云南腾冲市1950—2017年疟疾流行与防治措施
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摘要
目的了解腾冲市历年疟疾流行情况及防治措施,评估腾冲市疟疾防治工作成效,为指导疟疾消除后监测工作提供依据。方法对腾冲市1950—2017年疟疾防治疫情数据、报表、防治措施和相关文件等资料进行描述性分析和总结。结果腾冲市1950—2017年共报告疟疾病例104 067例,死亡2 904例,病死率2.79%,1951年发病率最高,为4 817.12/10万,2017年发病率最低,为5.46/10万,1950—1989年以本地感染病例为主,1990年后输入性病例逐渐增多,2006年输入性病例达最高峰,随后呈逐年下降趋势,至2017年降至最低。2012—2013年捕获按蚊12种,中华按蚊为优势蚊种,全市均有分布,其次是昆明按蚊,主要分布于北部乡镇,微小按蚊在南部乡镇散在分布。防治工作经历控制疟疾流行(1950—1985年)、消除前阶段(1986—2009年)和消除疟疾(2010—2017年)3个阶段,2012年10月发现最后1例本地感染病例,2013—2017年连续5年无本地感染疟疾病例报告,2017年11月通过省级消除疟疾考核评估。结论腾冲市疟疾防治成效显著,达到了消除疟疾标准,但存在中华按蚊、昆明按蚊、微小按蚊等疟疾传播媒介,下一步应加强监测,防止发生本地传播及输入病例继发传播,巩固消除疟疾的成果。
Objective To understand the malaria epidemic situation and control interventions in Tengchong City overthe years, evaluate the effectiveness, so as to provide the proof for the activities implemented in the malaria post-eliminationphase. Methods The data of surveillance, epidemic status, annual reports, sentinel monitoring, and related materials werecollected and analyzed in Tengchong City from 1950 to 2017. Results From 1950 to 2017, a total of 104 067 malaria caseswere reported, and there were 2 904 deaths and the mortality rate was 2.79% in Tengchong City, with the highest incidence(4 817.12/105) in 1951 and the lowest incidence(5.46/105) in 2017. The indigenous malaria infections were mainly prevalentfrom 1950 to 1989, while the imported malaria cases gradually increased since the year 1990, and after the peak time in 2006,the reported malaria cases decreased year by year till the lowest incidence in 2017. Twelve species of Anopheles were capturedfrom 2012 to 2013, while An. sinensis was predominant species and was widely distributed in the whole city. An. kunmingensis was mainly distributed in the northern townships, while An. minimus scatteredly distributed in southern townships. Thestrategies and interventions for malaria prevention and control have been implemented for 3 phases, including malaria controlphase from 1950 to 1985, pre-elimination phase from 1986 to 2009, and elimination phase from 2010 to 2017. The lastindigenous case was reported in October 2012, and none of local transmission was reported for at least five years since 2013.Conclusion Malaria control in Tengchong City has achieved remarkable progress and fulfilled the standards of malariaelimination. However, there still exist malaria transmission vectors, such as An. sinensis, An.kunmingensis, and An. Minimus.Therefore, the surveillance system should be strengthened to consolidate the achievements of malaria elimination.
Objective To understand the malaria epidemic situation and control interventions in Tengchong City overthe years, evaluate the effectiveness, so as to provide the proof for the activities implemented in the malaria post-eliminationphase. Methods The data of surveillance, epidemic status, annual reports, sentinel monitoring, and related materials werecollected and analyzed in Tengchong City from 1950 to 2017. Results From 1950 to 2017, a total of 104 067 malaria caseswere reported, and there were 2 904 deaths and the mortality rate was 2.79% in Tengchong City, with the highest incidence(4 817.12/105) in 1951 and the lowest incidence(5.46/105) in 2017. The indigenous malaria infections were mainly prevalentfrom 1950 to 1989, while the imported malaria cases gradually increased since the year 1990, and after the peak time in 2006,the reported malaria cases decreased year by year till the lowest incidence in 2017. Twelve species of Anopheles were capturedfrom 2012 to 2013, while An. sinensis was predominant species and was widely distributed in the whole city. An. kunmingensis was mainly distributed in the northern townships, while An. minimus scatteredly distributed in southern townships. Thestrategies and interventions for malaria prevention and control have been implemented for 3 phases, including malaria controlphase from 1950 to 1985, pre-elimination phase from 1986 to 2009, and elimination phase from 2010 to 2017. The lastindigenous case was reported in October 2012, and none of local transmission was reported for at least five years since 2013.Conclusion Malaria control in Tengchong City has achieved remarkable progress and fulfilled the standards of malariaelimination. However, there still exist malaria transmission vectors, such as An. sinensis, An.kunmingensis, and An. Minimus.Therefore, the surveillance system should be strengthened to consolidate the achievements of malaria elimination.
引文
[1]中华人民共和国卫生部.关于印发《中国消除疟疾行动计划(2010-2020年)》的通知[EB/OL].[2010-05-26].http://www.nhfpc.gov.cn/zwgk/wtwj/201304/15a4cc7a40b0452191fe409590ca99d8.shtml.
[2]董学书,王学忠,张国才,等.昆明按蚊(Anopheles Kunmingensis)的地理分布、生态习性、传疟作用及其防治研究[J].动物学研究,1990,11(4):317-323.
