范相博, 王松旺, 裴迎新, 戚晓鹏. 2011-2016年中国境外输入性疟疾流行病学特征研究[J]. 疾病监测, 2019, 34(10): 899-904. DOI: 10.3784/j.issn.1003-9961.2019.10.009
引用本文: 范相博, 王松旺, 裴迎新, 戚晓鹏. 2011-2016年中国境外输入性疟疾流行病学特征研究[J]. 疾病监测, 2019, 34(10): 899-904. DOI: 10.3784/j.issn.1003-9961.2019.10.009
Xiangbo Fan, Songwang Wang, Yingxin Pei, Xiaopeng Qi. Epidemiological characteristics of imported malaria in China, 2011–2016[J]. Disease Surveillance, 2019, 34(10): 899-904. DOI: 10.3784/j.issn.1003-9961.2019.10.009
Citation: Xiangbo Fan, Songwang Wang, Yingxin Pei, Xiaopeng Qi. Epidemiological characteristics of imported malaria in China, 2011–2016[J]. Disease Surveillance, 2019, 34(10): 899-904. DOI: 10.3784/j.issn.1003-9961.2019.10.009

2011-2016年中国境外输入性疟疾流行病学特征研究

Epidemiological characteristics of imported malaria in China, 2011–2016

  • 摘要:
    目的了解中国输入性疟疾疫情动态趋势,为疫情监测及实现2020年全国消除疟疾目标提供科学依据。
    方法资料来源于中国疾病预防控制中心信息管理系统2011 — 2016年中国境外输入性疟疾实验室确诊病例,利用ArcGIS、SPSS软件对资料进行描述性分析。
    结果2011 — 2016年,累计报告输入性疟疾确诊病例18 385例,死亡117例。 死亡病例94.87%由非洲输入,恶性疟占96.58%,死于恶性疟的病例发病到诊断的平均时间(6.92 d)长于存活病例(4.93 d)(F=15.21, P<0.001)。 输入病例以男性(94.57%)为主,26~45岁输入病例占全国累计输入病例数的60.92%,输入性病例中农民工占输入病例的70.82%。 输入来源主要为非洲(72.98%)和亚洲(24.87%,以缅甸为主),非洲输入病例主要集中在加纳(16.70%)、安哥拉(14.44%)、尼日利亚(11.58%)、赤道几内亚(10.79%),非洲输入病例从2011年的48.71%上升至2016年的84.02%,其中2013年加纳输入1 333例。 我国输入病例以云南省(18.43%)、广西壮族自治区(12.55%)等地区为主。 中国输入性疟疾主要以恶性疟和间日疟为主,间日疟所占比例从2011年的43.81%降至2016年的21.46%,恶性疟、三日疟和卵形疟占比分别从2011年的52.71%、0.67%、0.63%升至2016年的65.25%、2.15%、10.47%。
    结论当前我国境外输入性疟疾中恶性疟上升比例较快,主要是由于非洲输入病例占比逐年上升。 建议将劳务输出群体作为重点监测人群,提高临床医生能力及时诊断减少死亡病例,防止二代传播。

     

    Abstract:
    ObjectiveTo understannd the epidemiological characteristics of imported malaria in China during 2011—2016 and provide scientific evidence for the improvement of malaria surveillance and reaching the goal of elimination of malaria by 2020 in China.
    MethodsThe data of laboratory confirmed imported malaria cases from 2011 to 2016 were obtained from the Information System of Chinese Center for Disease Control and Prevention and analyzed with software SPSS and ArcGIS.
    ResultsA total 18 385 imported malaria cases, including 117 deaths, were reported in China during this period. Up to 94.87% of fatal cases were imported from Africa, and falciparum malaria accounted for 96.58%. The average interval between onset and diagnosis of falciparum malaria fatal cases (6.92 d) was longer than that of those who survived (4.93 d) (F=15.21, P<0.001). Imported cases were reported all the year round. The cases were mainly males (94.57%), aged 26–45 years (60.92%) and migrant workers (70.82%). The cases were mainly from Africa (72.98%) and Asia (24.87%, mainly from Myanmar). Africa imported cases were mainly from Ghana (16.70%), Angola (14.44%), Nigeria (11.58%), and Equatorial Guinea (10.79%). The proportion of Africa imported cases increased obviously from 48.71% in 2011 to 84.02% in 2016, in which 1 333 cases were from Ghana in 2013. The imported areas were mainly detected in Yunnan (18.43%) and Guangxi (12.55%). The imported malaria cases were mainly falciparum malaria and vivax malaria in China. The proportion of vivax malaria decreased from 43.81% to 21.46%, while the proportions of falciparum malaria, quartan malaria and ovala malaria increased from 52.71%, 0.67% and 0.63% in 2011 to 65.25%, 2.15% and 10.47% in 2016, respectively.
    ConclusionThe annual proportion of falciparum malaria increased rapidly in imported malaria cases in China, which might be attributed to the increase of imported malaria cases from Africa. It is suggested take labor export population to malaria endemic areas as key surveillance population and improve falciparum malaria diagnosis to reduce malaria related death and prevent secondary transmission.

     

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