江苏省2015—2019年输入性疟疾疫情及病例诊断

目的 分析江苏省2015—2019年输入性疟疾疫情流行特征及诊断情况,为防止疟疾输入再传播,巩固消除疟疾成果提供科学参考。方法 疟疾疫情资料来自国家传染病监测系统和寄生虫病防治信息管理系统,采用流行病学研究方法,描述2015—2019年江苏省疟疾发病、感染来源和病例三间分布情况,对输入性疟疾病例的诊断以及发病到诊断的时间间隔进行分析。结果 2015—2019年,江苏省共报告1 439例疟疾病例,其中1 436例为境外输入病例, 3例为输血感染病例。1 439例疟疾病例中,恶性疟1 075例（占74.7%）、间日疟63例（占4.4%）、卵形疟233例（占16.2%）、三日疟65例（占4.5%）、同一时间发病的混合感染病例3例（占0.2%）。境外输入性疟疾病例中,1 400例来自非洲（占97.5%）,其他来自亚洲28例（占1.9%）,以及南美洲和大洋洲8例（占0.6%）。江苏省13个设区市均有疟疾病例报告;疟疾病例以35~<50岁男性青壮年居多,每年的1、6和10月出现病例报告高峰。82.3%的病例由医疗机构诊断,由疾控机构诊断的病例占比逐年降低（P<0.05）。2019年发病到确诊超过9 d的病人所占比明显低于前四年（P<0.01）。结论 近5年江苏省疟疾疫情稳定,绝大部分为境外输入性病例,存在少数输血感染;病人就诊到确诊间隔时间有所缩短。继续做好风险人群健康宣教,提高医疗机构诊治能力,防止发生境外输入再传播,是今后疟疾防控工作的重点。

Epidemic situation and diagnosis of imported malaria in Jiangsu, 2015-2019

Objective To elaborate the epidemic of imported malaria in Jiangsu province from 2015 to 2019, and to prevent the importation and re-transmission of malaria, and we provide information for malaria control and elimination. Methods Data on imported malaria cases in Jiangsu Province from 2015-2019 were collected and sorted through the National Infectious Diseases Information Reporting Management System (IDIRMS) and the Parasitic Diseases Information Reporting Management System (PDIRMS). The incidence and distribution of malaria were described in Jiangsu Province from 2015 to 2019. The distribution of three dimension, diagnostic institutions and diagnostic timeliness of imported malaria cases were described and analyzed. Results From 2015 to 2019, a total of 1 439 cases were reported in Jiangsu Province, of which 1 436 were imported cases, and 3 cases were blood transfusion infection cases. The reported cases were comprised of Plasmodium falciparum (1 075, 74.7%), Plasmodium vivax (63, 4.4%), Plasmodium ovale (233, 16.2%), Plasmodium malariae (65, 4.5%), and mixed infections (3, 0.2%). Imported malaria cases mainly came from Africa(97.5%, 1 400/1 436), Asia (1.9%, 28/1 436), South America and Oceania (0.6%, 8/1 436). The cases were reported from 13 cities in Jiangsu Province. The main imported malaria cases were young men aged 35-<50 years. In January, June and October, more cases were reported than other months. And 83.2% of the cases were diagnosed by medical institutions. The percentage of cases diagnosed by disease control agencies has decreased year by year (P<0.05). The percentage of patients with more than 9 days time interval between onset and diagnosis in 2019 was significantly lower than that in the previous four years (P<0.01). Conclusion Malaria epidemic situation in Jiangsu Province has been stable in recent five years. Most malaria cases are imported from abroad, a small part of malaria cases are infected by blood transfusion. The interval between onset and diagnosis is shorter. Prevention of the re-transmisson of imported malaria, improving the efficiency of diagnosis and treatment, and strengthen health education are very important for malaria prevention in Jiangsu Province.