疟疾防治知识

疟疾(malaria)是由疟原虫经按蚊叮咬传播的传染病.临床上以周期性定时发作的寒战、高热、出汗退热以及贫血和脾大为特点.疟疾广泛流行于世界各地,据世界卫生组织统计,目前仍有92个国家和地区处于高度和中度流行,每年发病人数为1.5亿,死于疟疾者愈200万人.我国解放前疟疾连年流行,尤其南方,由于流行猖獗,病死率很高.解放后,全国建立了疟疾防治机构,广泛开展了疟疾的防治和科研工作,疟疾的发病率已显著下降.     

Malaria control in British Guiana

Anopheles darlingi-the sole malaria vector in British Guiana-was eradicated from the coastal areas by means of house-spraying with residual DDT. Between the seaward zone, where the conditions are ideal for the breeding of this anopheline, and the hinterland, there is a belt of very acid, peaty soil in which the vector cannot exist, and which therefore forms a natural barrier against it. Consequently, extensive routine spraying with DDT has not been necessary to prevent the reinvasion of the coastal areas; satisfactory protection has been obtained simply by concentrating the control operations on the gaps in this barrier.     

Malaria control in an Amazon municipality

This study aimed to evaluate the organization of malaria control actions in the Indigenous population of the municipality of S?o Gabriel da Cachoeira, Amazonas, AM, Brazil, from 2003 to 2007. This is an ecological study to evaluate the impact of control measures. Statistical analysis of the indicators revealed that the number of cases showed an increasing trend, with the highest numbers occurring in the rural areas. The same trend was observed for the Annual Parasite Index (API), however the highest APIs were found in the urban areas. The proportion of cases caused by Plasmodium falciparum showed a reduction. Hospitalization and mortality rates presented fluctuations and the fatality rate decreased. The findings indicate that control actions have proved partially effective and that they have provided a broader capacity to detect cases and to provide immediate treatment. Although the municipality still presents a high risk for transmission, the Pluriannual Plan in progress seems to have a good prognosis for the control of the disease, if maintained in a sustainable and permanent way.     

Malaria control through anti-mosquito measures in Italy

The Malaria Experiment Station at Rome (Stazione Sperimentale per la Lotta Antimalarica) has during the last four years carried on experiments in malaria control in certain Italian communities using (1) anti-larval measures alone, (2) anti-larval measures combined with intensive quininization, and (3) intensive quininization alone. In every case, the anti-larval measures were less expensive than the treatment of the malaria previously carried on in the community, and in four years produced an almost complete disappearance of endemic malaria which was not accelerated by the concomitant treatment of chronic carriers. Intensive quininization alone has not in two years produced any diminution in the parasite or spleen indices, although it has reduced the size of the largest spleens and has somewhat diminished the amount of malignant tertian and quartan fevers.Medical assistance to the malarious sick and the prevention of transmission through anti-mosquito measures are both necessary, and should be carried on simultaneously; but they have different aims, and one is not a substitute for the other.The intensity of malaria in a locality bears a definite relationship to the density of anophelines in human habitations, and responds rapidly to changes in the latter ; but the measure of contact between anophelines and man is a factor which varies widely in different regions with the same species, and with different species in the same region.The use of larvicides should not take the place of permanent measures to abolish anopheline breeding whenever these are possible, but larvicides (especially Paris green) should be used to hold malaria in check until definite measures can be applied ; and, where this is impracticable, communities may successfully and economically employ larvicides in an annual campaign against anopheline larvæ for an indefinite period of time.     

Malaria in the African highlands: past, present and future.

Many of the first European settlers in Africa sought refuge from the heat and diseases of the plains by moving to the cool and salubrious highlands. Although many of the highlands were originally malaria free, there has been a progressive rise in the incidence of the disease over the last 50 years, largely as a consequence of agroforestry development, and it has been exacerbated by scarce health resources. In these areas of fringe transmission where the malaria pattern is unstable, epidemics may be precipitated by relatively subtle climatic changes. Since there is little immunity against the disease in these communities, outbreaks can be devastating, resulting in a substantial increase in morbidity and death among both children and adults. We present here the results obtained using a mathematical model designed to identify these epidemic-prone regions in the African highlands and the differences expected to occur as a result of projected global climate change. These highlands should be recognized as an area of special concern. We further recommend that a regional modelling approach should be adopted to assess the extent and severity of this problem and help improve disease surveillance and the quality of health care delivered in this unstable ecosystem.     

