我国南方五省间日疟原虫环子孢子蛋白基因型与疟疾防治效果关系的探讨

目的 探讨我国南方间日疟原虫环子孢子蛋白（CSP）基因型种群结构、疟区分类及其防治意义。 方法 应用单管-套式/多重PCR对采自海南、云南、广西、广东、贵州等5省（自治区）共346份间日疟原虫阳性患者滤纸血样作环子孢子蛋白（CSP）基因型鉴定， 结合5省（自治区）疟疾历史资料和近年流行状况进行分析。 结果 广东、广西和贵州等3省（自治区）疟原虫PV-1型温带族虫株均占90% 以上，热带族仅有个别发现，未见PV-2型；云南省疟原虫PV-1温带族占71.4%、 热带族占28.6%，PV-2型仅个别发现；而海南省PV-1型温带族、热带族和PV-2型等3大基因型类群分别约占1/3。 结论 广东、广西和贵州等3省（自治区）间日疟原虫PV-1型温带族占绝对优势, 疟疾控制效果好, 而海南、云南两省间日疟原虫基因型类群较复杂，疟疾控制难度大，说明间日疟原虫种群基因型结构复杂性和多重感染程度是影响当地间日疟流行势态及其防治效果的重要因素，是防治与监测中重要的流行病学指征之一。

A Discussion on the CSP Genotyping of Plasmodium vivax and Malaria Control in Five Southern Provinces of China

Objective To explore circumsporozoite protein (CSP) genotype structure of Plasmodium vivax in southern China and evaluate its epidemiological significance. Methods Filter paper blood samples were collected from 346 vivax malaria patients in 5 provinces (Autonomous Region)including Hainan, Yunnan, Guangxi, Guangdong and Guizhou for identifying CSP genotypes, by using the method of single-tube nestedmultiplex PCR. The findings combined with relevant data were statistically analyzed. Results In Guangdong, Guangxi and Guizhou Provinces(Autonomous Region), the temperate zone family strains accounted for more than 90%, with only a few tropical zone family strains and no PV-type II each strain. In Yunnan Province, temperate strains and tropical strains accounted for 71.4% and 28.6% respectively, with occasional PV-type II strain. In Hainan Province, strains of temperate zone, tropical zone and PV-type II accounted for about one-third. Conclusions The temperate zone family strains were the predominant ones in the Provinces(Autonomous Region) of Guangdong, Guangxi and Guizhou where malaria control was carried out effectively; while in Hainan and Yunnan Provinces the difficulties in malaria control may probably be related to the complex structure of P. vivax population and multiple infections of different genotypes. The findings indicate that the complexity of the P. vivax genotype structure might be an indicative epidemiological feature for malaria control and surveillance.