广州市白云区基本消除疟疾地区疟疾监测与防治对策研究

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目的评价广州白云区基本消除疟疾后监测效果与防治对策,为调整疟防措施提供依据。方法白云区达到基本消除疟疾后,在全区范围内设专职或兼职镜检站22处,开展疟疾传染源搜索,及时发现和治疗现症病人,对病例进行流行病学调查和疫点处理,加强流动人口疟疾管理,定时对各镜检站的工作进行检查、督导,并对本地区小学生进行疟疾抗体检测及进行按蚊密度监测。结果 2005~2013年共报告全区疟疾病例69例,其中间日疟19例,恶性疟40例,未分型10例,均为输入性病例。69例病例中确定外籍病例26例,其中非洲籍22例,东南亚籍4例;本地居民外出非洲感染34例,外出东南亚感染9例。2010~2013年辖区医疗机构共血检“三热病人”19 958人次,发现疟原虫阳性3例。连续2年对学龄儿童疟疾抗体监测1 013人次,未发现阳性者。在2011~2013年按蚊监测中,只有2013年在白云区郊区捕获1只中华按蚊,其它均为致倦库蚊,表明本地区中华按蚊密度维持在极低水平。结论输入性疟疾病例为现阶段病例的主要来源,基本消除疟疾后的防治成果得到了巩固,现行疟防措施可以适当简化。加强非洲及东南亚等地流动人口的疟疾监测及管理是巩固疟防成果的关键。 Objective To evaluate the post-malaria post-malaria monitoring effect and prevention and control measures in Guangzhou Baiyun District, and provide the basis for the adjustment of malaria prevention measures. Methods After Baiyun District reached basic elimination of malaria, 22 full-time or part-time inspection stations were set up in the whole region to carry out search of sources of malaria infection, timely detection and treatment of current patients, epidemiological investigation and epidemic treatment of cases, Strengthen the management of malaria in floating population, regularly inspect and supervise the work of various inspection stations, and conduct malaria antibody tests and monitoring of mosquito density in primary schools in the region. Results A total of 69 cases of malaria cases were reported in the whole area from 2005 to 2013, including 19 cases of Plasmodium falciparum, 40 cases of Plasmodium falciparum and 10 cases of untypical cases, all of which were imported cases. 69 cases were identified in 26 cases of foreign patients, of which 22 were in Africa, 4 in Southeast Asia; local residents out of Africa in 34 cases, out of Southeast Asia in 9 cases. From 2010 to 2013, a total of 19 958 blood tests were conducted by medical institutions in the area under the jurisdiction of “three hot patients” and 3 cases were found positive for Plasmodium. Two consecutive years of school-age children malaria antibody monitoring 1 013 person-time, found no positive person. Anopheles sinensis was only captured in the suburbs of Baiyun District during 2013-2013 Anopheles mosquitoes, and the others were all Culex pipiens quinquefasciatus, indicating that the density of Anopheles sinensis in the area remained extremely low. Conclusions The imported cases of malaria are the main source of the current cases. The results of malaria control after the basic elimination of malaria have been consolidated, and the current malaria prevention measures can be simplified appropriately. Strengthening malaria surveillance and management of migrants in Africa and Southeast Asia is the key to consolidating the results of malaria prevention.
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