湖北省消除疟疾前后疟疾疫情变化趋势分析  

Epidemic characteristics of malaria cases before and after malaria elimination in Hubei Province

作　　者：吴冬妮[1] 张华勋[1] 朱红[1] 万伦[1] 孙凌聪[1] 曹慕民[1] 夏菁[1] 张娟[1] WU Dong-ni;ZHANG Hua-xun;ZHU Hong;WAN Lun;SUN Ling-cong;CAO Mu-min;XIA Jing;ZHANG Juan(Institute of Schistosomiasis Control,Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China)

机构地区：[1]湖北省疾病预防控制中心,血吸虫病防治研究所,湖北武汉430079

出　　处：《中国热带医学》2023年第6期579-584,共6页China Tropical Medicine

基　　金：湖北省自然科学基金项目(No.2020CFB130);湖北省卫生健康委员会科研项目(No.WJ2021Q047);湖北省卫生健康委员会科研项目(No.WJ2019Q055);湖北省卫生计生委疾控专项(No.WJ2016J-037)。

摘　　要：目的整理2017—2021年湖北省疟疾病例资料,对湖北省消除疟疾前后疟疾疫情变化趋势进行对比分析,为湖北省优化消除疟疾后防止输入再传播策略提供科学依据。方法收集2017—2021年传染病报告信息管理系统湖北省网报疟疾病例资料,对消除疟疾前(2017—2019年)和消除疟疾后(2020—2021)湖北省疟疾疫情开展流行病学特征分析。结果2017—2021年湖北省共报告境外输入性疟疾病例429例,疟疾疫情呈现先升后降的变化趋势。消除前共报告疟疾374例,其中恶性疟262例(70.05%);消除后报告55例,其中恶性疟25例(45.45%)。疟疾消除前后,四种疟原虫感染病例占比差异有统计学意义(χ^(2)=14.248,P<0.05)。消除前,1、7和11月为病例报告的高峰期;消除后,1—2月和12月为高峰期。消除疟疾前后,病例报告地均主要集中在武汉市、宜昌市、黄石市、襄阳市、十堰市和黄冈市,但病例分布范围呈现明显的缩小趋势。消除疟疾前后,湖北省疟疾病例均以30~<50岁中青年男性为主。工人和民工占比分别由消除前的37.70%和9.09%,提高至消除后的50.91%和18.18%,消除疟疾前后职业占比差异有统计学意义(χ^(2)=17.839,P<0.05)。发病至初诊时间≥5 d的病例占比由消除前的21.66%下降至消除后的10.91%,消除疟疾前后,发病至初诊时间间隔占比差异有统计学意义(χ^(2)=6.448,P<0.05)。乡镇卫生院的初诊正确率由消除前的18.18%提升至消除后的50.00%。县级医疗机构确诊疟疾病例的占比从消除前的22.73%上升到消除后的34.55%。消除疟疾前后,各级医疗机构确诊疟疾病例的占比差异无统计学意义(χ^(2)=5.630,P>0.05)。初诊至确诊的时间间隔在24 h的病例占比由消除前的43.85%提升至消除后的70.91%。消除疟疾前后,初诊至确诊时间间隔病例占比差异有统计学意义(χ^(2)=14.006,P<0.05)。消除疟疾前后,疟疾病例感染来源地均主要来自非洲国家。结论�Objective To collect and organize malaria case data in Hubei Province from 2017 to 2021,compare and analyze the malaria epidemic characteristics on the before and after malaria elimination,and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria.Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System,and conducting the epidemiological characteristics of malaria on pre-elimination(2017-2019)and post-elimination(2020-2021).Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021,and the malaria epidemic showed an obvious trend of rising first and then falling.On the pre-malaria elimination,374 malaria cases were reported,including 262 cases of P.falciparum(70.05%);on the post-malaria elimination,55 malaria cases were reported,including 25 cases of P.falciparum(45.45%).There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria(χ^(2)=14.248,P<0.05).On the pre-malaria elimination,the peak of disease onset mainly occurred in January,July,and November;on the post-malaria elimination,the peak of disease onset mainly occurred in January to February,and December.Both before and after malaria elimination,the reported cases were mainly concentrated in Wuhan,Yichang,Huangshi,Xiangyang,Shiyan and Huanggang,but the range of cases showed a clear trend of narrowing.Before and after malaria elimination,malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49.The proportions of workers and migrant workers increased from 37.70%and 9.09%before the elimination to 50.91%and 18.18%after the elimination,respectively,with a statistically significant difference(χ^(2)=17.839,P<0.05).The percentage of interval from onset of illness to

关 键 词：疟疾 消除疟疾前 消除疟疾后 防止输入再传播 

分 类 号：R531.3[医药卫生—内科学]