常州市2011～2013年输入性疟疾流行病学分析

目的了解近3年常州市境外输入性疟疾的流行特征。方法收集常州市2011~2013年的疟疾疫情数据、个案调查表及专题调查报告,用Excel表建立数据库。对输入性疟疾病例进行流行病学分析,并对临床表现、诊断治疗情况、镜检结果等进行分类统计。结果 2011~2013年全市共报告疟疾73例,均为境外输入性病例,病例主要分布在金坛市和溧阳市,发病季节呈全年分布,全部为男性,年龄范围24~60岁,以青壮年为主;职业主要为农民工和技术工人。感染来源地主要为安哥拉16例,占21.9%、尼日利亚14例,占19.2%、赤道几内亚13例,占17.8%。临床表现以发热为主,发病到初诊平均间隔3.1d;初发病例38例,占52.1%,再燃病例35例,占47.9%。病例初诊以县级医疗机构和县级疾控机构为主,分别占42.5%、27.4%,确诊单位与初诊单位的一致率为87.7%;实验室确诊病例70例,占95.9%。镜检结果为恶性疟53例,占75.7%、卵形疟14例,占20.0%、三日疟2例,占2.9%、间日疟1例,占1.4%。结论境外输入性疟疾是常州市疟疾的主要疫情特点,以恶性疟感染为主,感染来源地主要为非洲疟疾高发区。

Epidemiological analysis of imported malaria in Changzhou city from 2011 to 2013

Objective To understand the epidemic characteristics of imported malaria in Changzhou city in the past 3 years. Methods The malaria epidemic data of disease report, case questionnaire survey and special investigation reports in Changzhou city during 2011-2013 were collected, and the database was established with Excel. The clinical manifestation, diagnosis and treatment, microscopic examination results were classified and analyzed. Results The 73 malaria cases reported from 2011 to 2013 were all foreign imported cases. The cases were mainly distributed in Jintan city and Liyang City, and oecured throughout the year. The patients were all males aged between 24 and 60 years old, most of patients were young men, and were migrant workers and technical workers. 16 patients came from Angola （21.9%）, 14 patients from Nigeria （19.2%）, and 13 patients from Equatorial Guinea （17.8%）. The main clinical manifestation was fever, and the average interval between disease onset and initial medical visit was 3.1d. There were 38 cases of newly diagnosed （52.1%） and 35 cases of recrudescence （47.9%）. The first medical institution was mainly in county-level medical institutions （42.5%） and CDCs （27.4%）. The consistency rate of confirmed institution with first medical institution was 87.7%. 70 cases were laboratory confirmed, accounting for 95.9%. The microscopic examination results showed there were 53 Plasmodium falciparum malaria cases （75.7%）, 14 Plasmodium ovale malaria cases（20.0%）, 2 Plasmodium malaria cases（2.9%） , and 1 P]asmodium vivax case （1.4%）. Conclusion The major epidemic characteristics of malaria in Changzhou City were foreign imported, most of them were infected with Plasmodium faleipamm and infected in hyperendemic areas of Africa.