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目的分析中缅边境地区恶性疟配子体携带危险因素,探讨恶性疟配子体形成的影响因素以阻断多重抗药性恶性疟传播。方法采用单因素和多因素非条件logistic回归分析同一研究小组2002~2010年在中缅边境地区纳入研究的恶性疟病例资料。结果分析567例恶性疟病例13项信息,其中77例携带配子体,配子体携带率为13.58%,几何平均配子体密度为(140.15±3.58)个/μl。单因素非条件Logistic回归分析体温、对数无性体原虫密度、有疟史者末次发病时间、病程和2周内用药史为危险因素,血红蛋白含量为可能的危险因素;多因素非条件Logistic回归分析对数无性体原虫密度为主要危险因素(OR=0.322,OR95%CI为0.146~0.712)。结论近期获得疟疾保护性免疫力、不规范治疗和中重度贫血可能促进恶性疟配子体形成,配子体携带率随病程的延长和随无性体原虫密度的降低而升高。早发现、早诊断、早规范治疗,使用高效速效抗疟药和配子体杀灭药是减少配子体形成及阻断多重抗药性恶性疟传播的必要措施。
Objective To analyze the risk factors of falciparum malaria gametophyte in border areas between China and Burma and to explore the influencing factors of the formation of falciparum malaria gametophyte to block the transmission of multidrug-resistant falciparum malaria. Methods Univariate and multivariate non-conditional logistic regression analysis was used to analyze the data of falciparum malaria cases in the same study group from 2002 to 2010 in China-Myanmar border area. Results A total of 567 cases of falciparum malaria cases were analyzed. Among them, 77 cases carried gametophyte, carrying rate of gametophyte was 13.58% and geometric mean gametophyte density was (140.15 ± 3.58) / μl. Univariate non-conditional Logistic regression analysis of body temperature, logarithmic Protozoa density, the last onset of the disease with history of malaria, the course of the disease and medication history within 2 weeks as risk factors, hemoglobin content as a possible risk factor; Multivariate non-conditional Logistic regression analysis Log density of protozoa was the main risk factor (OR = 0.322, OR 95% CI 0.146 ~ 0.712). Conclusions Recent malarial protective immunity, non-standard treatment and moderate-severe anemia may promote the formation of falciparum malaria gametophyte. The rate of gametophyte carriage increases with the duration of disease and decreases with the decrease of the density of AECV. Early detection, early diagnosis, early standard treatment, the use of efficient anti-malarial drugs and gametophyte killing drugs is to reduce the formation of gametocytes and block the transmission of multi-drug resistant falciparum malaria necessary measures.