云南省1991—2000年疟疾监测报告

目的分析云南省1991－2000年疟疾监测结果，为制定云南省的疟疾防治措施提供依据。方法 收集1991－2000年全省发热病人血检和重点人群IFAT监测结果，边境地区流动人口管理及媒介监测资料进行流行病学统计分析。结果 10年间云南省共血检发热病人6193853例，检出阳性170578例，年平均血检率为3．52％，阳性率为2．75％，恶性疟占21．48％。重点人群的IFAT抗体阳性率为5．80％，阳性几何平均滴度在22．14－60．14之间。对边境地区不同流动人员的发热病人血检结果；外国入境边民的血检阳性率为13．05％；我国出境边民的血检阳性率为7．67％；内地到边境地区流动人员的血检阳性率为12．45％。云南省主要媒介微小按蚊，昆明按蚊和嗜人按蚊的人房次平均捕获数分别为2.29,2.46和2．90只。人，牛房比例分别为1：3．29，1：3．19和1：1．04。结论 云南省经过10年疟疾监测，发热病人血检阳性率已人1991年的3．30％下降至2000年的1．93％，以微小按蚊为主要传疟媒介地区的发病率已从1991年的万分之8．49下降至2000年的万分之3．79。云南省的疟疾发病保持了稳中有降。但在云南边境地区，受境外发病和流动人口的影响，疟疾的控制工作仍很艰巨。     

云南省1991～2000年疟疾监测报告

目的　分析云南省 1991～ 2 0 0 0年疟疾监测结果 ,为制定云南省的疟疾防治措施提供依据。　方法　收集 1991～ 2 0 0 0年全省发热病人血检和重点人群 IFAT监测结果 ,边境地区流动人口管理及媒介监测资料进行流行病学统计分析。　结果　 10年间云南省共血检发热病人 6 193 85 3例 ,检出阳性 170 5 78例 ,年平均血检率为 3.5 2 % ,阳性率为2 .75 % ,恶性疟占 2 1.48%。重点人群的 IFAT抗体阳性率为 5 .80 % ,阳性几何平均滴度在 2 2 .14～ 6 0 .14之间。对边境地区不同流动人员的发热病人血检结果 :外国入境边民的血检阳性率为 13.0 5 % ;我国出境边民的血检阳性率为7.6 7% ;内地到边境地区流动人员的血检阳性率为 12 .45 %。云南省主要媒介微小按蚊、昆明按蚊和嗜人按蚊的人房次平均捕获数分别为 2 .2 9、2 .46和 2 .90只。人、牛房比例分别为 1∶ 3.2 9、1∶ 3.19和 1∶ 1.0 4。　结论　云南省经过 10年疟疾监测 ,发热病人血检阳性率已从 1991年的 3.30 %下降至 2 0 0 0年的 1.93% ,以微小按蚊为主要传疟媒介地区的发病率已从 1991年的 8.49 下降至 2 0 0 0年的 3.79 。云南省的疟疾发病保持了稳中有降。但在云南边境地区 ,受境外发病和流动人口的影响 ,疟疾的控制工作仍很艰巨。     

云南省边境地区1991—1999年流动人口疟疾监测

目的 对我省边境地区流动人口的疟疾发病进行监测分析并提出疟疾防治对策。方法 对流动人员进行发热病人入血检和居民带虫血检监测。结果 1991－1999年流动人口发热病人血检平均阳性率为6．77％，带虫率为2．10％，同期流动到边境地区不同人群的发热病人血检阳性率和居民带虫率均高于当地人群。流动人口的疟疾发病是我省边境地区疟疾控制工作的主要难题之一，加强疟防知识宣传，提高流动人口的自我保护意识，可收到一定效果。     

