溧阳市消除疟疾后输入性疟疾疫情及病例诊断分析  

ANALYSIS OF AN IMPORTATION OUTBREAK AND CASE DIAGNOSIS AFTER MALARIA ELIMINATION IN LIYANG CITY,JIANGSU PROVINCE

作　　者：黄小妹[1] 黄立中[1] 蒋靓[1] 刘建俊 孔卫荣 HUANG Xiao-mei;HUANG Li-zhong;JIANG Liang;LIU Jian-jun;KONG Wei-rong(Department of Schistosomiasis,Parasitosis and Endemic Disease Prevention,Liyang Center for Disease Control and Prevention,Liyang 213300,Jiangsu,China)

机构地区：[1]溧阳市疾病预防控制中心血寄地防科,江苏溧阳213300

出　　处：《寄生虫与医学昆虫学报》2024年第2期65-71,共7页Acta Parasitologica et Medica Entomologica Sinica

摘　　要：目的对溧阳市消除疟疾后输入性疟疾疫情及病例诊断进行分析,为制定防止疟疾输入再传播防控策略提供依据。方法收集2013—2022年溧阳市疟疾疫情、病原学检测、个案流行病学调查报告、病例的复核报告等资料,运用SPSS 22.0软件进行统计分析。结果2013—2022年溧阳市共报告疟疾病例54例,均为境外输入性病例,其中恶性疟40例(74.07%),卵形疟10例(18.52%),间日疟4例(7.41%)。53例(98.15%)病例感染地来源于非洲。男性青壮年53例(98.15%),农民40例(74.07%);全年各月均有病例报告;全市10个镇(街道)均有病例分布,4例输入性间日疟分布在溧城街道、戴埠镇和上兴镇。临床症状以发热54例(100.00%)、发冷41例(75.93%)为主。从发病到初诊时间中位数为1 d,从初诊到确诊时间中位数为0 d。病例首诊确诊率66.67%(36/54),疾控机构和县级医院的首诊确诊率分别为100.00%(19/19)和76.19%(16/21)。确诊单位主要为疾控机构30例(55.56%)和县级医院23例(42.59%)。54例病例镜检阳性49例,阳性率90.74%。39例病例采用镜检法和RDTs检测,镜检阳性35例,阳性率89.74%;RDT阳性36例,阳性率92.31%,两种检测方法阳性率差异无统计学意义(χ^(2)=0.16,P>0.05)。病例的县级复核定性结果、诊断虫种与省级复核结果一致率分别为94.44%和96.30%。结论溧阳市已进入消除疟疾后阶段,但境外输入性间日疟仍对该市防止疟疾输入再传播构成潜在风险。因此,当前疟疾防控工作的重点是加强疟疾病例管理,提升医疗机构的疟疾检测与诊治能力,并加强疟疾健康教育,增强重点人群的疟疾防控意识。通过这些措施的实施,可以有效防止疟疾输入再传播,巩固消除疟疾成果。Objective To analyze the imported malaria epidemic and case diagnoses after eliminating malaria in Liyang,and also provide data for formulating strategies to prevent malaria re-transmission.Methods Data on malaria epidemic status,etiological detection,case epidemiological investigation reports,and case review reports in Liyang from 2013 to 2022 were collected and SPSS software(version 22.0)was used for statistical analysis.Results From 2013 to 2022,a total of 54 imported malaria cases were reported in Liyang City,including 40 cases of falciparum malaria(74.07%),10 cases of vivax malaria(18.52%)and four cases of tertian malaria(7.41%).All but one case originated in Africa,comprising 53 male cases aged 15-59 years and 74.07%of the victims are farmers.These malaria cases occur in all seasons,with a high prevalence in January,and are distributed in all 10 towns/streets.Notably,four tertiary malaria cases were reported in Licheng Street(2 cases),Daibu Town and Shangxing Town.The main clinical symptoms were fever(n=54,100.00%)and chills(n=41,75.93%).The median time from onset of illness to confirmation of diagnosis was one day.The rates of initial correct diagnosis were 100.0%in the Centre for Disease Control and Prevention(CDC)(19/19)and 76.19%(16/21)in district hospitals.The CDC confirmed 30 malaria cases and the district hospitals confirmed 23 cases.Of the 54 confirmed cases,49 were diagnosed by morphological observations on blood smears under the microscopes.Thirty-nine cases were diagnosed by both morphological observation and Rapid Detection Tips(RDT).There was no statistically significant difference between the two test methods(χ^(2)=0.16,P>0.05).The concordance rates of malaria species identification and diagnosis at the county level were 94.44%and 96.30%,respectively,with those re-qualified by the provincial department.Although Liyang City has entered the post-elimination phase of the malaria epidemic,there is still a potential risk of recurrence of endemic malaria caused by these imported P.vivax in the city

关 键 词：疟疾 输入性病例 疫情 病例诊断 溧阳市 

分 类 号：R382.3[医药卫生—医学寄生虫学]