2010-2015年腾冲市疟疾疫情流行病学分析

目的分析2010-2015年腾冲市疟疾疫情特征,为进一步推进消除疟疾进程,适时调整和制定防控措施提供依 据。方法收集2010-2015年腾冲市疟疾疫情资料,采用Microsoft Excel 2010软件对数据进行整理分析。结果2010- 2015年,腾冲市共报告疟疾病例1 408例,以间日疟为主,共1 091例,占77.49%,且比例逐年增加;恶性疟256例,占 18.18%,比例逐年降低;三日疟5例,卵形疟1例,混合感染1例,未分型54例。共有1 390例输入性病例,其中98.06%的 病例为缅甸输入。年龄主要集中在21 ~ 40岁（908例）,男女性别比例为11.03∶1。职业以农民和民工为主。2010-2015 年全年各月均有发病,以4-6月最多,发病高峰与流动人口回归有关。结论腾冲市输入性疟疾疫情仍比较严重,消除 疟疾工作面临很多的挑战。     

1999-2013年东台市疟疾疫情

目的 目的 掌握东台市1999-2013年疟疾疫情特点。 方法 方法 收集1999-2013年东台市疟疾确诊病例个案调查及疫 情防治资料进行流行病学分析。 结果 结果 1999-2013年东台市疟疾发病总人数为27例, 其中本地间日疟2例, 输入性间日 疟10例, 输入性恶性疟13例, 输入性恶性疟与卵形疟、 间日疟混合感染各1例, 输入性病例占92.59%, 本地病例占 7.41%。2003年以后无本地感染病例, 全部为输入性病例。2008年前输入性病例均为国内间日疟, 之后均为境外恶性疟 及两者混合感染病例。病人首诊以镇医院、 村级卫生机构为主, 均占33.33%。病人发病1 d内就诊的占62.96%, 发病至 就诊时间中位数为1 d, 发病至确诊时间中位数为3 d, 发病至确诊时间最长为33 d, 平均为5.74 d; 就诊至血检、 确诊时间 中位数均为1 d。 结论 结论 1999-2013年东台市疟疾以输入性病例为主, 加强出国劳务回归人员的监测是实现消除疟疾的 关键。     

2010-2013年徐州市疟疾疫情

目的 目的 掌握徐州市疟疾发病情况和趋势, 为制定疟疾防治措施提供科学依据。方法 方法 收集2010-2013年徐州 市网络报告疟疾病例信息和流行病学调查资料进行统计分析。结果 结果 2010-2013年徐州市共报告疟疾109例, 其中间日 疟44例, 占40.37％; 恶性疟62例, 占56.88％; 三日疟2例, 占1.83％; 卵形疟1例, 占0.92％; 恶性疟、 三日疟、 卵形疟均为 境外输入。93例为实验室确诊病例, 占85.32％, 16例为临床诊断病例, 占14.68％。全年均有发病, 无明显季节性。流动 人口血检阳性率为0.276%, 明显高于本地人口的0.005% （χ2 ＝868.23, P＜0.01）。结论 结论 徐州市疟疾疫情处于稳定下降 期, 本地感染病例明显下降, 境外输入性恶性疟病例逐年上升, 须加强流动人口和发热病人管理。     

2005～2010年云南省腾冲县疟疾疫情分析

目的了解腾冲县2005~2010年的疟疾发病情况。方法对各种疟疾资料进行整理,研究疟疾疫情和防控措施。结果腾冲县2005~2010年共报告疟疾病例7 601例,年均发病率为20.03/万,疟疾发病率呈逐年下降趋势。间日疟5 267例,恶性疟1 583例,混合感染82例,三日疟1例,未分型668例;死亡5例。发病以外源性为主,占总发病数的98.24%。结论腾冲县疟疾疫情严重,加强流动人口的管理是控制疟疾疫情的重要措施。     

