目的 分析福建省疟疾消除后基层监测响应系统现况，为制定疟疾消除后防治措施提供科学依据。方法 2020年10月对福建省85个县（市、区）级疾控机构开展基层疟疾防治能力的回顾性调查，调查内容主要包括疟疾防治经费、技术人员数量、药品储备、检测仪器、定点医院、病例监测、媒介监测、培训等，结合消除疟疾后2016—2020年疟疾防治工作年报表，按照输入再传播风险等级，分析福建省消除疟疾后基层监测响应系统现况。采用SPSS 17.0软件进行统计学分析，计量资料根据方差齐性采用t检验或Wilcoxon秩和检验，计数资料采用卡方检验。 结果 福建省2016—2020年共血检92 280人份，阳性505例（0.55%），均为输入性病例。就诊的505例疟疾病例中，初诊在基层（县级及以下医疗机构和疾控中心）就诊的占23.37%（118/505），基层初诊确诊占比27.97%（33/118）。94.12%（80/85）的基层疾控机构3年内（2018—2020年）有疟疾防治经费，平均为0.97万/（年·县），间日疟再传播风险县的疾控机构年平均经费（1.35万元）高于潜在间日疟再传播风险县（0.88万元）（t = 2.16，P < 0.05）。不具备疟原虫检测能力（缺乏显微镜或专业镜检人员）的基层疾控机构有20个（占23.53%），其中80%（16/20）的县近3年均有输入性疟疾病例报告。基层疾控机构抗疟药品和快速诊断检测（RDT）试剂盒储备的占比均较低，分别为4.71%（4/85）和8.24%（7/85），其中间日疟再传播风险县疾控机构有RDT储备的占比（4/17）高于潜在间日疟再传播风险县（4.41%，3/68），差异有统计学意义（χ² = 4.29，P < 0.05）。2016—2020年全省85个县（市、区）共培训12 040人次，防治人员和检测人员的培训数呈下降趋势（分别从2016年的1 509、656人下降至2020年的819、348人），临床医生培训数呈上升趋势（从2016年的404人上升至2020年的887人）。2018—2020年3年内85.88%（73/85）的基层疾控机构至少组织1次疟疾培训，其中仅3.53%（3/85）和2.35%（2/85）的县对乡村医生和个体医生开展培训。基层疾控机构3年内开展媒介按蚊种群和密度监测的县分别有29（占34.12%）和20个（占23.53%），共捕获媒介按蚊8 148只，均为中华按蚊，未捕获嗜人按蚊或微小按蚊。灯诱种群监测结果显示，间日疟再传播风险县捕获中华按蚊1.57只/（灯·晚），低于潜在间日疟再传播风险县2.16只/（灯·晚）（χ² = 5.72，P < 0.05）。结论 福建省疟疾消除后基层疟疾诊断和监测能力减弱。应根据风险等级，优化监测方案，稳定经费投入和人员培养，提高基层监测和响应的能力水平，巩固消除疟疾成果。

Objective To analyze the current status of primary surveillance and response system in Fujian Province after malaria elimination, and to provide the scientific basis for the formulation of malaria control and prevention measures. Methods In October 2020, a retrospective survey was carried out on the malaria control and prevention capability in 85 counties (cities and districts) during 2016—2020 in Fujian Province. The survey content included the funding for control, number of technical personnel, medicine back store, detection equipments, designated hospitals, clinical cases monitoring, transmission vector surveillance, and personnel training, combining with the annual malaria control reports in in post-elimination years, to analyze the current status of primary surveillance response system during the malaria post-elimination phase in the province based on the risk ranking of imported cases vs retransmission. SPSS 17.0 software was used for statistical analysis. The measurement data were analyzed using t-test or Wilcoxon rank sum test based on the homogeneity of variance, and the counting data were analyzed using chi-square test. Results A total of 92 280 blood samples were tested in the province from 2016 to 2020, among 505 were positive (0.55%), defined as imported cases. The reported cases first visited primary medical institutions accounted for 23.37%（118/505）, which increased year by year, with statistical significance (χ² = 16.49, P < 0.05). But the initial diagnosis rate was 27.97% (33/118), which did not increase with the number of patients (χ² = 2.50, P > 0.05). A total of 94.12% (80/85) of primary centers for Disease Control and Prevention had funding for malaria control and elimination in the previous three years (2018—2020), with an average of 9 700 yuan per county per year. The average annual funding in counties with higher risk of re-establishment of transmission by Plasmodium vivax was higher (13 500 yuan) than the counties with the potential risk (8 800 yuan). The difference was statistically significant (t = 2.16, P < 0.05). There were 20 primary CDCs (23.53%) without the capacity to detect malaria, which were due to the lack of microscopes or professionals, and 80% of them (16/20) had imported malaria cases in their service areas during the past three years. The percentage of CDCs with antimalarial drugs and rapid diagnostic test (RDT) in primary CDCs were 4.71% (4/85) and 8.24% (7/85), respectively. The percentage of CDCs with RDT in storage in counties with the risk of re-establishment of P. vivax transmission (4/17) were higher than those in counties with potential risk (4.41%, 3/68). The difference was statistically significant (χ² = 4.29, P < 0.05). From 2016 to 2020, a total of 12 040 people were trained in 85 counties of the province. The number of trainings for control and prevention personnel and laboratory personnel showed a downward trend (from 1 509 and 656 in 2016 to 819 and 348 in 2020), while the number of training for clinicians showed an increase trend (from 404 in 2016 to 887 in 2020). From 2018 to 2020, at least one training was organized by 85.88% (73/85) of the counties, but training for village and individual doctors was only organized by 3.53% (3/85) and 2.35% (2/85) of the counties. In three years, the Anopheles mosquito population and density monitoring which were carried out by 29 primary CDCs (34.12%) and 20 CDCs (23.53%). And a total of 8 148 Anopheles were captured, all of which were An. sinensis, but no An. anthropophagus or An. minimus. During the population monitoring by lamp trap, 1.57 An. sinensis per lamp per night were captured in counties with the risk of re-establishment of transmission by P. vivax, which was lower than that in counties with potential risk (2.16 per lamp per night) (χ² = 5.72, P < 0.05). Conclusion After the elimination of malaria in Fujian Province, the capacity of malaria diagnosis and surveillance of primary medical settings is weakening. It is imperative to optimize the surveillance scheme based on the risk ranking, provide stable funding and personnel training to enhance the primary surveillance-response capacity for consolidating the accomplishments of malaria elimination.