关键词: 疟疾, 消除, 风险评估

Abstract:

Objective  To identify the risk area in China during the malaria elimination process， and provide the evidence for promotion of the national malaria elimination programme and implementation of elimination strategy.  Methods  Data collection was conducted in 24 endemic provinces in 2010， including data of transmission capacity， potential risk of malaria transmission and the capacity of health professional team at county level. Quantitative assessment of the malaria transmission risk as well as the capacity of health facilities were conducted based on the calculation of malaria transmission risk index （MTI） and health facilities capacity index （CI）. ArcGIS 10.0 was used to develop the risk map based on the outcome of quantitative assessment.  Results  The data of transmission capacity， potential risk of transmission and the capacity of health professional team were collected from 2 147 counties in 24 provinces. Based on MTI and CI calculated for each county， statistic results showed that about 40% of the counties were under the average level of both MTI and CI. The relationship among potential risk of transmission， the capacity of health professional team and malaria incidence were analyzed in three dimensions， and four types were categorized among 2 147 counties. Type Ⅰ（super-high risk area） counties （20） distributed in Yunnan （9）， Guangxi （5）， Henan （1）， Hunan （1）， Hebei （1）， Sichuan （1）， Chongqing （1）， and Tibet （1）. 17 counties were classified into type Ⅱ（high risk area） area， distributed in Yunnan （3）， Guangxi （2）， Guizhou （2）， Shaanxi （2）， Guangdong （1）， Jiangxi （1）， Hubei（1）， Sichuan （1）， Gansu （1）， Hebei （1）， Fujian （1） and Tibet （1）. A total of 170 type Ⅲ （moderate risk area） counties distributed in 19 provinces including Yunnan （15）， Guizhou （14）， Hebei （14）， Sichuan （13）， Shanxi（10）， Guangxi （9）， Hunan （9）， Anhui （9）， Jiangsu （9）， Shaanxi （9）， Shandong （9）， Chongqing （8）， Gansu （8）， Jiangxi （7）， Henan （7）， Fujian （6）， Guangdong （5）， Hubei （5）， and Zhejiang （4）. 1 940 type Ⅳ （low risk area） counties distributed in 24 provinces.  Conclusion  The distribution of four types of risk area for malaria elimination is identified in China.

Key words: Malaria, Elimination, Risk assessment