中国寄生虫学与寄生虫病杂志

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2017年全国消除疟疾进展及疫情特征分析

张丽,丰俊,张少森,夏志贵*,周水森   

  1. 中国疾病预防控制中心寄生虫病预防控制所,国家热带病研究中心,世界卫生组织热带病合作中心,科技部国家级热带病国际联合研究中心,卫生部寄生虫病原与媒介生物学重点实验室,上海 200025
  • 出版日期:2018-06-30

The progress of national malaria elimination and epidemiological characteristics of malaria in China in 2017

ZHANG Li, FENG Jun, ZHANG Shao-sen, XIA Zhi-gui*, ZHOU Shui-sen   

  1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China
  • Online:2018-06-30

摘要:

目的 分析2017年全国消除疟疾进展及疟疾疫情特征,为消除疟疾策略和措施的有效实施提供科学依据。 方法 收集2017年全国31个省(直辖市、自治区,未包括台湾、香港和澳门地区)的疟疾疫情数据资料,使用Microsoft Excel 2010软件对消除疟疾进展情况和疫情特征等进行统计分析。 结果 2017年全国828个机构累计报告疟疾病例2 861例,较2016年(3 321例)下降13.9%,中国籍病例2 675例(93.5%,2 675/2 861),外国籍病例186例(6.5%,186/2 861);男女性别比为11.4 : 1,主要集中在20~49岁组(80.8%,2 311/2 861);临床诊断病例9例(0.3%,9/2 861),间日疟573例(20.0%,573/2 861),恶性疟1 822例(63.7%,1 822/2 861),三日疟67例(2.3%,67/2 861),卵形疟352例(12.3%,352/2 861),混合感染37例(1.3%,37/2 861),诺氏疟原虫感染1例。全国范围内无本地感染病例报告,境外输入性病例2 858例(99.9%,2 858/2 861),输血感染病例3例(0.1%,3/2 861);疟疾病例数位居前5位的省(自治区),依次为广西(13.4%,382/2 861)、云南(11.4%,3 25/2 861)、江苏(8.4%,239/2 861)、山东(7.3%,209/2 861)和四川(7.3%,209/2 861)。全国18个省(直辖市、自治区)报告重症病例136例(4.8%,136/2 861),6个省(直辖市、自治区)报告死亡病例7例(0.2%,7/2 861)。疟疾病例均在24 h内完成上报,3 d内流行病学个案调查完成率为83.7%(2 396/2 861)。  结论 2017年全国首次实现了无本地感染疟疾病例,应继续加强重点地区境外输入性疟疾的监测和管理,巩固消除疟疾成果。

关键词: 疟疾, 疫情, 中国

Abstract:

Objective To analyze the progress of malaria elimination and epidemiological characteristics of malaria in China in 2017, in order to provide evidence-based reference for implementation of malaria elimination program. Methods The malaria epidemic data in 31 provinces/municipalities/autonomous regions(Taiwan, Hongkong and Macao regions not included) were collected through the Malaria Annual Reporting System in 2017. The epidemic situation, population distribution, species classification, regional distribution and infection sources were analyzed in Microsoft Excel 2010 software.  Results There were accumulative 2 861 malaria cases reported by 828 institutions in 2017, decreased by 13.9% compared with 2016 (3 321 cases), comprising 2 675 Chinese cases (93.5%) and 186 foreigner cases (6.5%). The male-to-female ratio was 11.4 ∶ 1. The cases were concentrated at the age range of 20-49 years (80.8%, 2 311/2 861). Nine were clinically diagnosed patients (0.3%, 9/2 861). There were 537 Plasmodium vivax cases (20.2%, 537/2 861), 1 822 P. falciparum cases(63.7%, 1 822/2 861), 67 P. malariae cases (2.3%, 64/2 861), 352 P. ovale cases (12.3%, 352/2 861), 37 cases of mixed-infection (1.3%, 37/2 861) and one P. knowlesi case. None was indigenously infected, 2 858 (99.9%, 2 858/2 861) were imported from other countries, and 3 (0.1%, 3/2 861) were infected due to transfusion. The top 5 provinces with regard to the number of malaria cases were Guangxi (13.4%, 382/2 861), Yunnan (11.4%, 325/2 861), Jiangsu (8.4%, 239/2 861), Shandong (7.3%, 209/2 861) and Sichuan (7.3%, 209/2 861). Furthermore, 136 cases(4.8%, 136/2 861) with severe clinical symptoms were reported in 18 provinces/municipalities/autonomous regions, and 7 deaths (0.2%, 7/2 861) were reported in 6 provinces/municipalities/autonomous regions. Case reportings were done within 24 h for all the cases, 83.7% (2 396/2 861) had completed case investigations within three days.  Conclusion This is the first time that no indigenous cases were reported in China in 2017. Continued efforts are needed to strengthen the monitoring and management of imported cases from abroad in some key regions to prevent malaria retransmission.

Key words:  Malaria, Epidemic status, China