海南省和平镇1991～1996年疟疾控制新对策的效果

为探索应用生物、心理和社会医学模式指导疟疾防治的新对策,采用健康教育,社区参与,增强居民自我保护意识,提高抗疟依从性和参与性为主,辅以传统抗疟的干预措施。结果１９９６ 年与１９９１ 年相比,（１） 居民防疟知识掌握率、态度正确率和行为良好率分别从３１．３６％ ,４１．９５％ 和４７．０３％ 提高至９０．９８％ ,９３．０８％ 和９１．０８％ 。（２）年带虫发病率下降８４．７％ ;恶性疟原虫比例从占４０．７ ％ 下降至１２．７％ 。（３） 居民原虫率下降９０．３％ 。说明在疟疾流行基本条件未改变,高危环境依然存在的疟区,以生物、心理和社会医学模式来指导的防治对策,切实可行,有较好的防治效果。     

黔桂两省（区）灭疟联防区贵州12县（市）疟疾态势和防治效果

目的：评价疟疾联防２０年来的防治效果。方法：采用传统的疟疾度量调查的各项指标。结果：１疟疾发病率从１９７５年的５９．４降至１９９５年的２．７７，下降９５．３％；２当地发热病人血检阳性率和原虫率分别下降９６．８％和９２．３％；３恶性疟病人所占比例从１６．４％降至０，基本消灭了恶性疟。结论：加强疟疾高发县的流动人口疟疾管理与监测和综合防治是降低发病和减少疟疾输入的重要措施。     

黔桂两省（区）灭疟联防区贵州12县（市）疟疾态势…

评价疟疾联防２０年来的防治效果。方法：采用传统的疟疾度量调查的各项指标。结果：１疟疾发病率从１９７５年的５９．４‰降至１９９５年的２．７７‰；２．当地发热病人血检阳性率和原虫病分别下降９６．８％和９２．３％。３ 恶性疟病人所占比例从１６．４％降至０，基本消灭了恶性疟。结论：加强疟疾高发县的流动人口疟疾管理与监测的综合防治是降低发病和减少疟疾输入的重要措施。     

α—氯氰菊酯浸泡蚊帐控制疟疾及其媒介的现场试验

１９９０年在疟疾中度地方性流行区河南省固始县进行了α－氯氰菊酯浸泡蚊帐疟疾及其媒介的社区干预试验。实验结果显示浸泡蚊帐后疟疾人年发病率下降２．０％，显著低于对照区的３．６％，其保护效能为４３％；１０岁以下儿童原虫率浸泡区内对照区的１／４。嗜人按蚊和中华按蚊的室外叮人率分别下降７０．３％和２９．３％，停息于蚊帐内的按蚊数接近于０。     

α-氯氰菊酯浸泡蚊帐控制疟疾及其媒介的现场试验

１９９０年在疟疾中度地方性流行区河南省固始县进行了α－氯氰菊酯浸泡蚊帐控制疟疾及其媒介的社区干预试验。实验结果显示浸泡蚊帐后疟疾人年发病率下降２．０％，显著低于对照区的３．６％，其保护效能为４３％；１０岁以下儿童原虫率浸泡区为对照区的１／４。嗜人按蚊和中华按蚊的室外叮人率分别下降７０．３％和２９．３％，停息于蚊帐内的按蚊数接近于０。在使用浸泡蚊帐的人群中没有发现副反应。实验还发现，α－氯氰菊酯浸泡涤纶蚊帐的效果优于棉纱蚊帐且残效持续１年以上。α－氯氰菊酯浸泡蚊帐是控制疟疾的一种经济有效的措施。     

湖北省连续四年溴氰菊酯浸泡蚊帐防制媒介和控制疟疾流行的效果观察

１９９０～１９９３年在以嗜人按蚊为主要媒介的疟疾高发区采用２．５％溴氰菊酯浸泡蚊帐防治按蚊，结合防治传染源的综合措施，使嗜人按蚊疟区疟疾平均发病率从１９９０年的０．３８％降至１９９３年的０．１％；发热病人血检阳性率从１９９０年的２．７８％降为１９９３年的０．７６％。结果显示此类疟区用这种抗疟措施具有较好的防制效果。     

溴氰菊酯灭蚊抗疟九年效果报告

本文报道了成都市１９８７－１９９５年连续９年在４７万余人口３０个乡范围内以溴氰菊酯喷浸蚊账灭蚊抗疟的效果，采用剂量为９．６－１２．８ｍｇ／ｍ＾２，共处理蚊帐近６０万顶，处理率达９７％以上，使嗜人按蚊密度和叮人率下降９７％以上，学龄儿童疟原虫率和发热病人疟原虫阳性率降至０，疟疾发病率下降９８．４４％，其中１４个乡疟疾病例为０，成为建国以来疟疾处于低度流行时期。     