云南省边境疟疾流行现状与趋势

７０ 年代末,云南边境逐步开放,大量流动人口出入国境,边境疟疾回升。９ 年观察结果显示,人口流动与疟疾发病关系密切,来自内地的流动人口和山区下河谷生产人员疟疾发病率分别为１．１２％ 和０．６４％ 。中国边民与来自缅甸、老挝和越南入境边民发热病人血检阳性率分别为 ４．５３％ 、１９．７５％ 、２７．５５％ 和３．９０％ 。中国边民出境到缅甸、老挝和越南回归后发热病人血检阳性率分别为８．８０％ 、３２．８２％ 和３．３８％ 。微小按蚊是边境地区的主要媒介,平均半通宵密度０．３２ 只／人·半夜,人工小时捕蚊,平均人房０．２５ 只／ｈ,牛房 ０．８９ 只／ｈ,户密度平均人房０．０６只／户,牛房０．２１ 只／户。１９８９～１９９６ 年１０３ 个自然村发生疟疾暴发流行,通过开展边境疟疾联防,疟疾发病出现缓慢下降的趋势。加强对各种流动人群的分类管理措施,才能控制边境疟疾流行。     

云南省边境地区19911999年流动人口疟疾监测

目的对我省边境地区流动人口的疟疾发病进行监测分析并提出疟疾防治对策.方法对流动人员进行发热病人血检和居民带虫血检监测.结果 1991-1999年流动人口发热病人血检平均阳性率为6.77%,带虫率为2.10%,同期流动到边境地区不同人群的发热病人血检阳性率和居民带虫率均高于当地人群.流动人口的疟疾发病是我省边境地区疟疾控制工作的主要难题之一,加强疟防知识宣传,提高流动人口的自我保护意识,可收到一定效果.     

云南省边境疟疾流行现状与趋势

７０年代末，云南边境逐步开放，大量流动人口出国境，边境疟疾回升。９年观察结果显示，人口流动与疟疾发病关系密切，来自内地的流动人口和山区下河谷生产人员疟疾发病率分别为１．１２％和０．６４％。中国边民与来自缅甸、老挝和越南入培边民发热病人血检阳性率分别为４．５３％、１９．７５％、２７．５５％和３．９０％。中国边民出境到缅甸、老挝和越南回归后发热病人血检阳性率分别为８．８０％、３２．８２％和３．３８％。     

陆川县消除疟疾后13年监测效果评价

1994-2006年对消除疟疾后的广西陆川县血检发热病人及重点人群荧光抗体监测。13年间共血检发热病人25313人次，检出疟疾病例58例，阳性率为0．23％，其中外出回归人员感染病例占96．55％，外来流动人口病例占3．45％。检测62928份人群血清，未检出抗体阳性者。疟疾监测和防治措施可行有效。     

1992-2008年粤桂琼流动人口疟疾联合管理区广西玉林市疟疾监测措施与联防效果评价

目的分析粤桂琼流动人口疟疾联合管理区广西玉林市1992-2008年疟疾监测结果,评价联防联控措施。方法收集1992～2008年广西玉林市辖7县（区）当地居民发热病人、病灶点居民和流动人口及重点人群疟疾间接荧光抗体（IFAT）监测资料进行流行病学描述和统计分析。结果17年间玉林市共血检当地居民发热病人75．84万人次,重点居民913万人次,流动人口发热病人10．17万人次．流动人口非发热人群6．71万人次,四类人群血检阳性率分别为0．004％、0．001％、0．704％和0．003％,共检出疟疾病例747例,本地感染病例占总病例的3．75％（28／747）,输入性病例占96．25％（719／747）,重点人群IFAT抗体阳性率为006％（211／368746）。结论玉林市参加三省疟疾联防17年来．疟疾年带虫发病率一直控制在1／万以下,1999年起至今无当地感染疟疾病例和输入继发病例发生．流动人口发热病人血检阳性率从1992年的3．230％降至2008年的0．036％,流动人口疟疾管理与监测措施得当,联防效果显著。     

