江苏省消除疟疾后输入性疟疾疫情及其防控

Post-elimination importation of malaria and its prevention and control in Jiangsu Province

目的收集2019—2023年江苏省消除疟疾后输入性疟疾病例资料,分析全省消除疟疾后输入性疟疾疫情和当前防控措施,探讨下一步防控策略。方法通过中国疾病预防控制信息系统中的传染病报告信息系统以及江苏省疟疾疫情数据库,收集2019—2023年江苏省疟疾病例信息,采用统计软件Stata 12.0和SPSS 16.0进行统计分析。结果2019—2023年江苏省网络直报疟疾共534例,各年分别为244、90、32、36和132例,均为实验室确诊境外输入疟疾病例。2020—2022年新冠疫情防控期间,输入性疟疾病例明显减少,多次出现疟疾病例零报告月。534例疟疾病例中,绝大部分为赴撒哈拉沙漠以南的非洲和东南亚等国家务工、商务、国际学生或旅游归国人员。病例从发病到初诊的中位数及最小、最大天数分别为1(0,12)、1(0,8)、0(0,6)、0(0,10)和1(0,18)d,患者初诊时间差异统计学意义(Fisher_(确切检验),P=0.03)。相较于隔离点外,医学观察隔离点内的疟疾病例能在更短时间被确诊(Fisher_(确切检验),P=0.007)。共报告重症疟疾病例24例,无死亡病例,其中23例为恶性疟,1例为卵形疟。结论消除疟疾后,因受新冠疫情影响,江苏省境外输入性疟疾病例锐减,医学观察集中隔离点的疟疾病例诊断更及时,归国人员发病到就诊及时性有所提升。2023年境外输入病例出现急剧增加,今后需加强各项疟疾防控措施的落实,并保持防止疟疾输入再传播,巩固消除疟疾成果。

Objective To collect data on imported malaria cases in Jiangsu Province from 2019 to 2023 after malaria elimination and to analyze the current epidemic situation and prevention and control measures of imported malaria,discussing future prevention and control strategies.Methods Malaria case information for Jiangsu Province from 2019 to 2023 was extracted and downloaded from the China Information System for Disease Control and Prevention(CISDCP)as well as the Jiangsu Provincial malaria epidemic database.Statistical analysis was conducted using Stata 12.0 and SPSS 16.0 software.Results From 2019 to 2023,a total of 534 cases of malaria were directly reported online in Jiangsu Province,with annual cases numbering 244,90,32,36,and 132 respectively,all being laboratory-confirmed imported malaria cases from abroad.During the COVID-19 pandemic from 2020 to 2022,the number of imported malaria cases significantly decreased,with several months reporting zero cases.Among the 534 malaria cases,the vast majority were individuals who had traveled to countries in sub-Saharan Africa and Southeast Asia for work,business,international studies,or tourism.Over the five years,the median,minimum,and maximum days for patients from onset of illness to health-seeking were 1(0,12),1(0,8),0(0,6),0(0,10),and 1(0,18)days,with a statistically significant difference in health-seeking time among patients(Fisher's exact test,P=0.03).Over the past three years of the COVID-19 pandemic,compared to outside centralized isolation stations,malaria cases within centralized isolation stations were diagnosed in a shorter time(Fisher exact test,P=0.007).A total of 24 severe malaria cases were reported,with no deaths,including 23 cases of P.falciparum and 1 case of P.ovale.Conclusions After the elimination of malaria,imported malaria cases in Jiangsu Province have sharply decreased due to the impact of the COVID-19 pandemic.Malaria cases in centralized isolation stations(CIS)for COVID-19 control of Jiangsu Province are more likely to be promptly diagnosed,and the timeliness from onset to health-seeking among malaria patients returning from high-malaria areas improved.As COVID-19 prevention and control policies adjusted,there has been a sharp increase in imported malaria cases in 2023.It's still necessary to strengthen measures for malaria prevention and control and maintain the capacity to prevent malaria re-transmission in Jiangsu Province.