河南省许昌市消除疟疾前后输入性疟疾诊治能力比较  

Comparison on the ability of diagnosis and treatment of imported malaria before and after malaria elimination in Xuchang,Henan

作　　者：彭金华[1] 周雅冰 马莹莹[1] 吴宁[1] 李晓利[1] PENG Jinhua;ZHOU Yabing;MA Yingying;WU Ning;LI Xiaoli(Xuchang Center for Disease Control and Prevention,Xuchang,Henan 461000,China)

机构地区：[1]许昌市疾病预防控制中心,河南许昌461000

出　　处：《现代疾病预防控制》2024年第3期218-222,226,共6页MODERN DISEASE CONTROL AND PREVENTION

摘　　要：目的比较许昌市消除疟疾前后输入性疟疾诊治情况,分析存在的问题,为加强消除后疟疾监测和防止疟疾输入再传播提供科学依据。方法通过《中国疾病预防控制信息系统》收集许昌市疟疾疫情数据和个案调查资料,对消除疟疾前(2011—2016年)和消除疟疾后(2017—2022年)病例发病至初诊时间、初诊至确诊时间以及各级医疗卫生机构的初诊确诊率进行比较。结果2011—2022年许昌市共报告经实验室确诊的输入性疟疾118例,其中消除疟疾前67例,消除疟疾后51例。118例病例中,恶性疟占77.12%。消除疟疾前后,病例发病至初诊间隔天数的中位数均为1 d,初诊至确诊间隔天数的中位数分别为0 d和1 d,发病后0~3 d就诊的患者比例由消除疟疾前的80.60%提高至消除疟疾后的94.12%(χ^(2)=4.516,P<0.05);0~3 d确诊的疟疾患者比例由消除疟疾前的53.73%提高至消除疟疾后的72.55%(χ^(2)=4.346,P<0.05);市级医院和区(县)级医院确诊病例占比由消除疟疾前的31.3%提高至消除疟疾后的62.7%(χ^(2)=11.541,P<0.001);疟疾病例在本地诊断和治疗的比例均高于消除疟疾前(χ^(2)分别为10.529和19.383,P均<0.05)。结论消除疟疾后,许昌市市级医院和区(县)级医疗机构对疟疾的诊断能力有所提升,病例在本地诊断和治疗的比例大幅上升,发病至确诊时间逐渐缩短,但乡级及以下医疗机构的疟防意识较差,今后应加强对基层医务人员开展疟疾防治知识培训。Objective To comparing the diagnosis and treatment of imported malaria cases before and after malaria elimination in Xuchang and analyze the existing problems so as to provide scientific evidence for strengthening surveillance and preventing the secondary transmission of imported malaria cases.Methods Malaria epidemic and case investigation data were collected through the China Disease Prevention and Control Information System,and then the duration fromonset to first time to see doctor,the duration from the first time to see doctor to final diagnosis,and the rate of confirmed diagnosis at the first time to see doctor at all-level healthcare institutions were compared.Results A total of 118 laboratory-confirmed imported malaria cases were reported in Xuchang from 2011 to 2022,including 67 cases before malaria elimination and 51 cases after malaria elimination.Among the 118 cases,malignant malaria accounted for 77.12%.Before and after the elimination of malaria,the median durations from onset to first time so see doctor both were 1 day,and the median duration from first time so see doctor to final diagnosis was 0 day and 1 day,respectively;the proportion of cases who saw doctor within 3 days after onset increased from 80.60%before elimination to 94.12%after elimination(χ^(2)=4.516,P<0.05);the proportion of cases diagnosed within 3 days after onset increased from 53.73%before elimination to 72.55%after elimination(χ^(2)=4.346,P<0.05);the proportion of cases confirmed by city-level and county/district-level hospitals increased from 31.3%before elimination to 62.7%after elimination,(χ^(2)=11.541,P<0.01);the proportion of malaria cases diagnosed and treated locally was significantly higher than that before eliminating malaria(χ^(2)=10.529,19.383,P<0.05).Conclusions After the elimination of malaria,the ability of malaria diagnosis and treatment in city-level and county/district-level hospitals of Xuchang increased significantly compared with that before the elimination of malaria;the proportion of cases diagnosed an

关 键 词：输入性疟疾 消除 初诊确诊率 许昌 

分 类 号：R531.3[医药卫生—内科学]