福建省疟疾消除后基层监测响应系统现况分析  

Current status of the primary surveillance and response system during the post malaria elimination phase in Fujian Province

作　　者：陈朱云[1] 欧阳榕[1] 肖丽贞 林耀莹[1] 谢汉国[1] 张山鹰[1] CHEN Zhuyun;OUYANG Rong;XIAO Lizhen;LIN Yaoying;XIE Hanguo;ZHANG Shanying(Fujian Key Laboratory of Zoonosis,Fujian Provincial Center for Disease Control and Prevention,Fuzhou 350012,China)

机构地区：[1]福建省疾病预防控制中心,福建省人兽共患病研究重点实验室,福州350001

出　　处：《中国寄生虫学与寄生虫病杂志》2023年第2期170-175,共6页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：福建省科技计划引导性项目(2016Y0009);福建省科技创新平台建设项目(2019Y2001)。

摘　　要：目的 分析福建省疟疾消除后基层监测响应系统现况,为制定疟疾消除后防治措施提供科学依据。方法 2020年10月对福建省85个县(市、区)级疾控机构开展基层疟疾防治能力的回顾性调查,调查内容主要包括疟疾防治经费、技术人员数量、药品储备、检测仪器、定点医院、病例监测、媒介监测、培训等,结合消除疟疾后2016—2020年疟疾防治工作年报表,按照输入再传播风险等级,分析福建省消除疟疾后基层监测响应系统现况。采用SPSS 17.0软件进行统计学分析,计量资料根据方差齐性采用t检验或Wilcoxon秩和检验,计数资料采用卡方检验。结果福建省2016—2020年共血检92 280人份,阳性505例(0.55%),均为输入性病例。就诊的505例疟疾病例中,初诊在基层(县级及以下医疗机构和疾控中心)就诊的占23.37%(118/505),基层初诊确诊占比27.97%(33/118)。94.12%(80/85)的基层疾控机构3年内(2018—2020年)有疟疾防治经费,平均为0.97万/(年·县),间日疟再传播风险县的疾控机构年平均经费(1.35万元)高于潜在间日疟再传播风险县(0.88万元)(t=2.16,P <0.05)。不具备疟原虫检测能力(缺乏显微镜或专业镜检人员)的基层疾控机构有20个(占23.53%),其中80%(16/20)的县近3年均有输入性疟疾病例报告。基层疾控机构抗疟药品和快速诊断检测(RDT)试剂盒储备的占比均较低,分别为4.71%(4/85)和8.24%(7/85),其中间日疟再传播风险县疾控机构有RDT储备的占比(4/17)高于潜在间日疟再传播风险县(4.41%, 3/68),差异有统计学意义(χ2=4.29, P <0.05)。2016—2020年全省85个县(市、区)共培训12 040人次,防治人员和检测人员的培训数呈下降趋势(分别从2016年的1 509、656人下降至2020年的819、348人),临床医生培训数呈上升趋势(从2016年的404人上升至2020年的887人)。2018—2020年3年内85.88%(73/85)的基层疾控机构至少组织1次疟疾培训,其中仅3.53%(3/85)和2.35%(2/85)Objective To analyze the current status of primary surveillance and response system in Fujian Province after malaria elimination,and to provide the scientific basis for the formulation of malaria control and prevention measures.Methods In October 2020,a retrospective survey was carried out on the malaria control and prevention capability in 85 counties(cities and districts)during 2016—2020 in Fujian Province.The survey content included the funding for control,number of technical personnel,medicine back store,detection equipments,designated hospitals,clinical cases monitoring,transmission vector surveillance,and personnel training,combining with the annual malaria control reports in in post-elimination years,to analyze the current status of primary surveillance response system during the malaria post-elimination phase in the province based on the risk ranking of imported cases vs retransmission.SPSS 17.0 software was used for statistical analysis.The measurement data were analyzed using t-test or Wilcoxon rank sum test based on the homogeneity of variance,and the counting data were analyzed using chi-square test.Results A total of 92280 blood samples were tested in the province from 2016 to 2020,among 505 were positive(0.55%),defined as imported cases.The reported cases first visited primary medical institutions accounted for 23.37%(118/505),which increased year by year,with statistical significance(χ2=16.49,P<0.05).But the initial diagnosis rate was 27.97%(33/118),which did not increase with the number of patients(χ2=2.50,P>0.05).A total of 94.12%(80/85)of primary centers for Disease Control and Prevention had funding for malaria control and elimination in the previous three years(2018—2020),with an average of 9700 yuan per county per year.The average annual funding in counties with higher risk of re-establishment of transmission by Plasmodium vivax was higher(13500 yuan)than the counties with the potential risk(8800 yuan).The difference was statistically significant(t=2.16,P<0.05).There were 20 primary CDC

关 键 词：疟疾 消除 监测响应 福建 

分 类 号：R531.3[医药卫生—内科学]