目的 了解2016—2020年湖北省疟疾疫情流行特征,为优化消除疟疾后的防控策略提供科学支撑。 方法 通过国家传染病报告信息管理系统收集2016—2020年湖北省网报疟疾病例资料,对病例感染虫种、感染来源地、三间分布和就诊情况等进行分析。不同医疗机构间的初诊确诊率的比较采用χ² 检验。 结果 湖北省2016—2020年共报告疟疾病例560例,全部为境外输入性疟疾病例。其中,恶性疟387例 (占69.11%)、间日疟75例 (占13.39%)、卵形疟80例（占14.29%）、三日疟16例（占2.86%）、混合感染2例（占0.36%）。2016—2020年,报告疟疾病例数分别为151、96、127、151和35例,其中2020年报告疟疾病例数较2019年下降76.82%。所有疟疾病例感染地来自4个洲的39个国家,其中输入病例数居前5位的国家分别是刚果（金）（117例）、尼日利亚（49例）、埃塞俄比亚（48例）、安哥拉（45例）和刚果（布）（32例）。2016—2020年各月均有疟疾病例报告,其中1、2和11月为病例报告的高峰月,报告病例数分别为77、76和51例。湖北省除神农架林区外,16个市（州）均有疟疾病例报告,主要分布在武汉（184例）、宜昌（81例）、黄石（56例）、襄阳（39例）和十堰（36例）。病例以20~49岁年龄组居多,占85.36%（478/560）。男性病例540例,女性20例,男女性别比为27 ∶ 1。报告疟疾病例中,361例（占64.47%）在发病后2 d内就诊,69例（占12.32%）在发病11 d后就诊。396例初诊诊断为疟疾,初诊确诊率为70.71%。病例初诊主要集中在县级以上医疗机构（73.21%,410/560）,县级以上医疗机构初诊确诊率为77.32%（317/410）;在乡（镇）卫生院、个体医生和村卫生室初诊的分别为45例、16例和27例,初诊确诊率分别为40.00%（18/45）、1/16和11.11%（3/27）,不同医疗机构间的初诊确诊率差异有统计学意义（χ² = 103.744,P < 0.05）。24 h内确诊的病例占55.89%（313/560）,初诊至确诊时间间隔≥ 4 d的占26.43%（148/560）。疟疾病例主要由医疗机构确诊,占80.89%（453/560）。2016—2020年,湖北省报告2例输入性恶性疟死亡病例。 结论 2016—2020年,湖北省报告疟疾病例均为输入性疟疾病例,以恶性疟为主,武汉、20~49年龄组、男性人群为主要分布。病例主要在医疗机构就诊,县级及以上医疗机构初诊确诊率较高。

Objective To analyze the characteristics of imported malaria cases in Hubei Province from 2016 to 2020 to provide scientific basis for optimizing the control strategies for post-elimination phase. Methods The data of reported malaria cases in Hubei Province during 2016—2020 were collected from the National Infectious Disease Surveillance Reporting and Management System to analyze Plasmodium species, infection source, three compartment distribution and the experience of seeking medical care. The χ² test was applied for comparison of the correctness rate of initial diagnosis among different medical institutions. Results A total of 560 malaria cases were reported in Hubei Province during 2016—2020, all of them were imported from abroad. In total, 387 cases were infected with P. falciparum (69.11%), 75 with P. vivax (13.39%), 80 with P. ovale (14.29%), 16 with P. malariae (2.86%) and 2 with mixed infection (0.36%). The number of malaria cases reported by year in Hubei Province was 151, 96, 127, 151 and 35 in 2016—2020, respectively, among them the number reported in 2020 decreased by 76.82% compared to 2019. All the reported cases were imported from 39 countries in four continents. The top five countries with the highest imported number were the Democratic Republic of the Congo (117), Nigeria (49), Ethiopia (48), Angola (45) and the Republic of Congo (32). During this period, malaria cases were reported all year round, with the reporting peak in January (77), February (76) and November (51). Malaria cased were reported from all 16 cities (prefecture) except Shennongjia Forestry District, mainly from Wuhan (184), Yichang (81), Huangshi (56), Xiangyang (39), and Shiyan (36). Among all cases, 85.36% (478/560) occurred in the age group 20-49; 540 cases were in males and 20 in females, with a gender ratio of 27 : 1. Most of the malaria cases (361, 64.47%) visited doctor 2 days after outset of disease, but 69 cases (12.32%) consulted doctor over 11 days after outset. Overall, 396 cases were diagnosed as malaria, with a correctness rate of diagnosis 70.71% at the initial visit. Of the reported cases, 410 sought initial visit in county-based medical institutions or higher settings (410/560, 73.21%), and the correctness rate of diagnosis was 77.32% (317/410); The numbers of cases seeking initial visit to town health center, individual doctor or village clinic were 45, 16 and 27, respectively, with the correctness rate of diagnosis of 40.00% (18/45), 1/16, and 11.11% (3/27), respectively. The correctness rate of diagnosis was significantly different among different medical institutions (χ² = 103.744, P < 0.05). In addition, 55.89% (313/560) of the cases were diagnosed as malaria within 24 hours; 26.43% (148/560) of the cases spent more than 4 days of time span from initial visit to confirmed diagnosis. Most of the cases (80.89%, 453/560) were diagnosed as malaria in medical institutions. Two death cases of imported falciparum malaria were reported in the province during 2016—2020. Conclusion During 2016—2020, all reported cases in Hubei Province were imported cases, and most of them were caused by P. falciparum. The cases were mainly distributed in Wuhan City, in males and in the age group of 20-49 years. The majority cases sought health consultation in medical institutions, and the correctness rate of diagnosis upon the initial visit was higher in county-based medical institutions or settings at higher level.