目的 分析2020—2024年浙江省输入性疟疾病例流行特征，为输入性疟疾防控提供参考。方法 在中国疾病预防控制信息系统和寄生虫病防治信息管理系统中收集2020—2024年浙江省疟疾病例数据，对疟疾报告病例类型、三间分布、感染地来源、发病到初诊时间间隔、初诊到确诊时间间隔、再燃或复发情况等进行统计分析，数据采用χ²检验和非参数检验比较差异。结果 2020—2024年浙江省分别报告疟疾病例53、44、64、118、169例，共448例，均为输入性病例。其中以恶性疟报告病例为主，占77.23%（346/448）；卵形疟、间日疟、三日疟报告病例分别占13.39%（60/448）、6.03%（27/448）、3.35%（15/448）。疟疾报告病例感染来源地分布于4个洲，以非洲为主（占95.54%，428/448），其中跨境蚊传病例3例。浙江省11个地级市均报告疟疾病例，报告病例数居前3位的为杭州（占29.24%，131/448）、金华（占25.67%，115/448）和温州（占10.49%，47/448）。疟疾报告病例在2022年8月出现明显高峰（15例），2023、2024年7—10月持续高位（11~21例）。报告病例中，男性412例，女性36例，男女性别比为11.4∶1；年龄中位数为44岁。报告病例初诊正确率为75.89%（340/448），从发病到初诊、初诊到确诊间隔天数中位数均为1 d。59.38%（266/448）报告病例发病1 d内就诊，5.58%（25/448）病例超过5 d就诊。恶性疟报告病例2 d内就诊率为78.03%（270/346），高于其他类型疟疾的65.69%（67/102）（χ² = 6.445，P < 0.05）。72.32%（324/448）报告病例初诊1 d内确诊，4.91%（22/448）报告病例超过5 d确诊。恶性疟报告病例2 d内确诊率为85.84%（297/346），高于其他类型疟疾的76.47%（78/102）（χ² = 5.068，P < 0.05）。2020—2024年共报告了8例疟疾再燃或复发病例，其中恶性疟4例、卵形疟3例、间日疟1例。结论 2020—2024年浙江省输入性疟疾病例呈增多趋势，应强化监测响应措施，加强疟疾诊断能力，防止疟疾输入再传播。

Objective To investigate the epidemiological characteristics of imported malaria cases in Zhejiang Province, so as to provide insights into management of imported malari. Methods All data pertaining to malaria cases reported in Zhejiang Province from 2020 to 2024 were collected from China Disease Prevention and Control Information System and Parasitic Diseases Prevention and Control Information System, and malaria parasite species, temporal, spatial and population distributions, source of infections, time interval from illness onset to initial diagnosis, time interval from initial diagnosis to definite diagnosis, and relapse or recrudescence were descriptively analyzed among reported malaria cases. Chi-square test and nonparametric tests were used to compare differences. Results A total of 448 malaria cases were reported in Zhejiang Province from 2020 to 2024, with annual numbers of 53, 44, 64, 118 and 169 cases, respectively, and all cases were imported cases. Falciparum malaria was the predominant type, accounting for 77.23% (346/448), while ovale malaria, vivax malaria and malariae malaria accounted for 13.39% (60/448), 6.03% (27/448), and 3.35% (15/448), respectively. The reported malaria cases acquired infections across four continents, with Africa as the main source of infection (95.54%, 428/448) and there were 3 cases with cross-border mosquito-borne malaria. Malaria cases were reported across all 11 prefecture­level cities in Zhejiang Province, with Hangzhou (29.24%, 131/448), Jinhua (25.67%, 115/448), and Wenzhou (10.49%, 47/448) reporting the highest number of cases. The number of reported malaria cases peaked in August in 2022 (15 cases) and remained elevated from July to October in both 2023 and 2024 (11-21 cases monthly). The reported cases included 412 males and 36 females, with a male-to-female ratio of 11.4 ∶ 1, and had a median age of 44 years. The accuracy of initial diagnosis was 75.89% (340/448) among reported malaria cases, and the median time intervals from illness onset to initial diagnosis and from initial diagnosis to definite diagnosis were both one day. 59.38% (266/448) of reported malaria cases sought healthcare within one day of illness onset, while 5.58% (25/448) sought treatment after more than 5 days. The proportion of falciparum malaria cases seeking healthcare within 2 days of onset (78.03%, 270/346) was higher than that of non-falciparum malaria cases (65.69%, 67/102) (χ² = 6.445, P < 0.05). There were 72.32% (324/448) of malaria cases receiving definite diagnosis within one day of initial diagnosis, while 4.91% (22/448) were diagnosed more than 5 days. The proportion of falciparum malaria cases diagnosed within 2 days (85.84%, 297/346) was higher than that of non-falciparum malaria cases (76.47%, 78/102) (χ² = 5.068, P < 0.05). In addition, total of 8 cases with malaria relapse or recrudescence were reported in Zhejiang Province, including 4 cases with falciparum malaria, 3 cases with ovale malaria and one case with vivax malaria. Conclusion The number of imported malaria cases appeared an upward trend in Zhejiang Province from 2020 to 2024. Intensified surveillance-response interventions and improved malaria diagnostic capability are recommended to prevent re-establishment of imported malaria.