中国寄生虫学与寄生虫病杂志 ›› 2019, Vol. 37 ›› Issue (3): 352-359.doi: 10.12140/j.issn.1000-7423.2019.03.020
王笑笑1,2(), 周水森1,*(
), 黄芳1, 夏志贵1, 张少森1
收稿日期:
2018-11-20
出版日期:
2019-06-30
发布日期:
2019-07-10
通讯作者:
周水森
作者简介:
作者简介:王笑笑(1982-),女,硕士研究生,副主任医师,从事寄生虫病研究。E-mail:
基金资助:
Xiao-xiao WANG1,2(), Shui-sen ZHOU1,*(
), Fang HUANG1, Zhi-gui XIA1, Shao-sen ZHANG1
Received:
2018-11-20
Online:
2019-06-30
Published:
2019-07-10
Contact:
Shui-sen ZHOU
Supported by:
摘要:
疟疾无症状感染者在疟疾传播中具有重要作用,掌握其流行病学特征对实现消除疟疾目标具有重要的公共卫生意义。现有研究认为,无症状感染者分布广泛,在不同季节、不同传播水平地区以及任何年龄段均可发生,且受宿主、疟原虫、环境和传播媒介等多个方面的影响。本文综述了疟疾无症状感染者的定义、流行病学特征及其影响因素,为消除疟疾提供参考资料。
中图分类号:
王笑笑, 周水森, 黄芳, 夏志贵, 张少森. 疟疾无症状感染者流行病学特征及其影响因素研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(3): 352-359.
Xiao-xiao WANG, Shui-sen ZHOU, Fang HUANG, Zhi-gui XIA, Shao-sen ZHANG. Review on epidemiological characterization of asymptomatic malaria infection and its risk factors[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2019, 37(3): 352-359.
表1
疟疾无症状感染者检测方法和判定标准
国家或地区 | 研究设计 | 检测方法 | 判定标准 | |
---|---|---|---|---|
无症状持续时间 | 抗疟疾治疗 | |||
巴布亚岛[ | 横断面 | 镜检 | 调查前1周内 | 调查前1周无治疗 |
坦桑尼亚[ | 横断面 | 镜检/PCR | 调查后1周内 | 调查前1个月内未开展治疗 |
肯尼亚[ | 队列 | 镜检 | 调查后1周内 | 调查前4周未开展治疗 |
巴西[ | 队列 | 镜检/PCR | 调查前3 d和调查后15 d内 | 调查前30 d内未开展治疗 |
加蓬[ | 队列 | 镜检 | 调查后5 d | 无要求 |
巴西[ | 横断面 | 镜检/PCR | 调查后60 d内 | 无要求 |
赞比亚[ | 横断面 | 镜检 | 两次筛查(间隔2 d) | 无要求 |
委内瑞拉[ | 横断面 | PCR | 调查后2周内 | 无要求 |
哥伦比亚[ | 队列 | 镜检/PCR | 镜检阳性后2周或PCR 阳性后28 d | 无要求 |
塞内加尔[ | 横断面 | 镜检 | 调查当月 | 无要求 |
巴西[ | 横断面 | PCR | 基线调查后30 d内 | 无要求 |
刚果[ | 横断面 | 镜检/PCR | 调查前2周和调查后至少1周 | 无要求 |
孟加拉国[ | 横断面 | PCR | 无要求 | 调查前7 d无治疗 |
埃塞俄比亚[ | 横断面 | 镜检 | 近期 | 无要求 |
泰国[ | 横断面 | PCR | 调查后5个月内 | 无要求 |
苏丹[ | 队列 | 镜检 | 无要求 | 无要求 |
印度尼西亚[ | 横断面 | 镜检 | 无要求 | 无要求 |
斯里兰卡[ | 横断面 | 镜检/PCR | 无要求 | 无要求 |
表2
不同国家和地区的疟疾无症状感染率
国家或地区 | 研究设计 | 调查对象 | 样本量/例 | 无症状感染率/% | 恶性疟无症状 感染率/% | 间日疟无症状 感染率/% |
---|---|---|---|---|---|---|
东南亚 | ||||||
柬埔寨[ | 横断面 | 基于社区的 0~89岁全人群 | 6 931 | 2.00 | 0.91 | 1.06 |
泰国[ | 横断面 | 基于社区的 10~45岁人群 | 475 | 1.89 | 0.8 | 0.42 |
