2018年全国疟疾疫情特征及消除工作进展
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摘要
目的分析2018年全国疟疾疫情特征及消除疟疾进展,为消除疟疾策略和措施的有效实施提供科学依据。方法收集2018年全国31个省(直辖市、自治区,未包括台湾、香港和澳门地区)的疟疾疫情数据资料,使用Microsoft Excel 2010软件对消除疟疾进展情况和疫情特征等数据资料进行统计分析。结果2018年全国796个机构累计报告疟疾病例2 678例,较2017年(2 861例)减少了6.4%,中国籍病例2 518 (94.0%,2 518/2 678),外国籍病例160例(6. 0%, 160/2 678);男女性别比为12. 9∶1,病例年龄主要集中在20～59岁(89. 2%, 2 390/2 678);临床诊断病例5例(0. 2%, 5/2 678),间日疟397例(14. 8%, 397/2 678),恶性疟1 765例(65.9%, 1 765/2 678),三日疟83例(3.1%, 83/2 678),卵形疟376例(14.0%, 376/2 678),混合感染52例(1.9%, 52/2 678)。全国范围内无本地感染病例报告,境外输入性病例2 671例(99.7%, 2 671/2 678),输入继发病例4例,非蚊传病例2例,长潜伏期病例1例。报告疟疾病例数位居前5位的省(自治区),依次为广西(254例, 9.5%)、江苏(243例, 9.1%)、山东(233例, 8.7%)、四川(221例, 8.3%)、云南(213例,8.0%);全国15个省(直辖市、自治区)报告重症病例117例(4.4%, 117/2 678), 6个省(直辖市、自治区)报告死亡病例7例(0.3%, 7/2 678)。疟疾病例均在24 h内完成网络上报, 3 d内流行病学个案调查完成率为93.0%(2 491/2 678), 7 d内调查并处置了2 250个疫点。结论 2018年继2017年已连续两年全国实现了无本地感染疟疾病例报告,但应继续加强重点地区境外输入性疟疾的监测和管理,巩固消除疟疾成果。
Objective To analyze the epidemiological characteristic of malaria and the updates of malaria elimination in China so as to provide evidence-based reference for facilitating the National Malaria Elimination Program. Methods The malaria epidemic data in 2018 were collected from 31 provinces/municipalities/autonomous regions(Taiwan, Hongkong and Macao regions not included) in China through Malaria Annual Reporting System,and analyzed using Microsoft Excel 2010 software. Results Total 2 678 malaria cases were reported from 796 institutions in China in 2018, which is decreased by 6.4% compared to the cases reported in 2017(2 861 cases).The reported cases included 2 518 Chinese(94.0%) and 160 foreigners(6.0%). Most of the cases fell into the age range of 20-59 years(89.2%, 2 390/2 678) with a male-to-female ratio of 12.9 : 1. There were 397 cases infected with Plasmodium vivas(14.8%, 397/2 678), 1 765 infected with P. falciparum(65.9%, 1 765/2 678), 83 P. malariae(3.1%, 83/2 678), 376 P. ovale(14.0%, 376/2 678), 52 cases of mixed-infection(1.9%, 52/2 678) and 5 clinically diagnosed cases(0.2%, 5/2 678). No indigenous case was found while 2 671(99.7%, 2 671/2 678) were identified as imported cases, 4 cases of introduced cases, 2 induced cases and 1 long-term dormant case. The top 5 provinces with highest number of malaria cases were Guangxi(254, 9.5%), Jiangsu(243, 9.1%), Shandong(233,8.7%), Sichuan(221, 8.3%) and Yunnan(213, 8.0%). Total 117 cases with severe clinical symptoms were reported(4.4%, 117/2 678) from 15 provinces/municipalities/autonomous regions with 7 deaths(0.3%, 7/2 678) from 6 provinces/municipalities/autonomous regions. The 1-3-7 approach was implemented nationwide with good performance:all cases were reported within 24 hour(1 day) after diagnosis, 93.0%(2 491/2 678) of the cases were epidemiologically investigated within 3 days, and 2 250 sites with case identified were investigated and prevention measures were performed within 7 days. Conclusion Malaria was close towards elimination in China with no indigenous case reported for successive two years in the whole country from 2017-2018, however, more attention should be paid to the imported cases of malaria including the national surveillance and case management.
