广东省近10年疟疾监测及防治策略研究

目的探讨广东省疟疾流行特征,为制定防治策略和监测方法提供依据。方法使用回顾性流行病学调查方法,利用疟疾病人个案表确定病例性质和发病前所从事的职业。媒介监测以半通宵人诱法,然后将捕获的按蚊进行种群鉴定和解剖。结果1996～2005年广东省共发现疟疾11852例,年发病率在0.020/万～0.370/万之间;10年检出疟原虫阳性病人11677例,平均每年检出1167.7例,其中外来人口疟疾病占47.46%,本省居民占52.54%。通过职业分析,从事打石、砍伐和种养等职业的患病率最高。近10年间日疟是广东省流行的唯一虫种,偶见输入性恶性疟。在10个病灶点进行传疟媒介调查,人诱捕获7种按蚊,未发现子孢子自然感染。用除虫菊酯浸泡蚊帐阻断媒介传播疟疾效果显著,可作为处理流动人口疟疾疫点的重要措施。结论广东省疟疾发病率已控制在较低水平,目前疟疾流行以散发或输入为主,主要抓住病例的早治疗和疫点的早处理,阻断疟疾在广东省的传播指日可待。

Study on Control Strategy and Surveillance of Malaria in the Past Ten Years in Guangdong

Objective To analyze the characteristic of malarial epidemiology in Guangdong and provide basis for setting the surveillance and strategy for the treatment and prevention of malaria. Method With retrospective epidemiological investigative method, the characteristics of the cases and occupation of patients were analyzed. Anopheles were captured for anatomical analysis and classification down to genus. Result 11852 malaria cases were reported between 1996 and 2005 in Guangdong, with an annual morbidity of 0.020 and 0.370 per ten thousand. In the past ten years 11677 plasmodium-positive individuals were found, in ten years, of which 52.54% are local residents and 47.46% are migrants. The highest morbidity was found in loggers, quarry-men and farmers. In recent ten years, Plasmodium vivax was the only prevailing species in Guangdong, with occasional import of falciparum malaria. Six species of anopheles were trapped in ten sites but no mosquito was infected with sporozoites. Mosquito net treated with pentmethrin can effectively prevent malaria. Conclusion It is concluded that malaria morbidity in Guangdong had been controlled in low level, the malaria endemic areas are straggled through out the province and malaria cases are mainly imported. Malarial prevalence can be stopped if the patients are treated at the early stage and the control measures are implemented early at the endemic areas.