2007-2012年苏州市疟疾流行态势

目的 目的 分析苏州市近期疟疾流行特征, 为制订适合苏州市消除疟疾策略和措施提供科学依据。方法 方法 收集 2007-2012年苏州市疫情网络直报系统和寄生虫病防治信息专报系统的疟疾信息, 并结合苏州市现有疟疾监测资料进行 统计分析。结果 结果 2007-2012年全市共发生疟疾318例, 其中本地病例28例, 均为间日疟, 占病例总数的8.81%, 年发病率 为0.07/10万; 输入性病例290例, 占病例总数的91.19%, 年发病率为0.77/10万, 其中间日疟233例, 恶性疟20例, 混合感染 1例, 卵形疟1例; 6年间疟疾发病率逐年下降, 输入性病例有所上升, 后3年已无本地感染病例。结论 结论 苏州市本地感染疟 疾病例达到消除状态, 输入性病例增多。应加强跨地区疟疾联防联控和强化各类流动和出入境人员疟疾管理工作的措 施。     

2015年温州市疟疾疫情流行病学分析

目的 分析温州市疟疾疫情,为该市疟疾综合防治提供参考依据。 方法 收集2015年温州市疟疾疫情流行病学资料,采用描述性流行病学方法进行分析。 结果 2015年温州市共报告疟疾病例24例,年发病率为0.26/10万,均为境外输入性病例,无死亡病例,其中间日疟1例（占4.17%）、恶性疟20例（占83.33%）、卵形疟3例（占12.50%）。瑞安、苍南、鹿城3个县（区）病例数占全市总病例数的70.83%（17/24）;病例主要为男性青壮年;23例（占95.83%）为非洲国家输入性病例。 结论 2015年温州市疟疾疫情相对稳定,无本地疟疾感染病例报告,但输入性病例防治工作需加强。     

2005-2015年广西壮族自治区河池市疟疾流行病学特征分析

目的 分析2005-2015年广西壮族自治区河池市疟疾流行特征,为进一步调整和制订该市消除疟疾措施提供科学依据。方法 收集2005-2015年河池市11个市、县、区疟疾疫情资料,采用Microsoft Excel 2003和SPSS 17.0软件对数据进行统计和分析。结果 2005-2015年河池市共报告疟疾病例160例,年均发病率为0.36/10万,其中本地感染病例占6.25%（10/160）,输入性疟疾病例占93.75%（150/160）。4种疟原虫均有发现,以间日疟为主,占51.87%（83/160）;恶性疟次之,占34.38%（55/160）;三日疟和卵形疟分别占5.00%（8/160）、1.25%（2/160）;未分型报告12例,占7.50%。11年间疟疾发病率先降后升,2009年后再无本地疟疾病例报告;2010年报告1例输入性恶性疟死亡病例;2013年和2015年各出现1例恶性疟重症病例;2014年出现1例胎传新生儿间日疟重症病例。全部病例分布于10个市、县、区,以青壮年男性为主,以挖矿职业为主;疟疾发病主要集中在4-8月份;感染自非洲和东南亚者占60.00%（96/160）,自国内其他省者占33.75%（54/160）。患者发病到确诊治疗时间中位数为5 d,不同年份疟疾病例的发病至诊断治疗时间差异有统计学意义（c2 = 33.40,P < 0.05）。结论 河池市疟疾疫情仍面临很多挑战,消除疟疾各项工作仍需加强;加强流动人口的疟疾监测管理是巩固疟疾防治成果的关键。     

1995~2015年南京市疟疾疫情分析

目的  分析南京市1995年以来疟疾疫情的变化情况,为疟疾防控对策的制定提供科学依据。 方法  通过疫情监测报告、个案调查、发热病人血检等,对1995~2015年的本地病例和输入性病例进行统计分析。 结果  1995~2015年南京市共报告疟疾确诊病例905例。其中本地疟疾病例为407例,输入性疟疾病例498例;全部疟疾病例中,间日疟占85.6%（774/905）,恶性疟占13.4%（121/905）,其他占1.00%（9/905）。各型疟疾均有境外输入性病例,恶性疟全部为境外输入,且2007年后恶性疟病例数呈逐渐增加趋势,2007~2015年的恶性疟病例占该型疟疾病例总数的95.0%（115/121）。实验室血检发热病人898 035人,本地人口血检阳性率0.038%,流动人口血检阳性率为0.692%,两者差异有统计学意义（χ2=2 907.7,P<0.01）;媒介调查共捕获按蚊10 982只,中华按蚊为10 716只,占97.6%（10 716/10 982）,嗜人按蚊221只,占2.0%（221/10 982）。嗜人按蚊自2003年后均未捕获。 结论  南京市境外输入性疟疾逐年增多,应加强对境外输入性疟疾的监测,提高各医疗机构的镜检能力,确保输入性疟疾病例能及时诊治。     

