武汉市新冠肺炎流行期间一例输入性恶性疟死亡病例分析

目的 探讨新型冠状病毒肺炎流行期内一例恶性疟死亡病例发生因素,为重大公共卫生事件暴发时输入性疟疾提供防控策略参考。方法 收集该死亡病例流行病学、实验室检测及临床治疗等资料并进行分析。结果 该病例发病-诊断时间7 d,疟原虫密度>5.0×10⁵ /μL血,红细胞3.10×10¹²/L,血红蛋白89.00 g/L,血小板2.00×10⁹/L,白细胞18.85×10⁹ /L,总胆红素296.10 μmol/L,尿素55.30 μmol/L,肌酐799.00 μmol/L,葡萄糖2.20 mmol/L,乳酸 15.00 mmol/L, D-二聚体>7.80 μg/mL,诊断为恶性疟（脑型）、贫血、感染性休克、低血糖、肝肾功能衰竭、代谢性酸中毒及凝血功能异常。结论 重大公共卫生事件暴发时应制定分类指导,统筹兼顾的科学防控措施,应加强疟疾防治健康教育、病人排查并提供就医通道。

A death falciparum malaria case during epidemic period of coronavirus disease (COVID-19) in Wuhan

Objective To explore the death factors of a falciparum malaria case during the coronavirus disease (COVID-19) epidemic, and we provide reference for prevention and control of imported malaria in the major public health events. Methods The data of epidemiology, morphology and clinical treatment were collected and analyzed. Results The time "attack-confirm" of the case was 7 days, plasmodium density was more than 500 000 /μL, and clinical test results were red blood cells 3.10×10¹²/L, hemoglobin 89.00 g/L, platelets 2.00×10⁹/L, white blood cells 18.85×10⁹/L, total bilirubin 296.10 μmol/L, urea 55.30 μmol/L, creatinine 799.00 μmol/L, glucose 2.20 mmol/L, lactic acid 15.00 mmol/L, D- dimer > 7.80 μg/mL. The case was diagnosed as falciparum malaria (brain type), anemia, septic shock, hypoglycemia, liver and kidney failure, metabolic acidosis and coagulation dysfunction. Conclusion It was necessary to build a scientific prevention and control measures of classified guidance and comprehensive, strengthen health education on malaria control, check malaria patients and provide the medical access when major public health events break out.