广东省近10年疟疾流行与监测分析

近 １０ 年来,每年省内有近千万外来流动人口,时常引起局部疟疾流行。１９８８～１９９７ 年全省报告疟疾４９ ２０６例,疟疾年发病率在０．１８％ ～１．２４％ ;检出疟原虫阳性病人９５ ３２８ 例,平均每年检出９ ５３３ 例,其中外来人口疟疾病人占 ５３．３％ ,本省居民占４６．７％ 。间日疟是广东当前流行的唯一虫种,偶见输入性恶性疟,罕见输血感染三日疟。在 １６６ 个病灶点进行传疟媒介调查,人诱捕获９ 种按蚊,其中嗜人按蚊和微小按蚊发现子孢子自然感染。嗜人按蚊的媒介能量调查显示,昆虫学接种率为 ０．０８４～０．６６５ ,即在该区平均居住１．５～１１．９ ｄ 就可能感染疟疾。拟除虫菊酯浸泡蚊帐防治疟疾及传疟媒介可获得良好效果,也是处理流动人口疟疾疫点的重要措施。     

1978～1996年我院结核菌起始耐药发生趋势

本文报告我院１９７８～１９９６年住院的新发初治是性肺结核病人１７６２例的起始耐药及耐多药发生趋势。起始耐药率由１９７８～１９８０年２６．１％下降至１９９５～１９９６年的１４．２％，Ｈ和Ｓ的耐药率分别为由１９７８～１９８０年的１３．７％和１９．０％下降至１９９５～１９９６年的８．５％和１４．２％，Ｒ的耐药率１９７８～１９８０年为０．７％，１９９５～１９９６年上升至３．８％，耐二药和耐三药的耐药率１９     

四川省1995-1997年基本消灭疟疾县疫情分析

根据１９９５－１９９７年省地办《疟疾防治工作年报表》，将基本消灭疟疾达标县疫情分析如下：１　四川省辖２０个地、市、州，１８１个县，总人口为８４２９９万，全部达标验收的地区有攀枝花、自贡、南充、达川和巴中地区，共３６个县，当地无疟疾流行的地区为甘孜州和阿坝州，共３１个县。２　疟疾发病率　基本消灭疟疾的县，１９９５－１９９７年分别为６５、６８、７０个县，发病例数依次为８６３、４７０、２６９例，发病率分别为０．２１／万、０．１１／万、０．０６／万，逐年下降。达标县中，无疟县３年分别为１４、１９、２８…     

Impact of single round of indoor residual spray with lambda-cyhalotrin 10% WP on Plasmodium falciparum infection in Akola district, Maharashtra State.

Lambda-cyhalothrin 10% WP (ICON 10WP) was sprayed from 5th November 1997 at a dose of 25 mg/m2 as indoor residual spray in 74 high risk villages. The spray was completed within 10 days in most of the villages. The monthly entomological monitoring showed nil density of Anopheles culicifacies and Aedes and very low density of non-vector Anopheles and Culex. The impact of Lambda-cyhalothrin spray was discernible right in the month of November 1997 showing 52% reduction in P. falciparum cases as compared to the same month of preceding year. The reduction of P. falciparum cases in three months post-spray period was 77% (from 47 cases to 11 cases) as compared to similar months of preceding year and overall reduction of total malaria cases was 50% during the same period. Since the major part of transmission of P. vivax infection was over by the time Lambda-cyhalothrin spray was taken up, obviously the impact on P. vivax infection was not markedly high as compared to P. falciparum infection. Neither cerebral malaria cases nor deaths due to malaria were recorded in the sprayed villages.     

黔桂疟疾联防区20年疟疾防治效果评价

黔桂疟疾联防区２４个县,是两省（区）的边陲山区,也是两省（区）最严重的恶性疟和间日疟混合流行的疟疾高发区。经过联防２０年的同步防治,疟疾发病率从１９７５年的１１１．９４降至１９９５年的１．８７,年带虫发病率也降至１．４７,已无当地感染的恶性疟病例,经考核有８个县达到卫生部《基本消灭疟疾标准》     

Epidemiology and spatial analysis of malaria in the Northern Peruvian Amazon

A retrospective surveillance study was conducted to examine the micro-geographic variation of malaria incidence in three malaria-endemic communities in the Northern Peruvian Amazon. The annual malaria risk rate (per 100) ranged from 38% to 47% for Plasmodium vivax and from 15% to 18% for P. falciparum. Spatial clusters were found for P. vivax in Padre Cocha, Manacamiri, and Zungaro Cocha, and for P. falciparum only in Padre Cocha. Spatial-temporal clusters showed that the highest monthly number of P. vivax cases varied every year from December to March in 1996-1997 and from February to June in 1998-1999, and for P. falciparum from November to April in 1996-1997 and from January to April in 1998-1999. Our results suggest a constant presence of high-risk areas (hot spots) for malaria infection in periods with high or low malaria incidence. Modest targeted control efforts directed at identified high-risk areas may have significant impact on malaria transmission in this region.     

