2012-2015年江西省输入性疟疾病例诊断和报告情况分析

摘要/Abstract

摘要：

目的通过分析江西省输入性疟疾病例诊断和报告情况,为指导消除疟疾阶段的疾病监测工作提供科学依据。方法通过传染病报告信息管理系统和寄生虫病防治信息管理系统,收集2012-2015年江西省报告的疟疾疫情和个案数据,采用描述性流行病学方法分析疟疾病例的初次就诊（以下简称初诊）单位、实验室检测单位、报告单位、诊断方式、发病到初诊时间、初诊到报告时间和发病到报告时间等,评价消除疟疾阶段疟疾病例管理的质量。结果 2012-2015年江西省共报告207例疟疾病例,均为输入性病例,以实验室诊断为主（96.62%,200/207）。病例初诊单位主要为县级（29.95%,62/207）和地市级医疗机构（25.60%,53/207）;病例实验室检测单位主要为地市级医疗机构（36.27%,73/207）和县级疾病预防控制机构（20.29%,42/207）,不同年份间实验室检测单位构成比具有统计学意义（P < 0.05）;发病到初诊时间中位数为1 d（0~149 d）,初诊到报告时间中位数为3 d（0~144 d）,发病到报告时间中位数为5 d（0~149 d）。结论江西省疟疾病例初诊和实验室检测单位较多集中在市、县级医疗机构。

关键词: 输入性疟疾, 诊断, 报告, 江西省

Abstract:

Objective To provide scientific basis for malaria surveillance in the elimination phase by retrospectively analyzing the diagnosis and reporting of imported malaria in Jiangxi Province. Methods Data on malaria endemic situation and individual cases during 2012-2015 were collected through the National Information Management System for Infectious Diseases and the Report and Information Management System for Parasitic Diseases Control and Prevention. Detailed information on primary medical units, laboratory testing units, reporting units, diagnostic methods, time from onset to first medical visit, time from first medical visit to reporting, and time from onset to reporting was analyzed with the descriptive analysis method. Results A total of 207 malaria cases were reported during 2012-2015 in Jiangxi, all were imported cases and 96.62% （200/207） were diagnosed with laboratory tests. The main primary medical units were found to be county-level （29.95%, 62/207） and prefecture-level （25.60%, 53/207） medical institutions, while the main laboratory testing units were prefecture-level medical institutions（35.27%, 73/207） and county-level CDCs （20.29%, 42/207）. There was a significant difference in the proportion of different laboratory testing units among the years（P < 0.05）. The median time from onset to first medical visit was 1 d （0-149 d）, from first medical visit to reporting was 3 d （0-144 d）, and from onset to reporting was 5 d （0-149 d）. Conclusions The first visit and the laboratory testing of malaria cases mainly occur in the prefecture-level and county-level medical institutions.

Key words: Imported malaria, Diagnosis, Reporting, Jiangxi Province

中图分类号:

R531.3

雷蕾, 夏志贵, 李志宏, 龚艳凤, 肖宁. 2012-2015年江西省输入性疟疾病例诊断和报告情况分析[J]. 中国寄生虫学与寄生虫病杂志, 2017, 35(1): 80-84.

Lei LEI, Zhi-gui XIA, Zhi-hong LI, Yan-feng GONG, Ning XIAO. A retrospective analysis on the diagnosis and reporting of imported malaria in Jiangxi Province during 2012-2015[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2017, 35(1): 80-84.

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参考文献 19

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年份 Year	恶性疟原虫感染 Plasmodium falciparum infection		间日疟原虫感染 P. vivax infection		三日疟原虫感染 P. malariae infection		卵形疟原虫感染 P. ovale infection		混合感染 Mixed infection		未分型 Unidentified		总计 Total
年份 Year	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	总计 Total
2012 2013 2014 2015	30 31 31 32	54.55 63.27 68.89 55.17	22 12 9 18	40.00 24.49 20.00 31.03	0 2 0 1	0 4.08 0 1.72	0 1 1 4	0.00 2.04 2.22 6.90	1 2 1 2	1.82 4.08 2.22 3.45	2 1 3 1	3.64 2.04 6.67 1.72	55 49 45 58
总计 Total	124	59.90	61	29.47	3	1.45	6	2.90	6	2.90	7	3.38	207

