海南省三亚市1名间日疟原虫带虫者的调查与处置  

Investigation and deposition of a Plasmodium vivax carrier in Sanya City, Hainan Province

作　　者：林常勇 王善青[2] 陈朱[1] 罗丕泽[1] 魏家佳 吴德雷 郑爱军[1] LIN Changyong WANG Shanqing CHEN Zhu LUO Peize WEI Jiajia WU Delei ZHEN Aijun(Sanya Center for Disease Control and Prevention, Sanya, Hainan 572000, China)

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12期1243-1245,共3页China Tropical Medicine

摘　　要：目的分析和总结海南省三亚市天涯区高峰一名间日疟原虫带虫者的调查与处置,为防治和消除疟疾提供科学依据。方法通过回顾性调查收集该带虫者发现、诊断及处置等的相关信息,查阅三亚市历年疟疾资料等。结果在处置1起本地三日疟疫情中,通过PCR(巢式)检测发现1名间日疟无症状感染者,该无症状感染者入院治疗时无畏寒、发热等不适症状,体温正常,血常规检查未见异常,血涂片镜检和RDT检测均为阴性,但是PCR(巢式)检测为阳性;该无症状感染者为三亚本地居民,既往无疟疾史和输血史。近3年,未曾外出务工,也无畏寒、发热等疟疾临床表现;该无症状感染者经治疗后,多次随访血涂片镜检、RDT和PCR(巢式)检测均为阴性。后经另一个省级疟疾诊断参比实验室通过PCR荧光探针法检测该感染者治疗前采集的血样,其结果为阴性。随访至今该感染者无复发,现正常工作和生活。结论该间日疟原虫带虫者虽然一开始被诊断为本地间日疟无症状感染者,但其流行病学调查结果没有直接和明显的证据支持。此外,两次不同PCR方法的检测,其结果不一样,故不能排除第一次PCR检测结果为假阳性的可能。提示今后碰到此类情况,除考虑流行病学调查情况和临床表现的同时,还需寻求更多准确和有力的证据。Objective To analyze and summarize the survey and deposition of a Plasmodium vivax carrier in Tianya District, Sanya City, Hainan Province, so as to provide the evidence for improving the work of prevention, control and elimination of malaria. Methods The information about how to find, diagnose and treat the parasite carrier was collected and analyzed, and the malaria data of epidemic situation in Sanya City over the years were also reviewed. Results The malaria carrier was found by PCR detection and was sent to hospital with no symptoms of chills and fever. The carrier＇s routine blood test was normal and the blood malaria detection was negative by the microscopic examination of blood films and RDT, but was positive by PCR. The carrier lived in Sanya City from childhood and did not work outside the city in recent three years, and without family history of malaria and history of blood transfusion. After the treatment, the carrier＇s blood malaria detection was negative by the microscopic examination of blood films, RDT and PCR several times. Later, the carrier accepted another malaria detection by means of PCR fluorescence probe techniques in a provincial malaria diagnosis reference laboratory and the result was also negative. So far, the infected person has been living and working regularly, showing no recurrence.Conclusions The P. vivax carrier was diagnosed as a non-symptom infected person at first, but there were no direct and obvious evidence from the epidemiology investigation supporting the result. Furthermore, different kinds of PCR methods obtained different outcomes, which reveals the outcome of the first PCR detection may be false positive. Therefore, when the similar situation happens, it is necessary to explore other accurate and convincing evidence to support the detection result instead of only considering epidemiology investigation and clinical manifestation.

关 键 词：三亚 间日疟 带虫者 调查与处置 

分 类 号：R181.8[医药卫生—流行病学]