2011—2020年陕西省疟疾流行特征

doi:10.12140/j.issn.1000-7423.2022.04.006

摘要/Abstract

摘要：

目的分析2011—2020年陕西省疟疾病例流行特征与诊断情况,为消除疟疾后防止再传播的监测和防控工作提供依据。方法在国家传染病报告信息管理系统、寄生虫病防治信息管理系统中收集2011—2020年陕西省疟疾监测报告数据和疟疾病例个案流行病学调查数据,对病例感染虫种、感染来源、地区分布、月度分布和诊断及时性进行分析。病例报告月份分布采用圆形分布法进行分析,发病-诊断时间间隔采用Kruskal-Wallis检验。结果 2011—2020年陕西省共报告疟疾病例609例,其中境外输入病例604例,国内其他省输入病例4例（为2011—2013年报告病例,均来自云南）,1例复发病例（为2010年商洛市商州区报告病例,于2011年复发）。报告病例感染来源地主要为非洲（559例,占91.79%）和亚洲（45例,占7.39%）。恶性疟447例（占73.40%）,间日疟79例（占12.97%）,卵形疟56例（占9.19%）,三日疟11例（占1.81%）,未分型疟疾16例（占2.63%）。恶性疟病例主要来自几内亚（71例）、安哥拉（70例）、喀麦隆（43例）,间日疟主要来自埃塞俄比亚（17例）、巴基斯坦（9例）、安哥拉（7例）,卵形疟主要来自几内亚（19例）、尼日利亚（8例）、安哥拉（7例）,三日疟主要来自几内亚（3例）、安哥拉（3例）。2011—2020年每月均有疟疾病例报告,其中1月和7月累计报告病例数较多,分别占总报告病例数的10.84%（66/609）和9.69%（59/609）。2011—2020年陕西省疟疾报告月份分布无集中趋势（Z = 0.754,P > 0.05）。病例报告地以西安市雁塔区最多（230例）,占总报告病例数的37.77%;病例现住址地以安康市汉滨区最多（72例）,占总报告病例数的11.82%。2011—2020年,疟疾报告病例的年龄集中于20~50岁,占总报告病例数的86.70%（529/609）;职业以农民、工人和干部职员为主,分别占总报告病例数的38.92%（237/609）、19.21%（117/609）和11.82%（72/609）。2011—2017年报告疟疾病例发病-确诊时间间隔中位数为5~7 d,其后降至2020年的3 d,各年度报告疟疾病例发病-确诊时间间隔差异有统计学意义（χ² = 25.457,P < 0.05）。结论 2011—2020年陕西省报告的疟疾病例以境外输入性病例为主,感染来源地主要为非洲,感染虫种主要为恶性疟原虫。

关键词: 疟疾, 感染来源, 监测, 诊断

Abstract:

