襄阳市2007-2010年疟疾疫情及抗疟措施分析

目的 分析襄阳市2007-2010年的疟疾疫情,找出发病重点地区、人群及防治工作中存在的问题,为制定科学的抗疟对策提供依据.方法 收集襄阳市9个县、市2007-2010年疟疾网络疫情报告数据及抗疟措施执行情况,对疟疾发病地区、季节、人群分布及抗疟措施进行描述性分析.结果 2007-2010年襄阳市累计报告疟疾2 101...     

百色市疟疾流行现状和消除疟疾可行性探讨

目的 分析百色市2001-2010年疟疾流行现况和趋势,探讨百色市2018年消除疟疾的可行性.方法 收集2001-2010年百色市12个县(区)当地居民发热患者、病灶点居民和流动人口监测资料进行描述和分析.结果 10年间百色市共血检本地发热患者92.44万人次,病灶点居民1.90万人次,外出回归农民工2.69万人次,外来人群5.60万人次,检出疟疾病例297例,三类人群血检阳性率分别为0.005 9％、0、0.705 9％和0.092 6％.本地疟疾病例从2001年的10例下降到2007年的1例,2008-2010年连续3年无本地病例发生.结论 10年来百色市疟疾发病率控制在1/10万以下,按照世界卫生组织消除疟疾的标准,百色市疟疾疫情已进入消除疟疾阶段巩固期,但在黔桂交界、中越边境地区仍有个别本地病例发生,只要加大经费投入和技术措施执行力度,百色市2018年消除疟疾是可以实现的.     

2010年海南省疟疾疫情分析

2010年海南省报告疟疾78例,发病率为0.09/万, 流动人口血检阳性率高于本地居民, 居民抗体阳性率高于学生,现症病例均得到规范治疗, 间日疟根治服药率为96.56%, 高危人群预防服药率为94.15%。杀虫剂喷洒4 086户, 保护人口 26 843人; 杀虫剂浸泡/喷洒蚊帐153 116顶, 保护人口250 851人。2010年海南省消除疟疾措施有效, 但应加强疟疾疫情报告、 病例核实、 疫点处理、 流动人口疟疾防治、 疟疾监测等工作。     

间日疟、恶性疟混合感染1例治疗报告

2009年龙岩市报告1例间日疟、恶性疟混合感染病例,患者在国外感染、发病,曾接受过治疗,回国后再次发病。在国内经3个疗程青蒿琥酯(1 800 mg)和4个疗程的氯伯8 d疗法(氯喹4 800 mg、伯氨喹720 mg)治疗后痊愈。     

亳州市2005-2013年疟疾流行特征分析

目的 分析亳州市2005-2013年的疟疾疫情和流行特征,为疟疾防治提供依据. 方法 收集全市疟疾发病资料,用描述性流行病学方法分析疟疾病例在时间、地区和人群中的分布特点.结果 2005-2013年疟疾发病数分别为6 510、17 706、13 799、5 856、2 605、678、214、8和0例,总病例数为47 376例,平均年发病率为113.24/10万;涡阳县、蒙城县、利辛县和谯城区报告病例数分别为21 451、11 540、12061和2 321例;报告病例男女性别比为1.34∶1,以青壮年病例为主,11～20岁人群病例数最多,占总病例数的19.27％（9 130/47 376）,其余各年龄组人群发病数及构成比接近;农民与学生为主要发病人群,分别占68.44％ （32 424/47 376）和20.66％（9 787/47 376）;夏秋季节为发病的高峰期,主要集中在6 11月,共45 163例,占总病例数的95.33％;2006年较2005年,疟疾报告病例上升了2.69倍,2007 2013年,疟疾报告病例较上年分别下降22.18％、57.74％、55.77％、74.04、64.86、96.37％、100％. 结论 亳州市疟疾疫情连年呈大幅下降趋势,目前疫情基本稳定,2013年首年度实现了无本地感染病例.     

常州市武进区基本消灭疟疾后疫情监测

常州市武进区基本消灭疟疾后疫情监测显示,1992年以来,年内疟疾发病率波动在0.01/万～0.15/万,病例呈散在分布,输入性病例增多。加强输入性疟疾防控、流动人口抗疟管理、基层专业人员疟疾防治技能培训和全民健康教育是当前消除疟疾工作的重点。     

2005-2013年徐州市疟疾疫情分析

目的了解徐州市疟疾流行特点、规律和变化趋势,为制订有效防治措施提供科学依据。方法收集徐州市2005—2013年疟疾个案调查表和专报系统的流行病学调查资料,对资料进行描述性流行病学分析。结果 2005—2013年共报告疟疾968例,均为散在病例,无暴发流行。本地感染病例728例,占75.21%(728/968);境外输入性病例73例,占7.54%(73/968);国内输入性病例167例,占17.25%(167/968)。2012—2013年无本地感染病例。对2005—2010年和2011—2013年病例分型进行分段比较,差异有统计学意义(χ~2=674.37,P0.05)。结论徐州市自2012年以来无本地感染疟疾报告,疟疾病例感染来源从本地感染为主转变为本地人口外出感染为主。应认真做好出国务工人员及流动人口管理和监测,降低疟疾继发性传播的风险。     

