嘉兴市低疟区疟疾流行病学特点与监测方法探讨

目的分析低疟区疟疾流行特点,探讨低疟区疟疾监测方法。方法对嘉兴市基本消灭疟疾后的疟疾监测结果做发热病人血检情况,疟疾病例分类、地区分布、性别与年龄分布、发病时间分布,发病率与感染来源,疫点周围人群调查及病例治疗后复查血检情况,媒介按蚊等回顾性调查研究。结果嘉兴市15年累计发热病人血检阳性率24.25/万(302/124529),均为间日疟。其中:初诊为疟疾和疑似疟疾(简称二热病人)者血检阳性率60.29%(290/481),占总阳性数96.03%(290/302);感冒和发热原因不明者血检阳性率仅为0.97/万(12/124048),占总阳性数3.97%(12/302)。病人发病分布散在,本市户籍人口占25.50%(77/302),年均发病率0.23/10万,外来流动人口占74.50%(225/302)。以高疟区青壮年打工者为主要发病者;以5~10月份为发病高峰期;以中华按蚊为惟一媒介;无二代病例发生。结论嘉兴市疟疾发病率低,疫情稳定。以输入性病例为主的呈点状分布的流行特点。因此,疟疾监测在流动人口较多的低疟区,且以中华按蚊为惟一媒介,对当地人群可以采用二热病人、对流动人口采用四热病人的监测方案。

To Explore Epidemiological Characteristics and Monitoring Methods of Malaria in Low Malarial Area in Jiaxing City

Objective To analyse the epidemiological characteristics of malaria and explore monitoring methods of malaria in low malarial area. Methods According to the malarial monitoring results after basica elimination of malaria in Jiaxing city,a recalling investigation was conducted including blood test of fever patients, malaria cases classification,geographical distribution of cases, gender and age distribution of cases,incidence time distribution,incidence and infection sources,investigation of surrounding crowd in epdimic points, the review of cases by blood test,media anopheles etc. Results Positive rate of blood test is 24.25 per 10 000 in 15 years and all of the cases are tertian malaria. Positive rate of blood test of malaria and suspected malaria in preliminary diagnosis is 60.29%. positive rate of cold and heat unexplained is 0.97 per 10 000.City residents accounted for 25.50% of the positivec ases and the cumulative morbidity is 0.23 per 100 000, floating population accounting for 74.50% of positive cases. May to October is the peak in incidence.Malaria mainly occured in young adults in high incidence area. Anopheles sinensis was the only media and no second generation cases occurred. Conclusion The incidence of malaria is low and the epidemic is steady in Jiaxing City where most cases are imported.