山东省2017-2018年境外输入性疟疾流行病学特征分析  

Epidemiological characteristics of imported malaria in Shandong province, 2017-2018

作　　者：许艳[1] 赵长磊[1] 王用斌[1] 王龙江 卜秀芹[1] 张本光[1] 孔祥礼[1] Xu Yan;Zhao Changlei;Wang Yongbin;Wang Longjiang;Bu Xiuqin;Zhang Benguang;Kong Xiangli(Shandong Institute of Parasitic Diseases,Shandong First Medical University&Shandong Academy of Medical Sciences,Jining 272033,China)

机构地区：[1]山东省寄生虫病防治研究所,山东第一医科大学(山东省医学科学院),济宁272033

出　　处：《中华流行病学杂志》2020年第9期1494-1498,共5页Chinese Journal of Epidemiology

基　　金：山东省自然科学基金(ZR2019PH118,ZR2017YL005);山东省医药卫生科技发展计划(2016WS0391)。

摘　　要：目的 了解山东省境外输入性疟疾流行特征,为及时调整防控措施提供科学依据。方法 收集2017-2018年山东省疟疾疫情资料、病例个案调查资料及省级参比实验室病例复核资料,采用SPSS 18.0软件进行统计分析,采用QGIS 2.18软件绘制地图。结果 2017-2018年山东省共报告境外输入性疟疾442例,感染来源主要为非洲地区(占97.96%,433/442)。17个地市均有病例报告,主要集中在济宁市(88例)、烟台市(65例)、威海市(46例)、青岛市(44例)和德州市(42例),共报告285例(占64.48%,285/442)。病例分布于山东省77.37%(106/137)的县(市、区)。每月均有病例报告,未呈现明显的季节特征。发病-初诊时间间隔M=2 d(P25~P75:3 d)。初诊-确诊时间间隔M=0 d(P25~P75:3 d)。病例发病当天就诊率为27.83%(123/442)。69.68%(308/442)的病例初诊被诊断为疟疾,经χ2检验,县级以下医疗机构诊断正确率低于其他医疗机构(均P<0.01)。51.13%(226/442)的病例就诊当天确诊,经χ2检验,各级医疗机构当天确诊率差异无统计学意义(P>0.05)。结论 2017-2018年山东省境外输入性疟疾具有病例数量多、感染来源广、地区分布广等特征,病例及时就诊意识淡薄,基层医疗机构疟疾诊治意识和能力尚弱,应针对性的调整防控措施。Objective To understand epidemiological characteristics of imported cases of malaria in Shandong province and provide scientific basis for timely adjustment of prevention and control measures. Methods The incidence data of malaria, case investigation data and case review data by Shandong Provincial Reference Laboratory for Malaria Diagnosis from 2017 to 2018 were collected. Software SPSS 18.0 was used for statistical analysis and software QGIS 2.18 was used for mapping. Results A total of 442 imported cases of malaria were reported in Shandong from 2017 to 2018, and the main infection source was in Africa (97.96%, 433/442). All the 17 prefectures in Shandong reported imported malaria cases, mainly in Jining (88 cases), Yantai (65 cases), Weihai (46 cases), Qingdao (44 cases) and Dezhou (42 cases), accounting for 64.48% (285/442). The cases were distributed in 77.37%(106/137) of counties of the province. The cases were reported in every month without seasonal characteristics. The median (M) of time interval between onset and the first medical care seeking was 2 days, and the interquartile range (IQR) was 3 days. The M of time interval between the first medical care seeking and final diagnosis was 0 day, and the IQR was 3 days. The proportion of medical care seeking on onset day was only 27.83% (123/442). Only 69.68% (308/442) of cases were diagnosed with malaria in the first medical care seeking, and the diagnostic accuracy of medical institutions below the county level was lower than other medical institutions (all P<0.01). Only 51.13% (226/442) of cases were diagnosed with malaria in the first medical care seeking, the differences in the rates among medical institutions at different levels were not significant (P>0.05). Conclusions The imported malaria in Shandong was characterized by a large number of cases, multiple infection sources and wide area distribution during 2017-2018. The awareness of timely medical care seeking in the cases was low, meanwhile the awareness and ability of malaria diagnosis and treatm

关 键 词：境外输入 疟疾 流行特征 

分 类 号：R181.3[医药卫生—流行病学] R531.3[医药卫生—公共卫生与预防医学]