Chinese Journal of Schistosomiasis Control ›› 2021, Vol. 33 ›› Issue (3): 262-.

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Epidemiological characteristics and diagnosis of imported malaria cases in Zhejiang Province from 2017 to 2020

ZHANG Xuan, RUAN Wei, CHEN Hua⁃Liang, LU Qiao⁃Yi, YAO Li⁃Nong*   

  1. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
  • Online:2021-07-09 Published:2021-07-09

2017—2020年浙江省输入性疟疾疫情特征及病例诊断分析

张轩,阮卫,陈华良,陆巧绎,姚立农*   

  1. 浙江省疾病预防控制中心(杭州 310051)
  • 作者简介:张轩,女,硕士,主管医师。研究方向:寄生虫病防制

Abstract: Objective To analyze the epidemiological features and diagnosis of imported malaria cases in Zhejiang Province from 2017 to 2020, so as to provide the scientific evidence for the management of imported malaria in the province. Methods The data of malaria cases reported in Zhejiang Province were captured from the Information Management System for Parasitic Disease Control of China Information System for Disease Control and Prevention from 2017 to 2020, and the temporal, spatial and human distribution, and initial and definitive diagnosis of imported malaria cases were descriptively analyzed. Results A total of 593 malaria cases were reported in Zhejiang Province from 2017 to 2020, and all were overseas imported cases, including 532 men and 61 women, with a mean age of 41 years. There were 93.93% of the malaria cases from African countries, and the malaria parasites infecting these cases included Plasmodium falciparum, P. vivax, P. ovale, P. malariae and mixed infections, with P. falciparum as the predominant species (76.73%, 455/593). All malaria cases received totally correct initial diagnoses in county⁃ and city⁃level centers for disease control and prevention (CDC) and entry⁃exit inspection and quarantine sectors, and the proportion of malaria cases with confirmation at the day of initial diagnosis was 41.48% (207/499) in medical institutions and 66.18% (45/68) in CDC ([χ2] = 14.779, P < 0.001). In addition, the median interval [M (QR)] of malaria cases was 1 (2) d from onset to initial diagnosis and 1 (2) d from initial diagnosis to confirmation in Zhejiang Province from 2017 to 2020, and the median interval [M (QR)] of severe malaria cases was significantly longer than that of non⁃severe cases [2 (3) d vs. 1 (2) d; Z = -3.002, P < 0.05)]. Conclusions Zhejiang Province faces great challenges of malaria control, and post⁃elimination surveillance of malaria still requires to be reinforced. Meanwhile, the awareness of seeking medical services requires to be improved among returners from malaria⁃endemic regions and the diagnostic capability of malaria requires to be improved among medical professionals.

Key words: Malaria, Imported case, Epidemic status, Diagnosis, Zhejiang Province

摘要: 目的 分析2017—2020年浙江省输入性疟疾疫情特征和病例诊断情况,为该省输入性疟疾防控提供科学依据。方法 从中国疾病预防控制信息系统中寄生虫病防治信息管理系统中收集2017—2020年浙江省报告的疟疾病例调查数据,对输入性疟疾疫情和病例时间、地区、人群分布,以及病例初诊和确诊情况进行分析。结果 2017—2020年浙江省累计报告593例疟疾病例,均为境外输入性病例;其中男性532例、女性61例,平均年龄41岁。病例主要来自非洲国家(93.93%),感染虫种包括恶性疟原虫、间日疟原虫、卵形疟原虫、三日疟原虫和混合感染,其中恶性疟病例占比最高(76.73%,455/593)。病例在县级、地市级疾病预防控制(疾控)机构和出入境检验检疫部门初诊为疟疾的正确率最高,均为100%。医疗机构和疾控机构初诊当天即确诊的疟疾患者比例分别为41.48%(207/499)和66.18%(45/68)([χ2] = 14.779,P < 0.001)。2017—2020年浙江省输入性疟疾病例从发病到初诊、从初诊到确诊中位时间(四分位间距)[M(QR)]分别为1(2)、1(2) d,重症病例从初诊至确诊时间间隔[2(3) d]显著长于非重症病例[1(2) d](Z = -3.002,P < 0.05)。结论 浙江省输入性疟疾防治面临严峻挑战,仍需加强消除疟疾后监测工作;同时应提高疟疾流行区归国人员及时就诊意识,并提高医务人员疟疾诊断能力。

关键词: 疟疾, 输入性病例, 疫情, 诊断, 浙江省

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