Malaria control in South Malabar,Madras State

The author describes the activities and achievements of a two-year malaria-control demonstration-organized by WHO, UNICEF, the Indian Government, and the Government of Madras State-in South Malabar.Widespread insecticidal work, using a dosage of 200 mg of DDT per square foot (2.2 g per m(2)), protected 52,500 people in 1950, and 115,500 in 1951, at a cost of about Rs 0/13/0 (US$0.16) per capita.The final results showed a considerable decrease in the size of the endemic areas; in the spleen- and parasite-rates of children; and in the number of malaria cases detected by the team or treated in local hospitals and dispensaries.     

Malaria in African schoolchildren: options for control

Intensified malaria control efforts among young African children may increase disease risks among older children who attend school and whose education may be impaired by malaria. However, there is currently no consensus as to the approach to malaria control in schools, with relevant intervention strategies varying according to patterns of malaria transmission. Life skills messages regarding prevention and accessing prompt treatment are important everywhere. Providing free bed nets to schoolchildren may bring individual and community benefits and should be widely promoted. New approaches to school-based chemoprevention and treatment may also be able to play an important role in school-based malaria control, although these require further investigation.     

疟疾基本消灭后监测与防治对策的研究

目的评价潍坊市疟疾基本消灭后监测效果与防治对策,为调整防疟措施提供依据。方法1988年基本消灭疟疾后,在全市范围内设专职或兼职镜检站246处,积极开展病例侦察,及时发现和治疗现症病人,对病人进行流行病学调查和疫点处理,加强流动人口疟疾管理,定时对各镜检站的工作进行检查、督导,采用间接免疫荧光法(IFAT)随机抽查居民患病情况和媒介密度。结果1988~2005年共血检当地发热病人1886535人次,疟原虫阳性9例,血检往返高疟区流动人口270761人次,检出疟原虫阳性者27例,1999年后未再发生内源性病例,居民疟疾抗体监测5821人,阳性率0.206%,中华按蚊密度维持在较低水平。结论输入性病例为现阶段病例的主要来源,基本消灭疟疾的防治成果得到了巩固,现行疟疾防治措施可以适当简化,流动人口的监测与管理是防治重点。     

三都水族自治县疟疾防治措施与效果

目的总结三都水族自治县(以下简称三都县)疟疾防治策略和措施,评价防治效果,总结推广防治经验。方法将三都县1955—2013年历年的疟疾防治总结、各类报表资料,流行病学调查、媒介调查、综合防治措施进行回顾流行病学分析。结果 1955年三都县疟疾发病率为1 133/万,通过采取综合防治措施,2009—2010年发病率已控制在1/万以下,发病率均未超过5/万。2011、2012和2013年已经连续3年无病例。结论三都县已经达到国家卫生部颁布的《疟疾控制和消除标准(GB 26345-2010)》标准,三都县59年来的防治策略和综合性抗疟措施是有效的。     

Malaria control and long-term periodicity of the disease in Pakistan

The classic investigations of the malaria epidemics in the Punjab led to the conclusion that in this most populous and most malarious province of the present-day Pakistan, epidemics occurred regularly at intervals of approximately eight years. Against this background, the results of a Malaria Control Programme launched in 1975 are examined. The Programme, supported by USAID and WHO, represents in economic terms the greatest effort made against malaria in the country. Malathion, the main attack weapon of the Programme, was used on an unprecedented scale. This created logistic and—unexpectedly—toxicity problems among the spraying workers. Despite these difficulties, an over-all reduction of 76% in the slide positivity rate was observed in the first two years of operations of the Programme. The authors warn against measures which may curtail the activities of the Programme when, according to the cyclical periodicity of malaria in the Punjab, an epidemic wave can be expected in 1980–1981, with inevitable repercussions all over the country.