges.Preventing malaria reestablishment will be a long-term task after the elimination of malaria in China.This paper summarizes the five pillars and the new case-based"1-3-7"strategy for malaria elimination in China,analyzes the global malaria situation,and the new characteristics of the risk of re-establishment after malaria elimination in China.It is suggested that continuously political support,timely adjustment the risk stratification of re-establishment,strengthening the diagnosis and treatment capacity of imported malaria in hospitals/clinicals,and the monitoring and early warning/emergency response capacity in CDCs,attaching importance to innovative research and the production/supply of special antimalarial products will be important in the preventing re-establishment setting in China.