目的评估上海地区输入性疟疾流行病学特征及重症疟疾的危险因素。方法回顾性收集2013-2015年收治于上海市公共卫生临床中心的输入性疟疾病例资料,分析人口学、流行病学、实验室检查数据。组间比较采用Mann-Whitney法和Fisher’s精确检验,logistic回归分析危险因素评估。结果共收集输入性疟疾病例87例,平均发病年龄为36.4岁,男性82例(94.3%),女性5例(5.7%)。其中中国患者79例(90.8%),南苏丹3例(3.4%),印度2例(2.3%),喀麦隆、尼日利亚、布隆迪各1例(1.1%)。在75例能够明确感染来源地国家的病例中,感染来源地为非洲国家的多达63例(84.0%),其次为亚洲(11例,14.7%)。实验室确诊病例78例(89.7%),临床诊断病例9例(10.3%)。在实验室确诊病例中,感染恶性疟原虫(Plasmodium falciparum)最多,为66例(84.6%),感染间日疟原虫(P.vivax)10例(12.8%)。20例(23.0%)患者既往有疟疾史。患者发病至住院的中位数时间为5 d,30例(34.5%)患者在发病后的48 h内服用抗疟疾药物。符合重症疟疾标准的18例,其中1例为脑型疟,17例总胆红素>43μmol/L,3例血清肌酐>265μmol/L。多因素logistic回归分析显示,发病后48 h内服用抗疟药是预测重症疟疾的独立的危险因子(OR=0.05,95%置信区间0.01~0.43,P<0.05)。结论恶性疟原虫是本市输入性疟疾病例感染的主要虫种,非洲是主要的感染来源地。发病后及时给予抗疟治疗可降低重症疟疾的发生风险。 Objective To assess the epidemiological characteristics of imported malaria and the risk factors of severe malaria in Shanghai. Methods Retrospective data collection of imported malaria cases admitted to Shanghai Public Health Clinical Center from 2013 to 2015 were conducted to analyze demographic, epidemiological and laboratory data. Mann-Whitney method and Fisher’s exact test were used to compare between groups, and risk factors were evaluated by logistic regression analysis. Results A total of 87 imported malaria cases were collected, with an average age of 36.4 years. There were 82 males (94.3%) and 5 females (5.7%). There were 79 cases (90.8%) in China, 3 cases (3.4%) in South Sudan, 2 cases (2.3%) in India and 1 case (1.1%) in Cameroon, Nigeria and Burundi. As many as 63 cases (84.0%) were found in African countries, followed by Asia (11 cases, 14.7%) among the 75 cases of countries with a clear source of infection. 78 cases (89.7%) were laboratory confirmed, and 9 cases (10.3%) were clinically diagnosed. Among laboratory confirmed cases, Plasmodium falciparum was the most frequently infected, 66 (84.6%) were infected with Plasmodium falciparum and 10 (12.8%) were infected with P. vivax. Twenty patients (23.0%) had a history of malaria in the past. The median time from hospitalization to hospitalization was 5 days, and 30 (34.5%) patients took anti-malarial drugs within 48 hours of onset. Eighteen patients met the criteria of severe malaria, of which 1 was cerebral malaria, 17 with total bilirubin> 43 μmol / L and 3 with serum creatinine> 265 μmol / L. Multivariate logistic regression analysis showed that taking antimalarial drugs within 48 hours after onset was an independent risk factor for severe malaria (OR = 0.05, 95% confidence interval 0.01-0.43, P <0.05). Conclusions Plasmodium falciparum is the main species of imported malaria cases in the city. Africa is the main source of infection. Anti-malarial treatment in a timely manner after the onset of the disease can reduce the risk of severe malaria.