2003~2014年广西百色市右江区疟疾流行病学分析

【摘要】 目的  了解广西百色市右江区2003~2014年以来疟疾流行病学特点及态势。 方法  收集2003~2014年百色市右江区当地发热居民、外出务工返回人员和外来人员疟疾监测资料进行描述和分析。 结果  2003~2014年,右江区共监测本地发热患者119 216人次,外出务工返回人员522人次,外来流动人员22 260人次,三类人群血检阳性率分别为0.0017%、0.575％和0.119％。共检出本地感染疟疾3例和输入性疟疾27例,其中恶性疟20例,间日疟9例,未分型（临床诊断）1例。 结论  右江区疟疾发病以境外输入性病例为主,且半数以上为恶性疟。     

2005～2010年济南市疟疾疫情分析

目的了解济南市疟疾发病情况,探讨流行特征,为制定防治对策提供依据。方法对2005～2010年疟疾疫情资料进行整理。对疟疾疫情进行描述与分析。结果济南市2005～2010年共报告疟疾病例66例,其中恶性疟11例,间日疟32例,未分型23例;实验室确诊32例,临床确诊34例;本地病例和外地病例各33例;当地感染病例5例,占7.58%,输入性病例61例,占92.42%,11例恶性疟均为输入性病例。结论济南市疟疾病例以输入性病例为主;关口前移,把好疟疾输入关,加强疟区入济人员的疟疾监测,防止输入病例引起本市疟疾暴发流行应是济南市疟防工作的重点。     

Prospective risk of morbidity in relation to malaria infection in an area of high endemicity of multiple species of Plasmodium.

In an area of Papua New Guinea with high prevalence of Plasmodium falciparum (39.6%), Plasmodium vivax (18.3%), and Plasmodium malariae (13.8%), cross-sectional analysis found P. falciparum infection to be independent of the other species despite heterogeneities in transmission. Plasmodium vivax and P. malariae infections were negatively correlated. Plasmodium malariae infection was positively associated with homologous infection four months previously and with prior P. falciparum, but not P. vivax infection. There were no other indications that any Plasmodium species protected against heterologous infection. Prospective analysis of health-center morbidity supported the idea that P. malariae infection protects against disease, but indicated greater protection against non-malaria than P. falciparum-associated fevers. Plasmodium vivax appeared to protect against P. falciparum disease but not against other forms of morbidity. Covariate adjustment had considerable effects on estimated relationships between species, and confounding variables may account for many differences among reports of inter-species interactions in human malaria.     

Demographic risk factors for severe and fatal vivax and falciparum malaria among hospital admissions in northeastern Indonesian Papua

Between January 1998 and December 2000, the Jayapura Provincial Public Hospital in northeastern Indonesian New Guinea (Papua) admitted 5,936 patients with a diagnosis of malaria. The microscopic diagnosis at admission was Plasmodium falciparum (3,976, 67%), Plasmodium vivax (1,135, 19%), Plasmodium malariae (8, < 1%), and mixed species infections (817, 14%). Approximately 9% (367) of patients were classified as having severe malaria (277 P. falciparum, 36 P. vivax, 53 mixed infections, and 1 P. malariae) and 88 died (79 P. falciparum/mixed infections and 9 P. vivax). Risk of fatal outcomes among severe malaria patients was indistinguishable between those with falciparum versus vivax malaria (OR = 0.89; P = 0.771). Compared with non-pregnant women, pregnant women showed no higher risk of severe malaria (P = 0.643) or death caused by severe malaria (P = 0.748). This study compares admissions per population (based on census data), parasitemia, morbidity, and mortality among children versus adults, pregnant versus non-pregnant women, and urban/suburban versus rural residents.     