Objective To analyze the malaria epidemiological characteristics and malaria case information in Shaanxi province from 2011 to 2020 to provide basis for the surveillance and prevention of re-transmission after malaria elimination. Methods Malaria surveillance data and individual case epidemiological survey data in 2011—2020 in Shaanxi Province were collected from the national infectious disease reporting information management system and parasitic disease prevention and control information management system, analyzing the infected species, source of infection, regional distribution, monthly distribution and diagnosis timeliness. The distribution of monthly case report was analyzed using the circular distribution method, and the onset-diagnosis time interval was determined using the Kruskal-Wallis test. Results From 2011 to 2020, a total of 609 malaria cases were reported in Shaanxi Province, including 604 imported from abroad, four imported from other provinces in China (reported from 2011 to 2013, all from Yunnan Province), and one recurrent case (reported in Shangzhou District, Shangluo City in 2010, which recurred in 2011). The main sources of reported cases were Africa (559 cases, accounting for 91.79%) and Asia (45 cases, accounting for 7.39%). There were 447 cases of P. falciparum infection (accounting for 73.40%), 79 cases of P. vivax infection (accounting for 12.97%), 56 cases of P. ovale infection (accounting for 9.19%), 11 cases of P. malariae infection (accounting for 1.81%), and 16 cases of uncharacterized Plasmodium (accounting for 2.63%). The P. falciparum cases were mainly from Guinea (71 cases), Angola (70 cases) and Cameroon (43 cases). The P. vivax cases were mainly from Ethiopia (17 cases), Pakistan (9 cases) and Angola (7 cases). The P. ovale cases were mainly from Guinea (19 cases), Nigeria (8 cases) and Angola (7 cases). The P. malariae cases were mainly from Guinea (3 cases) and Angola (3 cases). From 2011 to 2020, malaria cases were reported every month, with more cases reported in January and July, accounting for 10.84% (66/609) and 9.69% (59/609) of the total cases, respectively. There was no central trend in the distribution of malaria reporting months in Shaanxi Province from 2011 to 2020 (Z = 0.754, P > 0.05). The Yanta District of Xi’an City had the most cases reported (230 cases), accounting for 37.77% of the total number of cases; the current address of the cases is the most in Hanbin District of Ankang City (72 cases), accounting for 11.82% of the total number of cases. From 2011 to 2020, the age of reported malaria cases was concentrated in 20-50 years old, accounting for 86.70% (529/609) of the total reported cases. The occupations are mainly farmers, workers and cadres, accounting for 38.92% (237/609), 19.21% (117/609) and 11.82% (72/609) of the total cases, respectively. The median time interval between onset of symptoms and diagnosis of malaria cases from 2011 to 2017 was 5 to 7 days, and then decreased to 3 days in 2020. There was a statistically significant difference in the time interval between onset of symptoms and diagnosis of malaria cases each year (χ² = 25.457, P < 0.05). Conclusion The malaria cases reported in Shaanxi Province from 2011 to 2020 were mainly imported from overseas, mostly from Africa, with the predominant infection species P. falciparum.

Key words: Malaria, Source of infection, Monitoring, Diagnosis

中图分类号:

R531.3

曹磊, 马琳, 朱妮, 张义, 王安礼, 王舒, 李欣欣. 2011—2020年陕西省疟疾流行特征[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(4): 454-459.

CAO Lei, MA Lin, ZHU Ni, ZHANG Yi, WANG An-li, WANG Shu, LI Xin-xin. Epidemiological characteristics of malaria in Shaanxi Province from 2011 to 2020[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2022, 40(4): 454-459.