2011年广东省疟疾疫情流行病学分析

目的 分析2011年广东省疟疾流行特点,为本省消除疟疾提供参考依据。方法 资料来自中国疾病预防控制中心疾病监测信息报告管理系统,采用描述性流行病学方法,分析2011年广东省网络报告疟疾病例的流行病学特点。结果2011年广东省共报告疟疾96例,其中间日疟40例,输入性恶性疟36例,未分型20例,年平均发病率为0.092/10万,死亡2例。全省17个市的34个县（市、区）报告疟疾病例,主要分布在深圳和广州,共报告57例,占全省病例的59.38%。全年各月均有病例报告,其中5-11月73例,占全年病例的76. 04%。男女性别比为5.86∶1。年龄分布主要集中在20～50岁,年龄最小1岁,最大65岁。发病以工人、商业服务人员、农民、家务及待业为主,共68例,占病例总数的70.83%。2011年广东省128例疟疾病例（96例本省籍和32例外省籍）主要输入来源为非洲和亚洲,分别为77例和30例,占总发病数的60.16%和23.44%。输入病例最多的为尼日利亚36例,其次为安哥拉19例,再次为缅甸11例。结论 2011年广东省疟疾疫情相对稳定;但输入性恶性疟增加,应加强监测和防控。     

1992-2012年汕头市疟疾疫情分析

目的 目的 了解汕头地区疟疾流行特点、 规律和变化趋势。 方法 方法 收集1992-2012年汕头市疟疾疫情资料, 采用描 述性流行病学方法对资料进行分析。 结果 结果 1992-2012年汕头市共报告疟疾556例, 年均发病率为0.056/万; 2003年后, 未 出现疟疾继发病例和局部暴发。疟疾病例男女性别比例为3.34∶1, 主要集中在15～45岁年龄组, 占总病例数的82.73%。 农民 （含农民工） 和工人发病分别占总病例数的39.21%和18.35%; 个别年份某些人群的发病人数超过农民、 工人的发病人 数。结论 结论 汕头市每年仍有一定疟疾病例报告, 必须继续加强防控与监测措施。     

2005-2014年江苏省疟疾疫情分析

目的 目的 分析2005-2014年江苏省疟疾疫情及流行特征, 为制订和调整全省疟疾消除策略和措施提供依据。方 方 法 法 收集2005-2014年江苏省疟疾疫情数据资料, 对疟疾发病情况、 感染来源以及病例的时间、 地区和人群分布进行分 析。结果 结果 2005-2014年, 江苏省共报告疟疾病例5 069例, 其中间日疟3 422例 （67.51%）、 恶性疟1 497例 （29.53%）、 未 分型150例 （2.96%）; 本地感染疟疾病例2 139例 （42.20%）、 国内输入病例1 131例 （22.31%）、 境外输入病例1 799例 （35.49%）; 男性病例3 809例, 女性1 260例, 男女性别比为3.02 ∶1。病例年龄以25～60岁为主, 占67.15%; 职业以农民和 民工为主, 分别占40.26%和23.63%。60.58%的病例分布于徐州、 宿迁、 淮安、 苏州市和南通市。2005-2009年病例以间 日疟为主, 自2010年起以恶性疟为主, 且主要为境外输入性感染, 从2012年起无本地感染病例。结论 结论 江苏省本地感染 疟疾疫情已得到有效控制, 初步实现消除疟疾目标。但境外输入性疟疾病例仍较多, 且感染呈多样性, 是目前的防控重 点。     

1951-2014年广西平果县疟疾疫情分析

目的 目的 探讨广西壮族自治区平果县疟疾疫情流行规律和分布特征, 为消除疟疾后制定适合本地特点的防控策 略和措施提供依据。方法 方法 采用回顾性分析方法, 对1951-2014年平果县疟疾疫情资料进行分析总结。结果 结果 1951- 2014年平果县累计报告疟疾病例71 365例, 疟疾发病率从1960年的429.43/万下降至1993年的0。1993年达到了基本消 除疟疾目标, 2002年起已无本地感染疟疾病例, 2014年通过了消除疟疾考核评估。结论 结论 广西壮族自治区平果县在不 同阶段实施的疟疾防治策略和综合抗疟措施有效。今后应加强流动人口监测和输入性病例及时处置, 这是巩固疟疾防 治成果的关键。     