Objective To analyze the epidemiological characteristic of malaria and the updates of malaria elimination in China so as to provide evidence-based reference for facilitating the National Malaria Elimination Program. Methods The malaria epidemic data in 2018 were collected from 31 provinces/municipalities/autonomous regions(Taiwan, Hongkong and Macao regions not included) in China through Malaria Annual Reporting System,and analyzed using Microsoft Excel 2010 software. Results Total 2 678 malaria cases were reported from 796 institutions in China in 2018, which is decreased by 6.4% compared to the cases reported in 2017(2 861 cases).The reported cases included 2 518 Chinese(94.0%) and 160 foreigners(6.0%). Most of the cases fell into the age range of 20-59 years(89.2%, 2 390/2 678) with a male-to-female ratio of 12.9 : 1. There were 397 cases infected with Plasmodium vivas(14.8%, 397/2 678), 1 765 infected with P. falciparum(65.9%, 1 765/2 678), 83 P. malariae(3.1%, 83/2 678), 376 P. ovale(14.0%, 376/2 678), 52 cases of mixed-infection(1.9%, 52/2 678) and 5 clinically diagnosed cases(0.2%, 5/2 678). No indigenous case was found while 2 671(99.7%, 2 671/2 678) were identified as imported cases, 4 cases of introduced cases, 2 induced cases and 1 long-term dormant case. The top 5 provinces with highest number of malaria cases were Guangxi(254, 9.5%), Jiangsu(243, 9.1%), Shandong(233,8.7%), Sichuan(221, 8.3%) and Yunnan(213, 8.0%). Total 117 cases with severe clinical symptoms were reported(4.4%, 117/2 678) from 15 provinces/municipalities/autonomous regions with 7 deaths(0.3%, 7/2 678) from 6 provinces/municipalities/autonomous regions. The 1-3-7 approach was implemented nationwide with good performance:all cases were reported within 24 hour(1 day) after diagnosis, 93.0%(2 491/2 678) of the cases were epidemiologically investigated within 3 days, and 2 250 sites with case identified were investigated and prevention measures were performed within 7 days. Conclusion Malaria was close towards elimination in China with no indigenous case reported for successive two years in the whole country from 2017-2018, however, more attention should be paid to the imported cases of malaria including the national surveillance and case management.
引文
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[17]毛强,裴福全,岑咏珍,等.广东省1例输血性恶性疟病例的实验室检测和溯源调查[J].中国寄生虫学与寄生虫病杂志,2018,36(5):529-535.
[18]廖峭,单振刚,王敏,等.广州市1例输入性恶性疟病例的流行病学调查[J].国际输血与血液学杂志,2018,41(1):15-20.
[19]张倩,耿启彬,孙军玲,等. 2005-2014年中国疟疾死亡病例流行特征分析[J].中华预防医学杂志,2016,50(4):302-305.
[20]钱丹,刘颖,杨成运,等. 2010-2015年河南省疟疾死亡病例分析[J].中国血吸虫病防治杂志,2017,29(1):87-89.
[2]丰俊,张丽,周水森,等.全国2005-2015年疟疾疫情分析[J].中国热带医学,2017,17(4):325-334.
[3]张丽,丰俊,张少森,等. 2015年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2016,34(6):477-481.
[4]张丽,丰俊,周水森,等. 2016年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志,2017,35(6):515-519.
[5]张丽,丰俊,张少森,等. 2017年全国消除疟疾进展及疫情特征分析[J].中国寄生虫学与寄生虫病杂志,2018,36(3):201-209.
[6]曹园园,周华云,朱国鼎,等.江苏省巩固消除疟疾成果面临的挑战[J].中国血吸虫病防治杂志,2018,30(4):460-464.
[7]曹俊,刘耀宝,曹园园,等.中国消除疟疾的持续挑战:输入性疟疾[J].中国寄生虫学与寄生虫病杂志,2018,36(2):93-96.
[8]杨维中,周晓农.中国在疟疾消除阶段面临的新挑战[J].中华预防医学杂志,2016,50(4):289-291.
[9]曹俊,周水森,周华云,等.中国疟疾从控制走向消除-消除阶段目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):449-443.
[10]汤林华.中国消除疟疾的目标、策略与路径[J].中国热带医学,2016,16(4):301-304.
[11]林常用,陈朱,王善青,等.海南省三亚市一起罕见的当地三日疟疫情分析与处置[J].中国热带医学,2016,16(5):481-484.
[12]林明和,王善青,杜建伟,等.在海南山区搜索残余疟疾病例的初步研究[J].中国热带医学,2015,15(5):617-618.
[13]滕聪,雷露,孙英伟,等. 2008-2013年辽宁省疟疾流行病学分析[J].中国血吸虫病防治杂志,2014,26(2):200-202.
[14]陈国伟,王军,黄兴周,等.云南省8个边境州市19个口岸入境者疟疾血清学检测[J].中国寄生虫学与寄生虫病杂志,2010,28(1):54-57.
[15]李建雄,周兴武,赵晓涛,等.云南省消除疟疾行动规划中期评估报告[J].中国热带医学,2016,16(4):343-348.
[16]周水森,严俊,夏志贵,等.西藏自治区消除疟疾的机遇、挑战与对策[J].中国寄生虫学与寄生虫病杂志,2015,33(6):425-428.
[17]毛强,裴福全,岑咏珍,等.广东省1例输血性恶性疟病例的实验室检测和溯源调查[J].中国寄生虫学与寄生虫病杂志,2018,36(5):529-535.
[18]廖峭,单振刚,王敏,等.广州市1例输入性恶性疟病例的流行病学调查[J].国际输血与血液学杂志,2018,41(1):15-20.
[19]张倩,耿启彬,孙军玲,等. 2005-2014年中国疟疾死亡病例流行特征分析[J].中华预防医学杂志,2016,50(4):302-305.
[20]钱丹,刘颖,杨成运,等. 2010-2015年河南省疟疾死亡病例分析[J].中国血吸虫病防治杂志,2017,29(1):87-89.