Epidemiology of malaria in a hypoendemic Brazilian Amazon migrant population: a cohort study

The present study describes aspects of the epidemiology of malaria in a migrant population living in a hypoendemic area in Brazil using an open cohort study design. Rural settlement residents in Leonislandia, Peixoto de Azevedo, Mato Grosso, Brazil were followed from September 1996 to April 1997. At baseline, an interview and malaria diagnoses were carried out and spleen size was measured. Incident cases were detected through follow-up visits and laboratory records. Cox regression was used to assess risk factors for time to malaria onset. Eighty percent (n = 414) of the study population (n = 521) contributed follow-up data. Overall, malaria prevalence during any study visit ranged from 0.3% to 5.4% and the malaria incidence rate (IR) was 4.49 (95% confidence interval = 3.66, 5.46) per 100 person-months. The IR of Plasmodium vivax malaria was approximately four times higher than the IR for P. falciparum malaria during follow-up. Among individuals who had had malaria during his or her lifetime, 14.03% reported hospitalization (median duration = 3 days) and 70.1% reported days of work lost (median duration = 4 days for P. falciparum malaria and 3 days for P. vivax malaria) related to the last malaria episode. No important risk factor was associated with the malaria IR. The fact that neither work-related factors nor age was associated with the risk of malaria indicates that indoor/peri-domiciliary transmission by the local vector is more important or as important as workplace-related transmission.     

Malaria outbreak in a tribal area of Gujarat state, India

Malaria incidence in Gujarat state had been on a general decline since 1989. However in some tribal villages in forested areas of Valsad district, southern Gujarat, there was an outbreak of malaria in September 1995. Five children died in Ashlona village. During investigation conducted in October 1995 in affected villages, the malaria parasite rate was 26% (217/833) with >91% infections due to P. falciparum. A high proportion of P. falciparum infections had ring stages suggesting active transmission. Against a minimum norm of 10% annual blood examination rate, there was a major breakdown of active surveillance for malaria. In the absence of health agencies in or near affected villages, the malaria parasite load continued to build up leading to an outbreak towards the end of monsoon season. Indoor residual spraying with deltamethrin caused significant reduction in densities of malaria vector An. culicifacies. Measures to prevent malaria outbreaks in inaccessible areas have been discussed.     

Malaria control through impregnated bednets--a pilot project in selected villages in Lao PDR

In 7 villages on the foothills of the Houayxai district of the Bokeo Province in Lao PDR between midyear 1995 to midyear 1997 an attempt was made to test the acceptability and use of DDT impregnated bed nets as well as environmental and behavioral risk factors. About 380 women between 15 to 45 years old and their children in the age range of 1 to 14 years had been studied. A pre-tested questionnaire had been applied and blood from women and children was taken from the finger prick and a conventional thick and thin blood smear was performed, fixed Giemsa stained and examined for malaria parasites. DDT (dichlorodiphenyltrichloroethane) impregnated mosquito nets were distributed in the intervention villages. The availability of mosquito nets increased statistically significant from approximately 50% to 70% for all family members in the intervention area between 1995 and 1997 and statistically significant decreased in the control area from 79% to 45.1%. There was a statistically significant decrease in malaria attacks as claimed by the females for the intervention area but not for the control villages. The proportion of positive blood smears did decrease overall for women and children in between 1995 to 1997. Occupation, location of the house and use of mosquito nets had been determined as the most important risk factors.     

Investigation of malaria prevalence at National Thermal Power Corporation, Shaktinagar, Sonbhadra District (Uttar Pradesh), India.