2001～2009年安徽阜阳市疟疾流行状况和防治措施评价

目的依据阜阳市2001-2009年疟疾流行情况资料和防治措施,分析评价现行疟防措施对控制疟疾流行所起的作用,指导今后疟防工作。方法借助中国疾病预防控制信息系统收集2001-2009年阜阳市疟疾网报信息,分析疟疾流行状况;收集近年来各项疟防措施落实情况进行综合评价。结果2001～2007年疟疾疫情逐年上升,通过消除疟疾传染源、防蚊灭蚊等综合性防治措施的落实,2007年8月份以后疟疾疫情快速上升趋势得到遏制,2009年疟疾发病明显降低。结论疟防措施有效地落实是控制疟疾流行的关键,以分类指导、突出重点为原则切实做好各项疟防工作才能有效地控制疟疾流行。     

Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya

The epidemiology of malaria over small areas remains poorly understood, and this is particularly true for malaria during epidemics in highland areas of Africa, where transmission intensity is low and characterized by acute within and between year variations. We report an analysis of the spatial distribution of clinical malaria during an epidemic and investigate putative risk factors. Active case surveillance was undertaken in three schools in Nandi District, Western Kenya for 10 weeks during a malaria outbreak in May-July 2002. Household surveys of cases and age-matched controls were conducted to collect information on household construction, exposure factors and socio-economic status. Household geographical location and altitude were determined using a hand-held geographical positioning system and landcover types were determined using high spatial resolution satellite sensor data. Among 129 cases identified during the surveillance, which were matched to 155 controls, we identified significant spatial clusters of malaria cases as determined using the spatial scan statistic. Conditional multiple logistic regression analysis showed that the risk of malaria was higher in children who were underweight, who lived at lower altitudes, and who lived in households where drugs were not kept at home.     

2001～2009年安徽阜阳市疟疾流行状况和防治措施评价

目的依据阜阳市2001-2009年疟疾流行情况资料和防治措施,分析评价现行疟防措施对控制疟疾流行所起的作用,指导今后疟防工作。方法借助中国疾病预防控制信息系统收集2001-2009年阜阳市疟疾网报信息,分析疟疾流行状况;收集近年来各项疟防措施落实情况进行综合评价。结果2001～2007年疟疾疫情逐年上升,通过消除疟疾传染源、防蚊灭蚊等综合性防治措施的落实,2007年8月份以后疟疾疫情快速上升趋势得到遏制,2009年疟疾发病明显降低。结论疟防措施有效地落实是控制疟疾流行的关键,以分类指导、突出重点为原则切实做好各项疟防工作才能有效地控制疟疾流行。     

Plasma and in vitro levels of cytokines during and after a Plasmodium falciparum malaria attack in Gabon

Fifty subjects living in a malaria endemic area were studied at diagnosis of a Plasmodium falciparum attack and 3 weeks later. Absolute numbers of CD3(+), CD4(+) and CD8(+) lymphocytes as well as plasma cytokines and secreted cytokines after in vitro mitogenic stimulation were measured. At enrollment, lymphopenia was observed, lending support to the reallocation hypothesis during the acute phase. A significant elevation of the number of CD8(+) cells was present in the peripheral blood during the recovery phase. During the acute phase, plasma IL-6 levels peaked while in vitro production capacity was high at both phases. Plasma IL-6 concentrations were positively related to blood parasite density at D0, as IL-4 and IFN-gamma, suggesting an early intervention of these cytokines. Plasma IL-2 levels were low at diagnosis although cells retained their ability to produce IL-2, which was found more frequently in plasma after cure. Acquisition of immunity with age was in relation with greater secretion abilities of cells for type 1 and type 2 cytokines during the parasite clearance phase. We conclude to an early implication of type 2 cytokines and IFN-gamma, with particularly high levels of IL-6.     

Naturally acquired immunity to Plasmodium falciparum malaria in Africa

Infection by Plasmodium falciparum parasites can lead to substantial protective immunity to malaria, and available evidence suggest that acquisition of protection against some severe malaria syndromes can be fairly rapid. Although these facts have raised hopes that the development of effective vaccines against this major cause of human misery is a realistic goal, the uncertainty regarding the antigenic targets of naturally acquired protective immunity and the immunological mechanisms involved remain major vaccine development obstacles. Nevertheless, a coherent theoretical framework of how protective immunity to P. falciparum malaria is acquired following natural exposure to the parasites is beginning to emerge, not least thanks to studies that have combined clinical and epidemiological data with basic immunological research. This framework involves IgG with specificity for clonally variant antigens on the surface of the infected erythrocytes, can explain some of the difficulties in relating particular immune responses with specificity for well-defined antigenic targets to clinical protection, and suggests a radically new approach to controlling malaria-related morbidity and mortality by immunological means.     

