海南省三亚市一起罕见的当地三日疟疫情分析及处置  

Investigation of a rare local epidemic of Plasmodium malariae infection in Sanya City,Hainan Province

作　　者：林常勇 陈朱[1] 王善青[2] 罗丕泽[1] 吴德雷 郑爱军[1] 魏家佳 

机构地区：[1]三亚市疾病预防控制中心,海南三亚572000 [2]海南省疾病预防控制中心,海南海口570203

出　　处：《中国热带医学》2016年第5期481-484,共4页China Tropical Medicine

摘　　要：目的对海南三亚市一起罕见的本地传播三日疟疫情调查和处置进行描述,以明确虫种、分布特征和流行程度。方法通过回顾性调查收集病例及相关数据,采用描述性统计学方法,阐明此次疟疾疫情的三间分布特征;通过镜检、RDT和PCR确定疟原虫虫种,媒介调查明确主要传播媒介,为及时规范治疗和媒介控制提供依据;对村民进行疟疾防治知识宣传,对村医进行疾病诊断和治疗知识培训,及时规范治疗患者和控制媒介,对疫情进行有效的控制。结果在疟疾流行季节通过镜检和PCR共确诊三日疟6例,间日疟1例,这是历史上首次在海南三亚发现本地三日疟病例,年龄主要在40岁以下,4—9月份为疫情发病期。在疫点村、周边居民和临近村庄的上山人群范围内开展主动病例调查,发现带虫者5例,带虫率0.39%。媒介调查发现村庄主要媒介为微小按蚊。经及时应急处理和规范治疗,患者全部治愈。通过对疫点村居民房舍进行溴氰菊酯滞留喷洒等综合性防制措施,有效控制了疫情的进一步蔓延。结论海南省三亚市首次发现本地感染三日疟为主的疟疾疫情,采取治疗患者、媒介防制等综合性措施后疫情得到控制。Objective To investigate the epidemiologic characteristics of a rare local epidemic of Plasmodium malariaeinfection and identify the parasite classification, distribution characteristics and epidemic situation for better control andelimination of malaria in Sanya City, Hainan Province. Methods Based on the retrospective study and case survey, therelative case information was collected to explore the distribution characteristics and the epidemic. A microscopic examinationand PCR were carried out to identify the parasite classification for effective treatment and vector control in time. A descriptiveepidemic investigation was performed to evaluate the effectiveness of integrated prevention measures including malariaprevention and treatment education for villagers, disease diagnosis and treatment knowledge training for village doctors, andvector control. Results A total of 6 cases of P. malariae,1 case of P. vivax infection were detected in malaria endemicseason and all the cases were diagnosed by microscope and PCR. This was the first report in Sanya City, Hainan Province forlocal P. malariae infection. All the patients were under 40 years old, and from April to September were the period for malariatransmission. The active case investigation was carried out in the foci of village residents and residents in nearby villages, and 5cases of carriers were found with the case rate of 0.39%. The main vector was Anopheles minimus. After the prompt emergencycontrol and standard treatment, all the patients were cured. The epidemic situation was controlled by the integrated strategiesfor prevention and control and all houses were residually sprayed with deltamethrin. Conclusion This is the first time to findthe local P. malariae infection epidemic, and the comprehensive measures, such as the treatment of patients and vector control,are performed and the epidemic is controlled.

关 键 词：三日疟 疫情 三亚 

分 类 号：R531.3[医药卫生—内科学]