中国寄生虫学与寄生虫病杂志

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2013年全国疟疾疫情分析

张丽,丰俊,夏志贵*   

  1. 中国疾病预防控制中心寄生虫病预防控制所,卫生部寄生虫病原与媒介生物学重点实验室,世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海 200025
  • 出版日期:2014-12-30 发布日期:2015-02-12

Malaria Situation in the People’s Republic of China in 2013

ZHANG Li,FENG Jun,XIA Zhi-gui*   

  1. National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention;Key Laboratory of Parasite and Vector Biology,MOH;WHO Collaborating Centre for Malaria,Schistosomiasis and Filariasis,Shanghai 200025,China
  • Online:2014-12-30 Published:2015-02-12

摘要:

目的 对2013年全国疟疾疫情特征进行分析,为消除疟疾工作提供参考依据。  方法  使用《疟疾防治工作调查表》(全国疾病控制调查制度2013年版“卫统32表”)收集2013年全国疟疾疫情数据资料,采用Microsoft Office Excel 2010和AcrGIS 10.0软件进行统计分析。  结果  2013年全国31个省(直辖市、自治区)共605县(市、区)报告疟疾病例4 128例,较2012年(2 718例)上升51.9%,发病率为0.030 5/万;病例主要分布在广西(30.3%,1 251/4 128)、云南(14.0%,576/4 128)、江苏(8.3%,341/4 128)、四川(5.8%,238/4 128)和浙江(5.0%,208/4 128)等5省(自治区)。临床诊断病例41例(1.0%,41/4 128),确诊病例4 087例(99.0%,4 087/4 128),其中间日疟930例(22.8%,930/4 087),恶性疟2 908例(71.2%,2 908/4 087),三日疟51例(1.2%,51/4 087),卵形疟133例(3.3%,133/4 087),混合感染65例(1.6%,65/4 087)。报告本地感染48例(1.2%,48/4 128),分布在云南(10个县)、西藏(1个县)和安徽(1个县)等3省(区)共12个县(市、区);报告的本地感染恶性疟病例,仅分布在云南省的沧源县(4例)、瑞丽市(1例)和盈江县(1例)。仅西藏自治区墨脱县报告本地感染疟疾发病率超过1/万。报告境外输入病例4 042例(97.9%,4 042/4 128),分布在30个省(直辖市、自治区);报告境内输入病例38例(0.9%,38/4 128),分布在9个省(直辖市、自治区)。全国16个省(直辖市、自治区)共报告重症病例156例(3.8%,156/4 128),14个省(直辖市、自治区)共报告死亡病例23例(0.6%,23/4 128)。疟疾病例诊断后24 h内报告率为100.0%,3日内流行病学个案调查率为96.1%(3 968/4 128),7日内疫点处置率为100.0%(4 128/4 128)。  结论  全国消除疟疾工作成果显著,但境外输入病例明显增多,云南省边境地区和西藏自治区墨脱县仍是我国消除疟疾的重点地区,境内跨地区输入病例也是在我国的感染病例需进一步加强管理。

关键词: 中国, 疟疾, 疫情

Abstract:

Objective  To analyze the malaria situation and epidemic characteristics in 2013 in China, and provide evidence for implementing the National Malaria Elimination Program(NMEP).  Methods  The epidemiological data of malaria cases reported through the annual malaria statistics reporting system in 2013 were collected, and analyzed by using Microsoft Excel 2010 and ArcGIS 10.0.  Results  A total of 4 128 malaria cases were reported from 605 counties of 31 Provinces/Municipalities/Autonomous Regions(P/M/A) in 2013, representing 51.9% increase compared with 2 718 cases in 2012, and the annual incidence was 0.030 5/10 000. The cases were mainly reported from Guangxi(30.3%, 1 251/4 128), Yunnan(14.0%, 576/4 128), Jiangsu(8.3%, 341/4 128), Sichuan(5.8%, 238/4 128), and Zhejiang(5.0%, 208/4 128). The laboratory confirmed cases took 99.0%(4 087/4 128) while the other 1.0%(41/4 128) were clinically diagnosed. Among the laboratory confirmed cases, 22.8%(9 30/4 087) were vivax malaria cases, 71.2%(2 908/4 087) were falciparum malaria cases, 1.2%(51/4 087) were quartan malaria cases, 3.3%(133/4 087) were ovale malaria cases, and 1.6%(65/4 087) were mixed infection cases. A total of 48(1.2%, 48/4 128) indigenous cases were reported from 12 counties in 3 provinces including 10 counties of Yunnan, 1 county of Tibet, and 1 county of Anhui. The indigenous falciparum malaria cases were reported in Cangyuan(4), Ruili(1), and Yingjiang(1) of Yunnan Province. The incidence of indigenous cases between 1/10 000 and 10/10 000 was found only in Motuo County of Tibet. Out of the 4 128 malaria cases, a proportion of 97.9%(4 042/4 128) were reported as the abroad-imported cases who distributed in 30 provinces, and the remaining 0.9%(38/4 128) were domestically-mobile cases reported from 9 provinces. Totally 156(37.8%, 156/4 128) severe cases were reported from 16 provinces and 23(0.6%, 23/4 128) malaria deaths were from 14 provinces. The monitoring and evaluation result of “1-3-7” indicators demonstrated that the proportion of cases reported within 1 day and investigated within 3 days after diagnosis was 100.0% and 96.1%, respectively, and the number of malaria foci disposed within 7 days were 1 678.  Conclusion  NMEP have yielded remarkable achievements in 2013, while the abroad-imported cases have increased significantly. The border areas of Yunnan and Motuo County of Tibet are still the key areas for malaria elimination in China. At the same time, domestically-mobile cases should be further managed.

Key words: China, Malaria, Situation