收稿日期: 2024-02-13
修回日期: 2024-04-17
网络出版日期: 2024-08-12
基金资助
深圳市医学重点学科传染病防控项目(SZXK064)
Analysis of the epidemic characteristics of imported malaria in Longgang District, Shenzhen City, 2018-2023
Received date: 2024-02-13
Revised date: 2024-04-17
Online published: 2024-08-12
Supported by
Shenzhen Key Medical Discipline Construction Fund(SZXK064)
为了解深圳市龙岗区消除疟疾后输入性疟疾疫情特征,分析疫情监测响应效果,通过国家传染病报告信息管理系统和寄生虫病防治信息管理系统、医疗机构、年报等资料收集2018—2023年龙岗区疟疾疫情资料和监测数据,并开展媒介监测。采用描述性流行病学方法对病例数、感染虫种、输入地、临床症状等数据和监测数据进行统计分析。结果显示,2018—2023年龙岗区共报告输入性疟疾病例173例,其中恶性疟144例(占83.2%),卵形疟13例(占7.5%),间日疟11例(占6.4%),三日疟1例(占0.6%),恶性疟与卵形疟混合感染4例(占2.3%)。输入来源地为非洲(169例,占97.7%)和东南亚(4例,占2.3%)。门诊病例7例(占4.0%),住院病例166例(占96.0%);重症病例1例(占0.6%)。7、8、10月为病例输入高峰(分别报告病例21、51、20例),2月报告病例最少(2例);报告病例以青壮年男性为主,男女比例13.4∶1。2018—2023年,龙岗区疟原虫血检阳性率为6.0‰(173/29 025),从初诊到确诊的平均时间从2018—2020年的2.32 d缩减至2021—2023年0.58 d(t = 2.102,P < 0.05),各级医疗机构初诊疟疾正确率从高到低依次为:地市级(96.4%,135/140),县区级(69.0%,20/29),社区健康服务中心及其他医疗机构(0/4)(Fisher精确检验,P < 0.01)。医疗机构对恶性疟、三日疟、间日疟、卵形疟和混合感染的镜检正确率分别为88.9%(128/144)、1/1、11/11、8/13、2/4,对疟原虫不同虫种的镜检结果正确率差异有统计学意义(Fisher精确检验,P < 0.01)。病例1 d内网络报卡率为100%,3 d内完成实验室复核、流行病学调查和个案专报系统上报率为100%,7 d内疫点处置完成率为100%;所有输入疟疾病例均未发生输入性继发病例。2018—2023年疟疾媒介监测未发现传疟按蚊。消除疟疾后龙岗区面临较大的境外输入性疟疾防控压力,医疗和疾控机构疟疾监测与响应体系运行效果良好,但须进一步提高医疗单位医务人员疟疾诊治及实验室检测水平。
甘立勤 , 李媛 , 刘武艺 , 梁享生 , 黄达娜 , 高世同 . 2018—2023年深圳市龙岗区输入性疟疾疫情特征[J]. 中国寄生虫学与寄生虫病杂志, 2024 , 42(4) : 533 -536 . DOI: 10.12140/j.issn.1000-7423.2024.04.017
In order to understand the epidemiological characteristics of imported malaria after malaria elimination in Longgang District of Shenzhen City and analyze the effect of epidemic surveillance and response, the surveillance data of malaria in Longgang District from 2018 to 2023 were collected from the National Information System for Infectious Diseases Surveillance, National Information System for Parasitic Diseases Control and Prevention, as well as medical institutions and annual reports. The vehicle monitoring was carried out. Descriptive epidemiological methods were used to analyze the data, such as the number of cases, parasite species, infection sources, clinical symptoms, and surveillance data. The results showed that 173 imported malaria cases were reported in Longgang District from 2018 to 2023, including 144 cases of Plasmodium falciparum infection (83.2%), 13 cases of P. ovale infection(7.5%), 11 cases of P. vivax infection (6.4%), 1 case of P. malariae infection (0.6%), and 4 cases of mixed infection with P. falciparum and P. ovale (2.3%). The main infection sources were Africa (169 cases, 97.7%) and Southeast Asia (4 cases, 2.3%). There were 7 outpatients (4.0%) and 166 inpatients (96.0%), including 1 severe case (0.6%). The number of imported cases peaked in July, August and October (21, 51 and 20 cases), and February saw the fewest cases (2 cases). Most of the reported cases were young and middle-aged males, with a male-to-female ratio of 13.4 ∶ 1. From 2018 to 2023, the positive rate of Plasmodium blood smears in Longgang District was 6.0‰ (173/29 025), and the average time from initial diagnosis to definitive diagnosis decreased from 2.32 d during 2018-2020 to 0.58 d during 2021-2023 (t = 2.102, P < 0.05). The correct rate of initial diagnosis was 96.4% (135/140) at the city level, 69.0% (20/29) at the county level, and 0/4 at community health service centres and other medical institutions (Fisher’s exact test, P < 0.01). The correct rates of microscopic examinations for P. falciparum, P. malariae, P. vivax, P. ovale and mixed infections were 88.9% (128/144), 1/1, 11/11, 8/13 and 2/4, the difference was statistically significant (Fisher’s exact test, P < 0.01). All the cases were reported within 1 day, and after finishing laboratory review, epidemiological investigation and case report within 3 days, all the epidemic spots were disposed of within 7 days. None of the cases gave rise to secondary cases. Anopheles mosquitoes were not found in Longgang from 2018 to 2023. Longgang District is under great pressure for the prevention and control of imported malaria after malaria elimination. The malaria surveillance and response system in medical and disease control institutions operates well. However, the capacity for malaria diagnosis, treatment, and laboratory testing among the medical staff and institutions should be further improved.
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