武汉市2016—2019年输入性疟疾病例流行病学与临床特征

目的 了解武汉市输入性疟疾的流行病学和临床特征,为疫情防控提供参考。方法 对2016—2019年武汉市85例输入性疟疾患者的流行病学和临床特征进行回顾性分析。结果 2016—2019年报告的85例疟疾病例全为境外输入病例,外籍患者3例,中国籍82例,恶性疟68例（80.00%）,间日疟12例（14.12%）,卵形疟4例（4.71%）,三日疟1例（1.18%),混合感染0例。1—12月都有输入性疟疾病例报告,5月份出现明显集中趋势,1、8月份存在小高峰。输入性疟疾病例以青壮年男性为主,来源于非洲国家79例（92.94%）,亚洲国家6例（7.06%）。患者一般在发病后4 d内就诊,63.53%患者既往有疟疾病史,均有发热症状,部分合并寒战、头痛及意识障碍。83.53%为轻症病例,重症病例中恶性疟占92.86%。不少患者出现贫血,血小板、白蛋白降低,合并肝功能、肾功能等多器官损害。采用青蒿素及衍生物规范抗疟治疗,无死亡病例。结论 武汉市面临的境外输入性疟疾压力持续存在,应加强对出国务工人员的监测和管理,保持高效的疟疾监测体系;对于输入性病例采用规范的抗疟原虫及综合治疗手段,预后良好。

Epidemiological and clinical characteristics of imported malaria cases in Wuhan, 2016-2019

Objective To understand the epidemiology and clinical characteristics of imported malaria in Wuhan,and we provide reference for epidemic prevention and control. Methods The epidemiological and clinical characteristics of 85 imported malaria patients in Wuhan from 2016 to 2019 were retrospectively analyzed. Results From 2016 to 2019, all the 85 malaria cases reported were imported from abroad, including 3 foreign patients, 82 Chinese nationals, 68 cases of falciparum malaria (80.00%), 12 cases of vivax malaria (14.12%), 4 cases of ovale malaria (4.71%) and 1 case of malariae malaria (1.18%), and 0 cases of mixed infection. Imported malaria cases were reported from January to December. There was an obvious concentration trend in May, and a small peak in January and August. Imported malaria cases were mainly male young and middle-aged people, 79 cases (92.94%) from Africa and 6 cases (7.06%) from Asia. The patients were generally treated within 4 days after the onset of the disease. And 63.53% of the patients had a history of malaria, and had fever symptoms. Some of them were combined with chills, headache and disturbance of consciousness. And 83.53% were mild cases, 92.86% of severe cases were falciparum. Many patients were with anemia, and platelet, albumin decreased, combined with liver function, kidney function and other organ damage. Artemisinin and its derivatives were used to standardize the antimalarial treatment, and no deaths occurred. Conclusion The pressure of imported malaria in Wuhan is persistent. We should strengthen the monitoring and management of the working population and maintain an efficient malaria monitoring system. Standardized anti malaria and comprehensive treatment should be adopted for imported cases, and the prognosis is good。