2017年江苏省疟疾诊断参比实验室样本检测结果分析

目的 分析2017年江苏省疟疾诊断参比实验室样本检测结果,为巩固江苏省疟疾诊断水平提供科学依据。方法 由江苏省疟疾诊断参比实验室收集2017年疟疾网报病例诊断结果和样本;对每份病例样本分别采用镜检、核酸检测复核和疟疾快速诊断试纸条（RDT）检测;比较分析不同地区和不同疟原虫虫种样本检测结果符合情况。结果 2017年江苏省共有疟疾网报病例242例,经复核确定疟疾病例共239例,其中恶性疟163例、间日疟21例、三日疟11例、卵形疟43例、恶性疟和卵形疟原虫混合感染1例。13个设区市疟疾网报病例的诊断符合率均＞80%,总符合率为88.8%;恶性疟原虫、间日疟原虫、三日疟原虫、卵形疟原虫检测符合率分别为98.8%、57.1%、63.6%、81.4%,RDT对4种疟原虫感染检出率分别为95.7%、85.0%、63.6%、79.1%。结论 2017年江苏省疟疾网报病例诊断质量总体较高,对非恶性疟人体疟原虫的虫种鉴别能力有待提高,RDT对非恶性疟人体疟原虫感染检测效果不理想。在当前消除疟疾阶段,应加强和保持各部门的疟疾诊断能力。     

Changing patterns of Plasmodium blood-stage infections in the Wosera region of Papua New Guinea monitored by light microscopy and high throughput PCR diagnosis.

In Papua New Guinea (PNG), complex patterns of malaria commonly include single and mixed infections of Plasmodium falciparum, P. vivax, P. malariae, and P. ovale. Here, we assess recent epidemiologic characteristics of Plasmodium blood-stage infections in the Wosera region through four cross-sectional surveys (August 2001 to June 2003). Whereas previous studies performed here have relied on blood smear/light microscopy (LM) for diagnosing Plasmodium species infections, we introduce a newly developed, post-polymerase chain reaction (PCR), semi-quantitative, ligase detection reaction-fluorescent microsphere assay (LDR-FMA). A direct comparison of the two methods for > 1,100 samples showed that diagnosis was concordant for > 80% of the analyses performed for P. falciparum (PF), P. vivax (PV), and P. malariae (PM). Greater sensitivity of the LDR-FMA accounted for 75% of the discordance between diagnoses. Based on LM, the prevalence of blood-stage PF, PV, and PM infections was found to be markedly reduced compared with an early 1990s survey. In addition, there were significant shifts in age distribution of infections, with PV becoming the most common parasite in children < 4 years of age. Consistent with previous studies, prevalence of all Plasmodium species infections increased significantly in samples analyzed by the PCR-based LDR-FMA. This increase was most pronounced for PM, PO, and mixed infections and in adolescent (10-19 years) and adult age groups, suggesting that LM may lead to under-reported prevalence of less common Plasmodium species, infection complexity, and a skewed distribution of infections towards younger age groups. This study shows that the application of LDR-FMA diagnosis in large epidemiologic studies or malaria control interventions is feasible and may contribute novel insights regarding the epidemiology of malaria.     

Plasmodium malariae in East Timor

A community-based rainy-season malaria prevalence survey was conducted in Bobonaro district, in recently independent East Timor, in 2001. Although the survey was primarily aimed at defining the prevalence of Plasmodium falciparum and P. vivax, six individuals with P. malariae infection were identified (prevalence 0.57%). We believe these are the first reported cases of P. malariae from the island of Timor.     