图/表 5

图1

表1

表2

图2

图3

参考文献 27

[1]	Feng NN, Tao W, Feng T, et al. Epidemiological analysis of malaria in Hebei Province from 2011 to 2019[J]. Chin J Parasitol Parasit Dis, 2021, 39(6): 786-793. (in Chinese)
	( 冯宁宁, 陶薇, 冯彤, 等. 2011—2019年河北省疟疾疫情分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(6): 786-793.)
[2]	Kheang ST, Sovannaroth S, Barat LM, et al. Malaria elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia[J]. BMC Public Health, 2020, 20(1): 544. doi: 10.1186/s12889-020-08634-4 pmid: 32321475
[3]	WHO. World malaria report 2021[R]. Geneva: World Health Organization, 2021: 1-36.
[4]	Chen ZY, Ouyang R, Xie HG, et al. Epidemic status of imported malaria at different stages of malaria elimination in Fujian Province[J]. Chin J Parasitol Parasit Dis, 2020, 38(6): 702-708. (in Chinese)
	( 陈朱云, 欧阳榕, 谢汉国, 等. 福建省消除疟疾不同时期输入性疟疾疫情分析[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(6): 702-708.)
[5]	Wu YQ, Liu YT, Zhang GQ. Investigation of mosquitoes in Shaanxi Province[J]. J Fourth Mil Med Univ, 1987, 8(1): 51-55. (in Chinese)
	( 吴元钦, 刘永泰, 张国琪. 陕西省蚊类的调查[J]. 第四军医大学学报, 1987, 8(1): 51-55.)
[6]	Li XX, Zhang Y, Yang GJ, et al. Diagnosis of imported malaria cases in Shaanxi, 2015—2019[J]. Chin Trop Med, 2021, 21(1): 64-69. (in Chinese)
	( 李欣欣, 张义, 杨国婧, 等. 陕西省2015—2019年输入性疟疾病例诊断情况[J]. 中国热带医学, 2021, 21(1): 64-69.)
[7]	General Office of National Health Commission. Circular of the General Office of the NHC on the adoption of the provincial malaria elimination assessment in Hebei and other provinces[Z]. Beijing: National Health Commission, 2019.
	( 国家卫生健康委办公厅. 国家卫生健康委办公厅关于河北等省份通过省级消除疟疾评估的通知[Z]. 北京: 国家卫生健康委, 2019.)
[8]	Xu QL, Zhou HR, Qian MB, et al. Research progress on economic burden of malaria[J]. Chin J Parasitol Parasit Dis, 2020, 38(6): 749-752. (in Chinese)
	( 许秋利, 周鸿让, 钱门宝, 等. 疟疾经济负担研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(6): 749-752.)
[9]	Gao Q. Challenge and response of imported malaria for preventing malaria re-establishment[J]. Chin Trop Med, 2021, 21(1): 1-4. (in Chinese)
	( 高琪. 输入性疟疾对巩固消除疟疾成果防止再传播的挑战和对策[J]. 中国热带医学, 2021, 21(1): 1-4.)
[10]	Feng J, Zhang L, Tu H, et al. From elimination to post-elimination: characteristics, challenges and re-transmission preventing strategy of imported malaria in China[J]. Chin Trop Med, 2021, 21(1): 5-10. (in Chinese)
	( 丰俊, 张丽, 涂宏, 等. 从消除到消除后:中国输入性疟疾的疫情特征、挑战及防止再传播策略[J]. 中国热带医学, 2021, 21(1): 5-10.)
[11]	Zhang L, Feng J, Tu H, et al. Malaria epidemiology in China in 2020[J]. Chin J Parasitol Parasit Dis, 2021, 39(2): 195-199. (in Chinese)
	( 张丽, 丰俊, 涂宏, 等. 2020年全国疟疾疫情分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(2): 195-199.)
[12]	Zhang L, Feng J, Xia ZG, et al. Epidemiological characteristics of malaria and progress on its elimination in China in 2019[J]. Chin J Parasitol Parasit Dis, 2020, 38(2): 133-138. (in Chinese)
	( 张丽, 丰俊, 夏志贵, 等. 2019年全国疟疾疫情特征分析及消除工作进展[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(2): 133-138.)
[13]	Hu XF, Wu S, Weng YQ, et al. Epidemiology of global malaria and imported malaria in China[J]. Dis Surveillance, 2021, 36(10): 1057-1062. (in Chinese)
	( 胡学锋, 吴霜, 翁贇琦, 等. 疟疾全球流行现状及我国输入性疫情分析[J]. 疾病监测, 2021, 36(10): 1057-1062.)
[14]	Tang LH, Gao Q, Yu XB, et al. Diagnosis of malaria: WS 259—2015[S]. Beijing: National Health and Family Planning Commission of the People’s Republic of China, 2015. (in Chinese)
