甘肃省2011—2019年输入性疟疾病例诊断情况

目的 分析2011—2019年甘肃省输入性疟疾病例诊断情况,为制定消除疟疾后防止再传播工作提供依据。方法 通过中国疾病预防控制中心信息管理系统和寄生虫病防治信息管理系统,收集整理2011—2019年甘肃省疟疾病例信息,对其发病情况、输入地分布、诊断方式、诊断机构、诊断及时性等情况进行统计描述与分析。结果 2011—2019年全省共报告国外输入性疟疾病例199例,194例为实验室确诊病例（97.49%）,5例为临床诊断病例（2.51%）。疟疾分型以恶性疟和间日疟为主,分别占57.79%（115/199）和36.18%（72/199）。所有病例职业以农民最多,占56.78%（113/199）。病例输入地主要分布于非洲的安哥拉、乍得、尼日利亚等22个国家,占69.85%（139/199）,剩余30.15%（60/199）的病例输入地为以印度尼西亚为主的亚洲。199例病例中,疾控机构诊断病例占22.11%（44/199）,医疗机构诊断病例占77.89%（155/199）。疾控机构病例诊断比例由2011年50.00%（9/18）降至2019年的11.11%（2/18）,医疗机构诊断病例比例由2011年50%（9/18）上升到2019年88.89%（16/18）。疾控机构诊断的病例中市级疾控机构诊断最少,为6.82%（3/44）。疟疾病例从发病到确诊时间中位数为2 d,其中卵形疟病例从发病到确诊时间最长,中位数为3 d。结论 继续提高医疗和疾控机构的诊断意识和水平,避免消除疟疾后因输入性疟疾误诊、漏诊而引起的再传播风险。

Diagnosis of imported malaria cases in Gansu, 2011-2019

Objective To analyze the diagnosis of imported malaria cases in Gansu province from 2011 to 2019, so as to provide a basis for the prevention of re-transmission after elimination of malaria. Methods Malaria cases in Gansu province from 2011 to 2019 were collected and analyzed, through the information management system of infectious disease report and parasitic diseases prevention and control, and the incidence of the disease, the distribution of imported origin, diagnosis methods, diagnosis institutions and diagnosis timeliness were statistically analyzed. Results From 2011 to 2019, 199 imported malaria cases were reported, 149 (97.49%) of which were laboratory confirmed, and five cases were clinically diagnosed, which accounting for 2.51%. P.falciparum and P.vivax accounted for 57.79%（115/199） and 36.18%(72/199), respectively. 56.78%（113/199） of the cases were farmers. Cases were mainly imported from Angola, Chad, Nigeria and other 22 countries in Africa, which accounting for 69.85%（139/199）, and the remaining 30.15%（60/199） were imported from Asia, which were mainly imported from Indonesia. Among the 199 cases, the CDCs and the medical institutions diagnosed 22.11% (44/199) and 77.89% (155/199) of the cases respectively. The proportion of cases diagnosed by the CDCs decreased from 50.00% (9/18) in 2011 to 11.11% (2/18) in 2019, while the proportion of cases diagnosed by the medical institutions increased from 50.00% (9/18) in 2011 to 88.89% (16/18) in 2019. Only 6.82% (3/44) of the cases diagnosed by CDCs were at the prefecture-level. The median time from onset to diagnosis of malaria cases was 2 d, of which P.ovale was 3 d as the longest. Conclusion We should continue to improve the diagnostic awareness and level of medical and disease control institutions, to avoid the risk of re-transmission caused by misdiagnosis and missed diagnosis of imported malaria.