2005-2015年泰兴市疟疾疫情流行病学分析

目的 了解2005-2015年泰兴市疟疾疫情的流行病学特征,为制订符合本市的疟疾防治措施提供依据。方法 收集2005-2015年泰兴市网报疟疾病例资料和流行病学个案调查报告,对数据进行描述性分析和相关分析。 结果 2005-2015年,全市共报告疟疾病例61例。其中本地病例4例,输入病例57例;间日疟9例,恶性疟47例,三日疟2例,卵形疟3例。输入性疟疾病例发病无明显季节性。虽然疟疾发作次数与外出时长无相关性（r = 0.154,P = 0.253）,但与病例就诊及时性存在负相关关系（r = -0.312,P = 0.014）。结论 泰兴市疟疾病例以输入性为主,感染虫种多样。境外输入性疟疾仍是本市疟疾防控工作的重点。     

High prevalence of malaria infection in Amazonas State, Venezuela

This study was carried out to determine the incidence of malaria in an endemic region of Amazonas State, Venezuela. For this, 200 random samples were collected from symptomatic and asymptomatic individuals from San Fernando de Atabapo and Santa Barbara. Epidemiological factors were related to malaria infection, which was diagnosed by microscopy observation and amplification of the 18S rDNA sequence by PCR. Malaria prevalence in these populations was 28.5%, whilst P. vivax and P. falciparum prevalences were 12 and 17%, respectively. No infection by P. malariae was found. A mixed infection was found on an asymptomatic individual. Prevalence patterns differed between age groups depending on the Plasmodium species. We found that 34.8% of the P. vivax and 15.2% of the P. falciparum infections were asymptomatic. The use of nets was helpful to prevent P. vivax infection, but did not protect against P. falciparum infection. The results suggest the presence of more than one mosquito vector in the area, displaying a differential pattern of infection for each Plasmodium species. There appear to be risk factors associated with malaria infections in some individuals. The population based approach and PCR diagnosis improved the accuracy of the statistical analysis in the study.     

Tumor necrosis factor-alpha in patients with malaria

Serum concentration of Tumor Necrosis Factor-alpha (TNF-alpha) was observed in 54 parasitologically confirmed cases of malaria. Of them, 15 cases were Plasmodium falciparum with cerebral involvement, three cases with mixed infections of P. falciparum and P. vivax, 32 cases of P. vivax, three cases of P. malariae and one case of P. ovale. Five out of 15 patients of P. falciparum (33.3 per cent), one out of 54 patients with mixed infection of P. falciparum and P. malariae (1.8 per cent) and the sole case of P. ovale (1.8 per cent) had fatal outcome. The serum TNF-alpha measured by avidin-biotin sandwich ELISA, was found to be significantly raised in P. falciparum and more so in fatal infections. The degree of parasitaemia, due to single or double infection, had positive effect on cytokine production. The mean TNF-alpha concentration was statistically significantly higher (p < 0.001) in P. falciparum than in P. vivax parasites infection. The mean TNF-alpha values in P. falciparum and P. vivax were 915 and 280.6 against the values in normal healthy controls of 12.9 pcg/ml respectively (p < 0.001). The study thus showed that the serum concentration of TNF-alpha correlated well with severity of malaria and these values could be used as an important prognostic marker of the disease.     

Application of real-time polymerase chain reaction (PCR) analysis for detection and discrimination of malaria parasite species in Thai patients

A TaqMan real-time PCR system was used to detect and discriminate the 4 species of human malaria parasites in clinical blood samples. A 150-base pair (bp) region of the small subunit ribosomal RNA (SSU rRNA) gene of each malaria parasite, including species-specific sequences to be detected by TaqMan probe, was used as a target for PCR analysis. The PCR method used universal primers and species-specific TaqMan probes for Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. The detection threshold for the method, as determined with serial dilution of cultured P. falciparum-infected erythrocytes, was 5 parasite-infected erythrocytes per reaction. Fifty blood samples of falciparum malaria and a second set of 50 samples of vivax malaria, diagnosed by microscopic examination at the Hospital for Tropical Diseases, Mahidol University, Thailand, were analyzed by real-time PCR. In the 50 samples of microscopically-diagnosed falciparum malaria, 40 were regarded as P. falciparum single infection, 7 were P. falciparum and P. vivax mixed infections, and 3 were P. vivax single infection by real-time PCR. In the second set of 50 samples of microscopically diagnosed vivax malaria, all were considered P. vivax single infection by PCR. Neither P. ovale nor P. malariae infection was identified in the 100 blood samples. Real-time PCR analysis was shown to be more sensitive and accurate than routine diagnostic methods. Application and extension of the PCR method reported here will provide a powerful tool for further studies of malaria.