2010—2023年武汉市疟疾流行特征分析  

Analysis of malaria epidemic characteristics in Wuhan from 2010 to 2023

作　　者：徐文秀 陈芳[1] 刘聪[1] 罗华堂[1] 杨燕[1] XU Wen-xiu;CHEN Fang;LIU Cong;LUO Hua-tang;YANG Yan(Wuhan Center for Disease Control and Prevention,Wuhan,Hubei 430000,China)

机构地区：[1]武汉市疾病预防控制中心,湖北武汉430000

出　　处：《现代预防医学》2024年第17期3242-3247,共6页Modern Preventive Medicine

摘　　要：目的分析2015年武汉市通过消除疟疾考核评估前后(2010—2015年和2016—2023年)疟疾病例流行特征,为制定疟疾防治政策、评价防治效果提供科学依据。方法收集2010—2023年武汉市疟疾病例流调内容、个案调查表等信息,以2015年作为消除疟疾前后的时间分隔分析病例的感染虫种、感染来源、诊治情况等。结果2010—2023年武汉市共报告疟疾病例547例,发病率为0.05/10万~0.74/10万,其中恶性疟73.8%、间日疟13.1%、卵形疟8.0%、三日疟2.3%、混合感染2.5%。除2010年报告4例本地病例以外均为境外输入性病例,非洲为病例主要来源地,占89.9%,非洲感染病例虫种以恶性疟为主,占79.6%,亚洲和大洋洲以非恶性疟为主,占77.7%,不同来源国家疟疾虫种差异有统计学意义(χ^(2)=83.6,P<0.05)。2010—2023年疟疾病例以20~49岁青壮年男性为主,其中农民以及工人占52.8%,病例主要分布在东西湖区、武昌区、江岸区,分别占25.9%、19.0%、12.7%。全年各月均有疟疾病例报告,2010—2015年7月为疟疾病例报告高峰共37例,4~9月报告病例数占比59.2%(197/302);2016—2023年2、8和12月存在流行高峰。报告病例初诊单位集中在县级及以上医疗卫生机构,占77.2%,其中省、市、县级医疗卫生机构初诊正确率比例较高,村卫生室或个体医生初诊正确率较低,不同单位初诊情况差异有统计学意义(χ^(2)=95.3,P<0.05);2016—2023年疟疾初诊正确率较2010—2015年明显提高,差异有统计学意义(χ^(2)=4.4,P<0.05)。2010—2015年、2016—2023年就诊到确诊的时间间隔为72 h以内的病例分别占63.9%、71.8%,差异有统计学意义(χ^(2)=3.87,P<0.05);恶性疟、间日疟、卵型疟、三日疟和混合感染24 h内确诊病例比例差异有统计学意义(χ^(2)=13.9,P<0.05)。结论2010—2023年武汉市疟疾病例以非洲输入恶性疟占比最高,青壮年男性农民及工人为主,虫种趋于多样化。应继续加强疟疾病例流�Objective To analyze the epidemic characteristics of malaria cases in Wuhan before and after the assessment of malaria elimination in 2015(2010—2015 and 2016—2023),providing a scientific basis for formulating malaria prevention and control policies and evaluating their effectiveness.Methods Data on malaria cases including epidemiological surveys and case reports from 2010 to 2023 were collected.The year 2015 was used as a time point to analyze the species of infecting parasites,sources of infection,and treatment conditions.Results A total of 547 malaria cases were reported in Wuhan from 2010 to 2023,with an incidence rate ranging from 0.05 to 0.74 per 100000 people.Among these,73.8%were caused by Plasmodium falciparum,13.1%by Plasmodium vivax,8.0%by Plasmodium ovale,2.3%by Plasmodium malaria,and 2.5%involved mixed infections.Except for four locally transmitted cases reported in 2010,all other cases were imported,with Africa being the primary source(89.9%).In African cases,Plasmodium falciparum accounted for 79.6%,while non-falciparum species predominated in Asia and Oceania(77.7%).There were statistically significant differences in malaria parasite species from different source countries(χ^(2)=83.6,P<0.05).From 2010 to 2023,malaria cases predominantly affected males aged 20 to 49,with farmers and workers comprising 52.8%of the cases.The majority of cases were reported in the Dongxihu District(25.9%),Wuchang District(19.0%),and Jiang’an District(12.7%).Cases were reported throughout the year,with a peak in July from 2010 to 2015(37 cases),and 59.2%of cases(197/302)occurring from April to September.Between 2016 and 2023,peaks were observed in February,August,and December.The initial diagnosis of reported cases was concentrated in county-level and higher medical institutions(77.2%),with higher accuracy rates in provincial,municipal,and county-level institutions compared to village clinics or individual practitioners(statistically significant differences,χ^(2)=95.3,P<0.05).The accuracy of initial diagnoses fo

关 键 词：武汉市 疟疾 流行特征 输入病例 

分 类 号：R531.3[医药卫生—内科学] R51[医药卫生—临床医学]