初诊单位 Medical unit	2012		2013		2014		2015		总计Total
初诊单位 Medical unit	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%
省级疾控机构 Provincial-level CDCs 省级医疗机构 Provincial-level medical institutions 地市级疾控机构 Prefecture-level CDCs 地市级医疗机构 Prefecture-level medical institutions 县级疾控机构 County-level CDCs 县级医疗机构 County-level medical institutions 乡镇卫生院 Township health centers 村卫生室 Village clinics 个体医生 Private practitioner 其他Others	1 5 1 18 2 15 4 2 7 0	1.82 9.09 1.82 32.73 3.64 27.27 7.27 3.64 12.73 0	1 3 1 12 5 15 1 4 5 2	2.04 6.12 2.04 24.49 10.20 30.61 2.04 8.16 10.20 4.08	0 5 0 11 2 10 5 6 5 1	0 11.11 0 24.44 4.44 22.22 11.11 13.33 11.11 2.22	0 6 1 12 4 22 0 8 4 1	0 10.34 1.72 20.69 6.89 37.93 0 13.79 6.89 1.72	2 19 3 53 13 62 10 20 21 4	0.97 9.18 1.45 25.6 6.28 29.95 4.83 9.66 10.14 1.93
总计Total	55	100	49	100	45	100	58	100	207	100

实验室检测单位 Laboratory testing units	2012		2013		2014		2015		总计Total
实验室检测单位 Laboratory testing units	病例数No. cases	构成比/%Proportion/%	病例数No. cases	构成比/%Proportion/%	病例数 No. cases	构成比/%Proportion/%	病例数No. cases	构成比/%Proportion/%	病例数No. cases	构成比/%Proportion/%
省级疾控机构 Provincial-level CDCs 省级医疗机构 Provincial-level medical institutions 地市级疾控机构 Prefecture-level CDCs 地市级医疗机构 Prefecture-level medical institutions 县级疾控机构 County-level CDCs 县级医疗机构 County-level medical institutions 个体医生 Private practitioner 其他Others	3 10 4 29 5 4 0 0	5.45 18.18 7.27 52.73 9.09 7.27 0 0	6 9 1 10 17 4 1 1	12.24 18.37 2.04 20.41 34.69 8.16 2.04 2.04	2 7 1 16 11 6 0 2	4.44 15.56 2.22 35.56 24.44 13.33 0 4.44	2 11 0 18 9 16 0 2	3.45 18.97 0 31.03 15.52 27.59 0 3.45	13 37 6 73 42 30 1 5	6.28 17.87 2.90 35.27 20.29 14.49 0.48 2.42
总计Total	55	100	49	100	45	100	58	100	207	100

初诊单位 First visited medical units	发病到初诊时间中位数/d Median time from onset to first medical visit/d	初诊到报告时间中位数/d Median time from first medical visit to report/d	发病到报告时间中位数/d Median time from onset to report/d	实验室检测病例数/ 初诊病例数比值 No. laboratory testings /No. first medical visits
省级疾控机构 Provincial-level CDCs 省级医疗机构 Provincial-level medical institutions 地市级疾控机构 Prefecture-level CDCs 地市级医疗机构 Prefecture-level medical institutions 县级疾控机构 County-level CDCs 县级医疗机构 County-level medical institutions 乡镇卫生院Township health centers 村卫生室Village clinics 个体医生Private practitioner 其他Others	1.0 2.0 3.0 1.0 2.0 2.0 0.5 0 1.0 4.5	4.0 4.0 2.0 1.0 1.0 2.5 6.0 5.0 5.0 6.0	5.0 7.0 6.0 4.0 4.0 5.0 8.5 5.0 6.0 19.5	6.50（13/2） 1.95（37/9） 2.00（6/3） 1.38（73/53） 3.23（42/13） 0.48（30/62） 0（0/10） 0（0/20） 0.05（1/21） 1.25（5/4）
总计Total	1.0	3.0	5.0

时间	2012			2013			2014			2015			总计Total
时间	中位数Median	四分位数Quartile		中位数Median	四分位数Quartile		中位数Median	四分位数Quartile		中位数Median	四分位数Quartile		中位数Median	四分位数Quartile
发病到初诊时间/d Time from onset to first medical visit/d 初诊到报告时间/d Time from first medical visit to report/d 发病到报告时间/d Time from onset to report/d	2 2 5	0, 5 1, 5 4, 9		1 3 5	0, 3 1, 6 3, 9		2 3 5	0, 4 0, 6 4, 10		1 2.5 5	0, 2.75 1, 5.75 3, 9		1 3 5	0, 3 1, 6 3, 9