2017—2023年河南省许昌市输入性疟疾特征及病例诊断分析

Characteristics and case diagnosis analysis of imported malaria in Xuchang City,Henan Province from 2017 to 2023

从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2017—2023年河南省许昌市疟疾消除后输入性疟疾疫情数据及病例流行病学个案调查资料,分析疫情和病例诊断特征。2017—2023年许昌市共报告疟疾病例65例,其中恶性疟48例(占73.8%)、卵形疟10例(占15.4%)、三日疟2例(占3.1%)、间日疟3例(占4.6%)和混合感染2例(占3.1%)。男女性别比为20.7∶1。报告地区主要为建安区(30.8%,20/65)、禹州市(26.2%,17/65)和魏都区(18.5%,12/65),无明显季节分布特征。病例从发病到确诊间隔时间P50为2 d(P25,P75:1 d,4 d);有、无疟疾史病例从发病到确诊的时间中位数均为2 d(1,4),两者差异无统计学意义(Z=-0.636,P>0.05);就诊后3 d内确诊率为83.1%(54/65)。2017—2023年许昌市省级、市、县(区)三级医疗卫生单位报告疟疾病例占比分别为7.7%(5/65)、50.8%(33/65)、41.5%(27/65)。病例首诊单位省、市、县(区)、乡村级占比分别为7.7%(5/65)、29.2%(19/65)、29.2%(19/65)、33.9%(22/65)(χ^(2)=7.999,P<0.05),首诊确诊率分别为5/5、17/19、16/19、0(0/22)(χ^(2)=47.228,P<0.01)。报告病例均为境外输入性病例,以非洲的尼日利亚(20.0%,13/65)、刚果(金)(15.4%,10/65)和几内亚(9.2%,6/65)为主。

The data on imported malaria and epidemiological investigation of individual cases reported in Xuchang City,Henan Province,were collected from the Infectious Disease Surveillance Reporting and Management Sys‑tem,and the Parasitic Disease Prevention and Control Information Management System from 2017 to 2023.The epide‑miological characteristics and case diagnosis were analyzed.There were 65 malaria cases reported in Xuchang City,in‑cluding 48 Plasmodium falciparum infections(73.8%),10 P.ovale infections(15.4%),2 P.malariae infections(3.1%),3 P.vivax infections(4.6%)and 2 mixed infections(3.1%).The male‑to‑female ratio was 20.7∶1.The cases were mainly reported by districts of Jian’an(30.8%,20/65),Yuzhou(26.2%,17/65)and Weidu(18.5%,12/65),and there was no apparent seasonal variation in distribution.The time interval P50 between the onset and diagnosis of the cases was 2 days(P25,P75:1 d,4 d).The median time interval from onset to diagnosis for cases with and without a history of malaria was 2 days(1,4),with no statistically significant difference(Z=-0.636,P>0.05).The malaria diagnosis accuracy rate within 3 days after medical consultation was 83.1%(54/65).The proportion of malaria cases reported by provincial,municipal,and county(district)medical facilities in Xuchang City from 2017 to 2023 was 7.7%(5/65),50.8%(33/65),and 41.5%(27/65),respectively.The proportion of initial diagnosis medical facilities at the provincial,municipal,county(district),and rural levels was 7.7%(5/65),29.2%(19/65),29.2%(19/65),and 33.9%(22/65),re‑spectively(χ^(2)=7.999,P<0.05)and their malaria diagnosis accuracy rates were 5/5,17/19,16/19,and 0(0/22),re‑spectively(χ^(2)=47.228,P<0.01).The reported cases were all imported cases,mainly from Nigeria(20.0%,13/65),the Democratic Republic of Congo(15.4%,10/65),and Guinea(9.2%,6/65)in Africa.