2017-2020年郑州市输入性疟疾流行特征及重症病例影响因素  

Epidemic characteristics of imported malaria and influencing factors of severe cases in Zhengzhou from 2017 to 2020

作　　者：高利华[1] 张月泉[1] 师佳佳[1] 吕明洁[1] 刘颖[2] 袁中良[1] GAO Lihua;ZHANG Yuequan;SHI Jiajia;LYU Mingjie;LIU Ying;YUAN Zhongliang(Zhengzhou Center for Disease Control and Prevention,Zhengzhou,Henan 450007,China;Henan Center for Disease Control and Prevention)

机构地区：[1]郑州市疾病预防控制中心,河南郑州450007 [2]河南省疾病预防控制中心

出　　处：《河南预防医学杂志》2022年第8期575-578,634,共5页Henan Journal of Preventive Medicine

摘　　要：目的 分析2017-2020年郑州市输入性疟疾流行特征及重症病例影响因素,为疟疾防控工作提供科学依据。方法 整理中国疾病预防控制中心传染病监测信息系统和寄生虫病防治信息管理系统中2017-2020年郑州市报告的疟疾病例个案信息,对重症和非重症病例的就诊过程、诊断机构、诊断时间等进行统计分析。结果 2017-2020年,郑州市共报告疟疾确诊病例218例,均为输入性,主要输入地为非洲(211例,占96.8%)。病例中男女性别比为42.6∶1;现住址为非郑州市辖区143例(65.6%);由省级医疗机构报告205例(94.0%)。临床分型恶性疟163例(19.9%),卵形疟38例(17.4%),间日疟9例(4.1%),混合感染1例(0.5%);重症病例14例(6.4%)。14例重症病例初诊为非疟疾、转诊、有并发症比例均为100.0%,分别高于非重症病例的37.3%(76/204)、48.5%(99/204)和0.0%(χ2分别为21.278、13.902和201.667,P均<0.05);重症病例的初诊-确诊时间和发病-确诊时间(d)的中位数(四分位间距)[M(QR)]均长于非重症病例[5.5(6.8) vs 1.0(3.0);7.0(11.5) vs 3.0(5.0)](Z值分别为-3.949和-4.223,P均<0.05);在医疗机构初诊的病例中,重症病例和非重症病例初诊在县级以下医疗机构的比例分别为61.5%(8/13)和22.0%(41/186),差异有统计学意义(χ2=8.915,P<0.05)。结论 应提高医疗机构(尤其是县级以下医疗机构)对疟疾的诊断能力,缩短初诊-确诊时间,以降低疟疾重症的发生率。Objective To analyze the epidemic characteristics of imported malaria and the factors affecting severe cases in Zhengzhou from 2017 to 2020,and provide scientific evidence for malaria prevention and control efforts.Methods The individual case information of malaria cases reported in Zhengzhou from 2017-2020 was collected from the Chinese Information System for Infectious Diseases Control and Prevention and the Parasitic Diseases Information Reporting Management System of Chinese Center for Disease Control and Prevention;the course of visits,the institution of diagnosis,and the diagnosis time of severe and non-severe cases were analyzed statistically.Results From 2017-2020,a total of 218 confirmed cases of malaria were reported in Zhengzhou,all of which were imported cases.The main importing region was Africa(211 cases,96.8%),and the male to female sex ratio among the cases was 42.6∶1;143 cases(65.6%) were out of Zhenzhou city jurisdiction;205 cases(94.0%) were reported by provincial health facilities.Cases were clinically typed as 163 cases of falciparum malaria(19.9%),38 cases of ovale malaria(17.4%),9 cases of vivax malaria(4.1%),and 1 case of mixed infection(0.5%).Of the cases,14 cases(6.4%) were severe cases.Of the 14 severe cases,the proportions of cases who were initially diagnosed as diseases other than malarial,referred,and had complications were 100.0%,which were higher than those of non-severe cases(37.3%,76/204;48.5%,99/204;0.0%,0/204)(χ2= 21.278,13.902,and 201.667,respectively,all P<0.05).The median(interquartile range) [M(QR)] duration between initial diagnosis and onset to diagnosis(d) among the severe cases were both longer than those among the non-severe cases[5.5(6.8) vs 1.0(3.0);7.0(11.5) vs 3.0(5.0)](Z-scores were-3.949 and-4.223,respectively,all P<0.05).Among the cases initially diagnosed in medical institutions,the proportions of severe cases and non-severe cases initially diagnosed in medical institutions below county level were 61.5%(8/13) and 22.0%(41/186),respectively,which were statis

关 键 词：疟疾 输入性 重症疟疾 危险因素 郑州市 

分 类 号：R531.3[医药卫生—内科学]