泰国[ | 横断面 | 成人 | 241 | 6.20 | 3.30 | 2.50 |
泰国[ | 横断面 | 全人群 | 1 347 | 2.45 | ||
缅甸[ | 横断面 | 全人群 | 1 638 | 2.32 | 1.10 | 0.37 |
缅甸[ | 横断面 | 全人群 | 1 180 | 2.37 | 0.34 | 1.87 |
缅甸[ | 横断面 | 0.5~80岁 (Mong pawk) 0.8~81岁(Laiza) | 346(Mong pawk) 385(Laiza) | 7.80(Mong pawk) 14.55(Laiza) | 7.80(Mong pawk) 2.34(Laiza) | 0(Mong pawk) 12.21(Laiza) |
印度尼西亚[ | 横断面 | 5~15岁 | 1 197 | 7.77 | 6.10 | 1.50 |
湄公河次区域(泰缅 边境、柬埔寨和越 南)[ | 横断面 | 6个月以上人群 | 4 975 | 19.86 | 3.30 | 7.18 |
亚洲其他国家 | ||||||
伊朗[ | 横断面 | 基于社区的 0~60岁以上人群 | 500 | 0 | ||
伊朗[ | 横断面 | 2~60岁以上人群 | 1 000 | 0 | ||
斯里兰卡[ | 横断面 | 移动疟疾诊所的 无症状就诊者 | 140 | 1.40 | 0 | 1.40 |
斯里兰卡[ | 横断面 | 全人群 | 140 | 1.43 | 0 | 1.43 |
孟加拉国[ | 横断面 | 全人群 | 1 418(雨季) 436(旱季) | 23.62(雨季) 23.62(旱季) | 13.61(雨季) 13.30(旱季) | 3.17(雨季) 5.05(旱季) |
孟加拉国[ | 横断面 | 全人群 | 3 391 | 1.33 | 1.33 | 0.03 |
孟加拉国[ | 队列 | 孕妇 | 716a | 4.61 | 4.61 | |
印度[ | 横断面 | 全人群 | 963 | 8.41 | 8.41 | |
非洲 | ||||||
塞内加尔[ | 横断面 | 2~10岁 | 372 | 13.71 | 13.71 | 0 |
塞内加尔[ | 横断面 | 2~10岁儿童和 17~81岁妇女 | 2 231(儿童) 2 427(妇女) | 2.15(儿童) 2.01(妇女) | 2.03 | 0 |
乌干达[ | 队列 | 1~10岁儿童 | 472 | 3.2 | 3.2 | 0 |
加纳[ | 横断面 | 0~5岁 | 214 | 31.78 | ||
赞比亚[ | 横断面 | 全人群 | 186(病例组b) 141(对照组) | 8.0 0.7 | 8.0 0.7 | 0 |
卢旺达[ | 横断面 | 0~5岁 | 545 | 13.4 | 13.4 | 0 |
卢旺达[ | 横断面 | 6~10岁 | 1 089 | 22.4 | 18.8 | 0 |
坦桑尼亚[ | 横断面 | 6~14岁 | 200 | 57.50 | 57.50 | |
坦桑尼亚[ | 横断面 | 8~16岁 | 400 | 14.00 | 14.00 | |
肯尼亚[ | 队列 | 2.5~17岁 | 246 | 33.70 | 33.70 | 0 |
肯尼亚[ | 横断面 | 全人群 | 10 430 | 34.04 | 0 | |
刚果[ | 横断面 | 1~9岁 | 313 | 16.29 | 16.29 | 0 |
刚果[ | 横断面 | 5岁以下 | 700 | 23.1 | 23.1 | 0 |
埃塞俄比亚[ | 横断面 | 6~15岁 | 385 | 6.75 | 5.19 | 1.56 |
埃塞俄比亚[ | 横断面 | 2岁及以上全人群 | 1 094 | 8.23 | 6.12 | 2.74 |
尼日利亚[ | 横断面 | 3~15岁 | 198 | 59.60 | ||
尼日利亚[ | 横断面 | 4~15岁 | 117 | 25.6 | ||
美洲 | ||||||
巴西[ | 横断面 | 5岁以上人群 | 324 | 13.9 | 1.2 | 12.7 |
巴西[ | 横断面 | 全人群 | 3 799 | 3.71 | 3.40 | 0.32 |
海地[ | 横断面 | 育龄妇女 | 653 | 16.54 | 16.54 | 0 |
大洋洲 | ||||||
所罗门群岛[ | 横断面 | 全人群 | 1 725 | 18.5 | 9.1 | 11.7 |
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