Malaria in industrial complexes is promoted by extensive mosquitogenic potential generated by excavations and importation of parasite through migratory labor. The National Thermal Power Corporation (NTPC), Shaktinagar, Sonbhadra district was surveyed for malariogenic conditions from 1994 to 1996. The major mosquito breeding sites were drains, storm-water drains, lakes, outside tanks, overhead tanks, sluice-valve chambers, ornamental tanks, wells, pit wells and water reservoirs, etc. Anopheles culicifacies was the major vector of malaria in this area. Sibling species identification of An. culicifacies revealed that species C predominated during the transmission season and responsible to transmit malaria. Insecticide susceptibility tests against An. culicifacies sl showed that An.culicifacies population was 100% susceptible to malathion, fenitrothorn and deltamethrin while it was found 44% resistant to DDT. The malaria cases recorded in 1994, 1995 and 1996 were 847, 590 and 409 respectively. In vitro study on P. falciparum cases showed that 41, 70, 50% of the isolates tested were resistant to chloroquine in 1994, 1995 and 1996 respectively while an in vivo follow-up study showed 20-30% P. falciparum cases resistant to chloroquine. An integrated approach involving alternate vector control measures along with judicious use of insecticides has been suggested to bring down malaria in industrial complexes.     

福建省嗜人按蚊防制措施与效果

经调查发现福建省嗜人按蚊主要分布于闽西北南平和三明地区及闽中永泰等 15县 (市、区 ) 6 1个乡 (镇 )2 5 9个村。南平和三明两地区 14县 (市、区 )嗜人按蚊分布区采取 DDT室内滞留喷洒和溴氰菊酯浸泡蚊帐的防制措施 ,有效地控制了嗜人按蚊。反复查灭是清除嗜人按蚊的主要措施 ,灭蚊后 95 .34%的分布点经复查均未再捕获嗜人按蚊 ,其中复查 2次以上的分布点占 5 8.4% ,最多复查次数达 12次 ,显示嗜人按蚊在闽西北地区已基本被清除 ,疟疾发病数从防制前 1980年的 12 92 1例降至 1998年的 8例 ,有效地控制了疟疾流行。 1996～ 1998年 ,未再发现当地疟疾继发感染者 ,基本阻断了闽西北地区疟疾的传播     

Relationship between entomological inoculation rate,Plasmodium falciparum prevalence rate,and incidence of malaria attack in rural Gabon

To assess the relationships between variations of Plasmodium falciparum transmission and those of peripheral parasitaemia prevalence or malaria attack incidence rates in regions with limited fluctuations of transmission, we conducted a follow-up in two Gabonese populations. Entomological surveys were carried out from May 1995 to April 1996 in Dienga, and from May 1998 to April 1999 in Benguia. In Dienga, malaria transmission was seasonal, being not detected during two 3-month periods. Mean entomological inoculation rate (EIR) was 0.28 infective bite/person/night. In Benguia, malaria transmission was perennial with seasonal fluctuations, mean EIR being 0.76 infective bite/person/night. In Dienga, 301 schoolchildren were followed from October 1995 to March 1996. Clinical malaria attack was defined as fever associated with >5000 parasites/microl of blood. P. falciparum prevalence varied from 28 to 42%, and monthly malaria attack incidence from 30 to 169 per thousand. In Benguia, the entire population (122 persons) was followed from November 1998 to April 1999. Prevalence varied from 22 to 50%, and monthly malaria attack incidence from 52 to 179 per thousand. In each area, entomological variations were not related to parasite prevalence, but preceded malaria attack incidence with 1- or 2-month time lag, corresponding to the pre-patency period that differs in the two populations, possibly according to differences in immunity related to parasite transmission.     

Bio-environmental control of malaria in a tribal area of Mandla district, Madhya Pradesh, India

Bizadandi block of District Mandla was selected for demonstration of bio-environmental control of malaria. The project presently covers 80 experimental villages and 12 control villages. In this area, because of indifferent surveillance and spraying in the past (from 1978-86) the API was reported low and the parasite reservoir in the community had built up over the years. At the outset of the study the malaria prevalence was high with preponderance of P. falciparum. Densities of A. culicifacies were very high and A. fluviatilis was also present. P. falciparum predominated in both experimental and control area during 1988 than in 1987. Annual blood examination rate (ABER) was 73.6 and 57.5 and annual parasite incidence (API) was 114.7 and 228.0 in experimental and control villages in 1987, while in 1988, ABER and API was 63 and 73 and 112 and 316 in experimental and control, respectively. There was constant stabilization of Pf in neighbouring blocks in 1988 while in experimental areas Pf percentage has come down appreciably during March to June. It is very alarming to note that the parasite reservoir in control villages was sufficient to maintain active transmission even when antimalarial activities are at a peak. The application of residual insecticides like DDT and HCH has no tangible impact on the reduction in vector densities and the transmission of malaria. Even if a replacement insecticide like malathion is used it may produce very limited impact on vector densities in such forested zones. Thus, there is an urgent need to intensify integrated malaria control operations in the area on long term basis.