岑溪市消除疟疾后12年监测结果分析

对广西岑溪市1996～2007年疟疾监测资料进行回顾性分析,结果12年间共血检当地发热病人4 805人次,未发现疟疾病例;血检外出回归人员和外来流动人口发热病人16 675和1 412人次,分别检出疟疾病例12和14例,血检阳性率分别为0.07%和0.99%;重点人群IFAT抗体阳性率为0.08%。提示岑溪市疟疾监测和防治措施可行有效,加强对流动人群、特别是从高疟区回归人群疟疾管理和监测是巩固疟疾防治成果的重要措施。     

2009年浙江省疟疾重点监测地区疫情

目的分析2009年浙江省疟疾重点监测县(市、区)疫情,了解新形势下浙江省疟疾流行特征,为制定适宜的防制策略提供依据。方法对发热病人进行血检,对疟疾病例进行流行病学个案调查,对部分小学生采用疟疾间接荧光抗体试验检测,对疟疾媒介进行监测。结果 7个疟疾重点县(市、区)共查出39例疟疾病例,发病率为0.75/10万。血检当地发热病人10 485例,发现疟原虫阳性5例,阳性率为0.048%;血检外来流动人口中的发热病人5 393例,发现疟原虫阳性34例,阳性率为0.63%,所有病例均为输入性病例。媒介监测所捕获的按蚊均为中华按蚊;2个县(市)小学生的平均抗体阳性率为0.67%。结论浙江省疟疾疫情呈下降趋势,仍需加强监测力度以有效控制疟疾疫情。     

以皮疹、腹泻为首发症状的脑型疟1例

非洲地区是疟疾的高流行地区,其中恶性疟的发病率和病死率最高.本文通过报道我国援坦桑尼亚医疗队诊治的1例以皮疹和腹泻为首发症状的脑型恶性疟患者的体会,以期为临床医生在诊治疟疾时提供参考、借鉴.     

Parasite-specific lactate dehydrogenase for the diagnosis of Plasmodium falciparum infection in an endemic area in West Uganda

The measurement of parasite lactate dehydrogenase (pLDH) has been presented as an easy and rapid method for the diagnosis of malaria in humans. In order to evaluate the sensitivity and specificity of such a test we examined blood samples from 429 Ugandan patients. While pLDH activity was significantly linked to parasitaemia, sensitivity and specificity were found to be rather low at 58.8 and 62.2% respectively. The positive and negative predictive values failed to meet necessary standards. We conclude that the methods of measurement of pLDH activity in malaria infection, although potentially useful for the fast diagnosis of malaria, need to be improved to be of true value in endemic areas.     

江汉平原控制间日疟对策的研究

从１９８６年开始，在江汉平原有代表性的江陵县境内２５万人口范围地区，研究控制间日疟的对策，经过实施以根治传染源和消除病灶点为主的综合性措施，该范围内的发病率由１９８６年的１１．５６‰下降到１９９１年的０．２８‰，为江汉平原广大流行区控制疟疾提供了科学依据。     

Effectiveness of chemoprophylaxis and other determinants of malaria in travellers to Kenya

Summary objective  To investigate the effectiveness of chemoprophylaxis and the determinants of malaria importation from Kenya.
method  In a population-based case-control study, 51 travellers from Bavaria diagnosed with falciparum malaria imported from Kenya (cases) and a sample of 383 healthy Bavarian travellers returning from Kenya (controls) were interviewed. Data were analysed by multiple logistic regression.
results  Mefloquine (OR = 0.055; 95% Cl 0.019-0.16) and chloroquine combined with proguanil (OR = 0.128; 95% CI 0.039-0.419) were highly protective against P. falciparum malaria, whereas other drugs were ineffective (OR = 1.225; 95% CI 0.536-2.803). Ineffective prophylaxis (10.4%) and non-prophylaxis (11.2%) were the main reasons for malaria importation. Travelling alone or with friends, male sex, and travel duration over 4 weeks could be identified as additional risk factors. The main reason for inadequate chemoprophylaxis was inappropriate medical advice (87.5%). Prophylaxis refusal occurred frequently despite correct advice (58.1%). Diagnosis was often delayed unnecessarily (27.5%).
conclusion  Malaria importation from Kenya could be reduced substantially (34%) by eliminating inappropriate medical advice.     