	( 汤林华, 高琪, 余新炳, 等.疟疾的诊断: WS 259—2015[S]. 北京: 中华人民共和国国家卫生和计划生育委员会, 2015.)
[15]	Chinese Center for Disease Control and Prevention. Technical programme to prevent imported re-transmission after malaria elimination[Z]. Beijing: Chinese Center for Disease Control and Prevention, 2020. (in Chinese)
	( 中国疾病预防控制中心. 消除疟疾后防止输入再传播技术方案[Z]. 北京: 中国疾病预防控制中心, 2020.)
[16]	Bo SS, Zhang XJ, Wang XC, et al. Research progress on malaria status among Chinese overseas labor personnel[J]. Chin J Parasitol Parasit Dis, 2020, 38(3): 400-404. (in Chinese)
	( 薄珊珊, 张晓娟, 王晓春, 等. 我国出国劳务人员疟疾的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(3): 400-404.)
[17]	Li J, Wei SJ, Zhang WW, et al. Analysis of malaria epidemiological characteristics in Guangxi Province in 2010—2019[J]. Chin J Parasitol Parasit Dis, 2020, 38(5): 589-594. (in Chinese)
	( 黎军, 韦树娇, 张伟尉, 等. 2010—2019年广西疟疾流行特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(5): 589-594.)
[18]	Yang MM, Wang WM, Cao YY, et al. Epidemic situation and diagnosis of imported malaria in Jiangsu, 2015—2019[J]. Chin Trop Med, 2021, 21(1): 33-36, 54. (in Chinese)
	( 杨蒙蒙, 王伟明, 曹园园, 等. 江苏省2015—2019年输入性疟疾疫情及病例诊断[J]. 中国热带医学, 2021, 21(1): 33-36, 54.)
[19]	Lu LD, An D, Li Y, et al. Survey on malaria prevention and control among abroad labor workers dispatched by two companies in Guizhou Province[J]. Chin J Parasitol Parasit Dis, 2019, 37(5): 612-615. (in Chinese)
	( 卢丽丹, 安冬, 李杨, 等. 贵州省两家机构出境务工人员疟疾防控现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(5): 612-615.)
[20]	Gong YF, Lei L, Li ZH, et al. Spatial-temporal distribution of malaria in Jiangxi Province from 1950 to 2017[J]. Chin J Schisto Control, 2019, 31(4): 414-417. (in Chinese)
	( 龚艳凤, 雷蕾, 李志宏, 等. 1950—2017年江西省疟疾时空分布特征分析[J]. 中国血吸虫病防治杂志, 2019, 31(4): 414-417.)
[21]	Lü FL. The interaction between COVID-19 and malaria[J]. J Trop Med, 2021, 21(10): 1356-1360. (in Chinese)
	( 吕芳丽. 新型冠状病毒肺炎与疟疾的相互影响[J]. 热带医学杂志, 2021, 21(10): 1356-1360.)
[22]	Wang FL, Jia XZ, Song HB, et al. Clinical characteristics of 97 cases of imported malaria and analysis of antimalarial drug use in Shaanxi[J]. Chin Trop Med, 2021, 21(5): 467-470, 495. (in Chinese)
	( 王凤兰, 贾小洲, 宋红波, 等. 陕西省97例输入性疟疾的临床特点及抗疟药物用药分析[J]. 中国热带医学, 2021, 21(5): 467-470, 495.)
[23]	Li SH, Ji PH, Zhou RM, et al. Analysis of diagnosis of malaria reference laboratories in Henan Province during 2015—2019[J]. Chin J Parasitol Parasit Dis, 39(4): 1-5. (in Chinese)
	( 李素华, 纪鹏慧, 周瑞敏, 等. 2015—2019年河南省疟疾参比实验室诊断能力分析[J]. 中国寄生虫学与寄生虫病杂志, 39(4): 1-5.)
[24]	Cao YY, Cotter C, Wang WM, et al. Malaria elimination in China: improving county-level malaria personnel knowledge of the 1-3-7 strategy through tabletop exercises[J]. Am J Trop Med Hyg, 2020, 102(4): 804-810. doi: 10.4269/ajtmh.19-0560
[25]	Mo XT, Xia S, Ai L, et al. Study on a framework for risk assessment of imported malaria in China during malaria elimination[J]. Chin Trop Med, 2021, 21(6): 505-511. (in Chinese)
	( 莫晓彤, 夏尚, 艾琳, 等. 在消除阶段我国疟疾风险评估指标体系研究[J]. 中国热带医学, 2021, 21(6): 505-511.)
[26]	Tie P, Wang T, Yan CF, et al. Incidence analysis of malaria in Shanxi, 2014—2018[J]. Dis Surveillance, 2020, 35(2): 136-139. (in Chinese)
	( 帖萍, 王婷, 闫昌福, 等. 2014—2018年山西省疟疾疫情分析[J]. 疾病监测, 2020, 35(2): 136-139.)
[27]	Yang CY, Qian D, Lu DL, et al. Malaria situation in Henan, 2011—2019[J]. Mod Prev Med, 2021, 48(3): 393-397. (in Chinese)
	( 杨成运, 钱丹, 鲁德领, 等. 2011—2019年河南省疟疾疫情分析[J]. 现代预防医学, 2021, 48(3): 393-397.)