2010-2014年常州市疟疾疫情分析

目的 目的 掌握2010-2014年常州市疟疾疫情, 为制订和调整适合该市的疟疾消除策略和措施提供依据。方法 方法 收集2010-2014年常州市网络报告疟疾疫情和专报系统的流行病学调查资料, 对该5年的疟疾疫情及病例诊治情况进行 统计分析。结果 结果 2010-2014年常州市共报告疟疾病例132例, 较2005-2009年的182例下降了27.47%。132例疟疾病 例除2例为本地病例外, 其余130例均为境外输入性病例。132例疟疾病例中, 4例为临床诊断病例, 128例为实验室确诊 病例; 128例确诊病例中, 恶性疟97例、 间日疟14例、 卵形疟13例、 三日疟4例。132例疟疾病例分布于5个市 （区）, 其中 金坛市56例、 溧阳市51例、 天宁区19例、 武进区3例、 新北区3例; 从发病到就诊中位时间为2 d, 从就诊到确诊中位时间 为1 d, 92.42% （122/132） 的确诊单位为县级疾控机构、 县级医疗机构和市级医疗机构。2011-2014年常州市未发现本地 感染疟疾病例。结论 结论 2012-2014年常州市连续3年实现无本地感染疟疾病例, 初步实现消除疟疾目标, 但境外输入性 疟疾病例仍较多, 且感染虫种呈多样性。境外输入性疟疾仍是常州市疟疾防控工作的重点。     

Public health impact of drug resistant Plasmodium falciparum malaria

The alarming increase in Plasmodium falciparum resistance to commonly used anti-malarial drugs represents a major public health threat. The impact is however difficult to quantify. In low transmission areas, an increase in acute manifestations ("epidemic") is often quickly apparent and resistance is rapidly propagated due to high drug pressure on existing parasite populations. In high transmission areas, the clinical effects are mainly prolonged/chronic infections with increasing risk of severe anemia. Mortality estimates from public health records in Africa generally suggest significant increases (from 2- to 11-fold) in malaria-associated mortality among children when resistance develops and spreads. Hospital attendances and admissions show similar trends. Change of policy to alternative efficacious treatment with radical cure is necessary at an earlier stage (from 10% treatment failure) than previously assumed in order to prevent deaths in millions of African children. Early switch to artemisinin based combination therapy (ACT) represents such a critical and urgent strategy.     

Cytoadherence in paediatric malaria: ABO blood group,CD36, and ICAM1 expression and severe Plasmodium falciparum infection

As a leading cause of childhood mortality worldwide, selection pressure by Plasmodium falciparum continues to shape the human genome. Severe disturbances within the microcirculation result from the adhesion of infected erythrocytes to host receptors on monocytes, platelets, and endothelium. In this prospective study, we compared expression of all major host cytoadhesion receptors among Ugandan children presenting with uncomplicated malaria (n = 1078) versus children with severe malaria (n = 855), including cerebral malaria (n = 174), severe anaemia (n = 522), and lactic acidosis (n = 154). We report a significant survival advantage attributed to blood group O and increased monocyte expression of CD36 and ICAM1 (CD54). The high case fatality rate syndromes of cerebral malaria and lactic acidosis were associated with high platelet CD36 expression and thrombocytopenia, and severe malaria anaemia was characterized by low ICAM1 expression. In a logistic regression model of disease severity, odds ratios for the mitigating effects of blood group O, CD36, and ICAM1 phenotypes were greater than that of sickle haemoglobin. Host genetic adaptations to Plasmodium falciparum suggest new potential malaria treatment strategies.     

Spatial and temporal variations of malaria epidemic risk in Ethiopia: factors involved and implications

The aim of this study was to describe spatial and temporal variations in malaria epidemic risk in Ethiopia and to examine factors involved in relation to their implications for early warning and interpretation of geographical risk models. Forty-eight epidemic episodes were identified in various areas between September 1986 and August 1993 and factors that might have led to the events investigated using health facility records and weather data. The study showed that epidemics in specific years were associated with specific geographical areas. A major epidemic in 1988 affected the highlands whereas epidemics in 1991 and 1992 affected highland-fringe areas on the escarpments of the Rift Valley and in southern and north-western parts of the country. Malaria epidemics were significantly more often preceded by a month of abnormally high minimum temperature in the preceding 3 months than based on random chance, whereas frequency of abnormally low minimum temperature prior to epidemics was significantly lower than expected. Abnormal increases of maximum temperature and rainfall had no positive association with the epidemics. A period of low incidence during previous transmission seasons might have aggravated the events, possibly due to low level of immunity in affected populations. Epidemic risk is a dynamic phenomenon with changing geographic pattern based on temporal variations in determinant factors including weather and other eco-epidemiological characteristics of areas at risk. Epidemic early warning systems should take account of non-uniform effects of these factors by space and time and thus temporal dimensions need to be considered in spatial models of epidemic risks.