武汉市输入性疟疾流行因素监测及传播风险评估

目的 了解武汉市输入性疟疾流行因素,评价本地传播风险,为指导消除疟疾后监测重点和防治策略调整提供科学依据。方法 收集武汉市2011-2017年输入性疟疾病例侦查、传疟媒介监测、防控能力和自然社会因素调查等数据资料,采用文献报道的输入性疟疾引起继发传播的风险评估方法,定性分析全市传播风险,定量计算各区疟疾传播潜能指数（TPI）、防控能力指数（ICI）和传播风险指数（MRI）。结果 武汉市近7年报告输入性疟疾358例,恶性疟占74.02%（265/358）,间日疟占13.97%（50/358）;远城区仍监测到传疟媒介中华按蚊;居民防治知识平均知晓率64.47%;全市防控能力较强。各区传播风险指数由高到低排在前例的依次为：黄陂（2.79）、江汉（1.56）、武昌（1.50）、硚口（1.45）、东西湖（1.26）、新洲区（1.24）。结论 武汉市存在输入性疟疾引起本地传播的“较小风险”。但个别区传播风险较高,需进一步加强传染源和媒介监测,提高防控能力。

Epidemic factor surveillance of imported malaria and risk assessment of indigenous transmission in Wuhan

Objective To understand the epidemic factors of imported malaria and assess the risk of indigenous transmission in Wuhan City, so as to provide the evidence for adjusting control strategy and key areas of surveillance after malaria elimination. Methods The data of malaria cases, vector mosquito distribution, social-natural factors and intervention capacity were collected from 2011 to 2017. The vector surveillance and questionnaire survey on prevention knowledge and people’s behavior were carried out in the field. The risk assessment methods reported in the literature were used including qualitative analysis and quantitative calculation. The transmission potential index (TPI), intervention capacity index (ICI), and malaria risk index (MRI) were calculated for each district. Results Totally 358 imported malaria cases were reported, including 265 P. falciparum-infected cases (74.02%) and 50 P. vivax-infected cases (13.97%). Anophele sinensis was still detected in distant suburban areas. The average awareness rate of knowledge on malaria prevention in residents was 64.47%. The ability of prevention and control of the city was better. The top six districts with highly potential risk indicators were Huangpi District (2.79), Jianghan District (1.56), Wuchang District (1.50), Qiaokou District (1.45), Dongxihu District (1.26) and Xinzhou District (1.24). Conclusions There is less risk of the secondary transmission induced by imported malaria in Wuhan City. However, the risk is high in several districts, where the disease and vector surveillance should be reinforced and the intervention capacity should be improved.