湖南郴州市疟疾流行及基本消灭疟疾后的防治效果分析

目的　分析疟疾流行及基本消灭疟疾后的防治效果 ,为进一步巩固灭疟成果提供依据。方法　收集历年疟疾防治资料 ,进行疟疾病原学、免疫学和昆虫学监测 ,处理疟疾疫点。结果　 2 0世纪 5 0年代居民原虫率最高达83 .8% ,发病率达 82 98.92 /10万。经过几十年的反复查治 ,疟疾年发病率逐年下降 ,1977年降至 6.3 6/10万。 1987年经湖南省卫生厅考核 ,确认达到基本消灭疟疾标准。 1987～ 2 0 0 2年发热病人血检 5 742 6例 ,查出疟原虫阳性 15 63例 ,其中间日疟 15 3 8例 ,恶性疟 2 3例 ,间日疟与恶性疟混合感染 1例 ,三日疟 1例。 1987～ 2 0 0 2年疟疾年发病率 0 .0 4/10万～6.72 /10万 ,并呈逐年下降趋势 ,输入性疟疾占总病例数的 94.2 8% (15 15 /160 7)。通过对现症病人根治 ,结合流行季节周围人群预防服药和灭蚊工作 ,未发现二代病例和健康带虫者。结论　郴州市基本消灭疟疾后病例以输入性为主 ,但不能排除本地还有疟疾传播。在今后的疟疾防治工作中 ,应加强对进入高疟区回归人群的监测 ,巩固灭疟成果。

Epidemiology of Malaria and Preventive Effect after Basically Elimminated Malaria in Chenzhou

Objective To study malarial epidemic situation and preventive effect after basically elimminated malaria and provide foundation for solidifing elimminated malaria in Chenzhou. Methods The data in prevention and cure of malaria were collected over the years. The pathogeny, immunology and insectology surveillance of malaria were carried out and the malarial epidemic situation was dealt with. Results Chenzhou was a high epidemic area of malaria by the spread of An.Sinensis. The rate of protozoa and incidence was high to 83.8% and 8 298.92/10 000 respectively in 50's of the 20th century. In 1977, the rate was down to 6.36/100 000 gradually by repeated checking and treatment in the past years. In 1987, Hunan Health Department affirmed that Chenzhou had arrived the standard of the basically elimminated malaria. In 1987-2002, 57 426 fever cases were checked by blood; 1 563 malaria cases were found; the vivax malaria was 1 538; falciparum malaria was 23; mixed infection of vivax and falciparum malaria was 1;malariae malaria was 1. The incidence rate of malaria was 0.04/100 000- 6.72/100 000 and trended to descend gradually. The constituent ratio of imported malaria was 94.27% (1 515/ 1 607). Secondary case and healthy infectious people had not been found by permanent controlling the patient, taking preventive drug and elimminating malarial mosquito when the disease was in epidemic period. Conclusion The imported malaria cases were dominated in Chenzhou after basically elimminated malaria, but the local spread of malaria could not be excluded. The crowd coming from the district of higher incidence rate of malaria should be monitored in our later malarial prevention.