海南省疟疾发病及疫情漏报情况调查

目的　掌握疟疾实际发病人数 ,分析疫情漏报原因 ,提出相关措施 ,减少疟疾疫情漏报。　方法　在海南省疟区分层整群随机抽样 ,选取 4个市县 12个乡镇 36个行政村作为调查点 ,采取问卷调查方式由工作人员逐户上门调查访问 ,了解疟疾发病人数 ;对调查点的各医疗机构和私人诊所进行调查 ,通过对医生的访问并查阅血检记录、门诊登记、治疗处方、住院记录等 ,统计疟疾病例数。　结果　共调查 386 35人 ,疟疾发病 1733例 ,发病率为 4 .4 9% ,同期该人群报告疟疾疫情 93例 ,漏报 16 4 0例 ,漏报率为 94 .6 3%。医疗机构漏报率从高到低依次为私人诊所 30 .30 %、乡镇卫生院2 2 .0 1%、村卫生室 14 .6 3%、农场医院 11.4 6 %、患者自诊自治 9.39%、县医院 6 .4 6 %、农场连队卫生室 5 .73%、县防疫站为 0。对 12 5个各类医疗机构调查结果显示 ,血检或诊断为疟疾的共 4 6 85例 ,但上报疫情仅为 388例 ,漏报 4 2 97例 ,漏报率为 91.72 % ,同时漏报疟疾死亡 1例。　结论　海南省疟疾疫情漏报问题较为严重 ,漏报主要发生在基层乡村各医疗机构和私人诊所

INVESTIGATION ON MORBIDITY AND FAILING REPORT EPIDEMIC SITUATION OF MALARIA IN HAINAN PROVINCE

Objective To have a good grasp of real malaria cases in time and analyze the reason of failing report epidemic situation and put forward some proposals for reducing the fail to report malaria cases. Methods Thirty six villages of four counties in Hainan Province were chosen for the investigative points according to graduation, entirety and random sampling. Inhabitants were investigated by workers who must go to the doorstep of every family to sure how many malaria cases in the family. The hospital and clinic survey were made in investigative points by visiting doctors and checking the blood examination, clinic records, treat recipes and inpatient records to find out malaria cases. Results There were 1 733 malaria cases were found from 38 635 investigated inhabitants and the morbidity was 4.49%. The malaria epidemic situation of report was only 93 cases in the same inhabitants and period. There were 1 640 cases missing and the rate of failure to report was 94.63%. The rate of failure to report in proper order were private clinic 30.30 %, town hospital 22.01%, village clinic 14.63%, farm hospital 11.46%, patients treat themselves 9.39%, county hospital 6.46 %, team clinic of farm 5.73% and county epidemic prevention station 0. There were 4685 malaria cases checked out by blood examination or clinical diagnosis in 125 hospitals and clinics. While they reported only 388 cases and 4 297 cases were missed. The rate of failure to report was 91.72%. Conclusion The failure to report malaria epidemic situation was grave in Hainan Province. The locales to miss the malaria cases were mainly private clinic and town or village clinic.