Mononeme: a new secretory organelle in Plasmodium falciparum merozoites identified by localization of rhomboid-1 protease

Compartmentalization of proteins into subcellular organelles in eukaryotic cells is a fundamental mechanism of regulating complex cellular functions. Many proteins of Plasmodium falciparum merozoites involved in invasion are compartmentalized into apical organelles. We have identified a new merozoite organelle that contains P. falciparum rhomboid-1 (PfROM1), a protease that cleaves the transmembrane regions of proteins involved in invasion. By immunoconfocal microscopy, PfROM1 was localized to a single, thread-like structure on one side of the merozoites that appears to be in close proximity to the subpellicular microtubules. PfROM1 was not found associated with micronemes, rhoptries, or dense granules, the three identified secretory organelles of invasion. Release of merozoites from schizonts resulted in the movement of PfROM1 from the lateral asymmetric localization to the merozoite apical pole and the posterior pole. We have named this single thread-like organelle in merozoites, the mononeme.     

Risk associated with asymptomatic parasitaemia occurring post-antimalarial treatment

Objective  Parasites may recur asymptomatically after initial clearance by antimalarial treatment. Current guidelines recommend treatment only when patients develop symptoms or at the end of follow-up. We wanted to assess prospectively the probability of becoming symptomatic and the risks of this practice.
Methods  We analysed data collected in 13 trials of uncomplicated paediatric malaria conducted in eight sub-Saharan African countries. These studies followed all cases of post-treatment asymptomatic parasitaemia until they developed symptoms or to the end of the 28-day follow-up period, at which time parasite genotypes were compared to pre-treatment isolates to distinguish between recrudescences and new infections.
Results  There were 425 asymptomatic recurrences after 2576 treatments with either chloroquine, sulfadoxine/pyrimethamine or amodiaquine, of which 225 occurred by day 14 and 200 between day 15 and day 28. By day 28, 42% developed fever (median time to fever = 5 days) and 30% remained parasitaemic but afebrile, while 23% cleared their parasites (outcome unknown in 4%). Young age, parasitaemia ≥500 parasites/μl; onset of parasitaemia after day 14, and treatment with amodiaquine were the main variables associated with higher risk of developing fever.
Conclusion  In areas of moderate to intense transmission, asymptomatic recurrences of malaria after treatment carry a substantial risk of becoming ill within a few days and should be treated as discovered. Young children are at higher risk. The higher risk carried by cases occurring in the second half of follow-up may be explained by falling residual drug levels.     

贵州省凯里等12个基本消灭疟疾县（市）的监测结果

目的：评价本地区基本消灭疟疾９年来的监测结果。方法：采用传统的疟疾度量调查各项指标。结果：（１）年带虫发病率波动在０．００５６‰至０．０００３３‰间；（２）居民发热病人血检阳性率平均为０．７３，居民普查原虫率平均为０．８２；（３）流动人口发热病人血检阳性率及原虫率分别为４１３．１和７．０６；（４）在９９４个疫点中，活动性疫点占１０．７％。结论：输入病例是疟疾病例的主要来源（９３．４％），仍需继续加强流动人口的管理。     

输入性恶性疟1例血液学筛查并文献复习

本文报道1例输入性恶性疟的血液学筛查和原虫形态学特征, 并结合文献进行复习。     

The immunology of malaria—a view from the bush

During the past few years a great deal has been learnt about malaria parasites and the immune responses that they evoke in their hosts. However, this new knowledge has so far had little impact on the practical problems of malaria control in tropical developing countries where malaria is still responsible for much mortality and morbidity. In Africa the malaria situation is now more serious than it was 20 years ago. Exciting new developments in molecular biology suggest that this situation may change in a few years time but attempts should be made to put the advances that have been made to the best practical use as soon as possible rather than delaying until even better technologies have been developed. This approach will require close collaboration between immunologists in sophisticated laboratories in industrialised countries and smaller laboratories in the countries of the developing world where malaria is still a major problem.