[3]张国才,董学书,王学忠,等.腾冲县昆明按蚊的分布及传疟作用调查[J].中国寄生虫病防治杂志,1989,2(3):206.
[4]中华人民共和国卫生部.疟疾控制和消除标准:GB26345-2010[S].北京:中国标准出版社,2011.
[5]曹俊,周水森,周华云,等.中国疟疾从控制走向消除:消除阶段的目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):439-443.
[6]王加志,尹授钦,李胜国,等.云南腾冲市2010-2015年疟疾防控措施及效果分析[J].中国寄生虫学与寄生虫病杂志,2016,34(5):435-438,455.
[7]杨恒林,肖宁,杨亚明,等.中缅和中老边境地区消除疟疾的挑战、机遇与对策[J].中国热带医学,2017,17(4):321-324,335.
[8]丰俊,张丽,张少森,等.全国2005:2015年疟疾疫情分析[J].中国热带医学,2017,17(4):325-335.
[9]刘慧,李兴亮,陈华,等.缅甸克钦邦芒温区疟疾流行情况调查[J].中国病原生物学杂志,2011,6(1):55-59.
[10]陈国伟,李华宪,蔺应学.缅甸克钦邦第二特区拉咱市疟疾流行特征横向调查[J].中国媒介生物学及控制杂志,2012,23(4):352-356.
[11]董学书.云南省的传疟媒介及其有关的生态习性[J].中国寄生虫病防治杂志,2000,13(2):144-147.
[12]尹授钦,李希尚,康显虎,等.云南省腾冲县传疟媒介构成初步调查[J].国际医学寄生虫病杂志,2013,40(1):37-39.
[13]李希尚,李胜国,王加志,等.云南省腾冲市2012-2013年蚊媒调查分析[J].中国媒介生物学及控制杂志,2016,27(4):398-401.
[14]张少森,周水森,周正斌,等.中国-缅甸边境地区微小按蚊种群密度及其生态习性调查[J].中国媒介生物学及控制杂志,2017,28(3):216-219,254.
[15]邓永元.云南腾冲高海拔区疟疾流行因素分析[J].中国热带医学,2003,3(2):158-159.
[16]王加志,尹授钦,李胜国,等.云南腾冲市2000~2015年本地感染疟疾疫情流行病学分析[J].热带病与寄生虫学,2016,14(3):152-154.
[17]尹授钦,夏尚,周兴武,等.云南省边境地区疟疾传播风险评估[J].中国寄生虫学与寄生虫病杂志,2016,34(3):255-260.2018-07-16
[2]董学书,王学忠,张国才,等.昆明按蚊(Anopheles Kunmingensis)的地理分布、生态习性、传疟作用及其防治研究[J].动物学研究,1990,11(4):317-323.
[3]张国才,董学书,王学忠,等.腾冲县昆明按蚊的分布及传疟作用调查[J].中国寄生虫病防治杂志,1989,2(3):206.
[4]中华人民共和国卫生部.疟疾控制和消除标准:GB26345-2010[S].北京:中国标准出版社,2011.
[5]曹俊,周水森,周华云,等.中国疟疾从控制走向消除:消除阶段的目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):439-443.
[6]王加志,尹授钦,李胜国,等.云南腾冲市2010-2015年疟疾防控措施及效果分析[J].中国寄生虫学与寄生虫病杂志,2016,34(5):435-438,455.
[7]杨恒林,肖宁,杨亚明,等.中缅和中老边境地区消除疟疾的挑战、机遇与对策[J].中国热带医学,2017,17(4):321-324,335.
[8]丰俊,张丽,张少森,等.全国2005:2015年疟疾疫情分析[J].中国热带医学,2017,17(4):325-335.
[9]刘慧,李兴亮,陈华,等.缅甸克钦邦芒温区疟疾流行情况调查[J].中国病原生物学杂志,2011,6(1):55-59.
[10]陈国伟,李华宪,蔺应学.缅甸克钦邦第二特区拉咱市疟疾流行特征横向调查[J].中国媒介生物学及控制杂志,2012,23(4):352-356.
[11]董学书.云南省的传疟媒介及其有关的生态习性[J].中国寄生虫病防治杂志,2000,13(2):144-147.
[12]尹授钦,李希尚,康显虎,等.云南省腾冲县传疟媒介构成初步调查[J].国际医学寄生虫病杂志,2013,40(1):37-39.
[13]李希尚,李胜国,王加志,等.云南省腾冲市2012-2013年蚊媒调查分析[J].中国媒介生物学及控制杂志,2016,27(4):398-401.
[14]张少森,周水森,周正斌,等.中国-缅甸边境地区微小按蚊种群密度及其生态习性调查[J].中国媒介生物学及控制杂志,2017,28(3):216-219,254.
[15]邓永元.云南腾冲高海拔区疟疾流行因素分析[J].中国热带医学,2003,3(2):158-159.
[16]王加志,尹授钦,李胜国,等.云南腾冲市2000~2015年本地感染疟疾疫情流行病学分析[J].热带病与寄生虫学,2016,14(3):152-154.
[17]尹授钦,夏尚,周兴武,等.云南省边境地区疟疾传播风险评估[J].中国寄生虫学与寄生虫病杂志,2016,34(3):255-260.2018-07-16