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目的了解上海市疟疾监测和疫情变化情况,为评价和推进消除疟疾工作提供科学依据。方法收集2005-2012年上海市疟疾监测年报、疟疾疫情数据和人口资料,分析该市发热病人疟原虫血检情况、血检阳性率、人群疟原虫带虫率、人群疟疾抗体水平,以及传疟蚊媒的种群和密度等。结果 2005-2012年,上海市累计血检发热病人400 177人次,血检率为0.36%,各年份的血检率在0.15%~0.83%,其中2010年前的年血检率均低于0.20%,之后血检率明显升高。8年间共发现疟原虫阳性者604例,血检阳性率为0.15%,其中阳性者以2006-2008年为多,2009年后逐年减少,2012年仅有26例,2011年后的所有病例均为国外感染。各年份的血检阳性率从0.61%逐渐降低至0.03%。血检对象中本市居民占79.02%,而血检阳性者中外来流动人员占83.44%。8年期间主动病例筛查15 759人次,分别于2007年和2008年发现5例疟原虫带虫者。对1 239 440人次的流动人员进行疟疾抗体检测,阳性率为0.04%,抗体阳性者均未查出疟原虫;对7 065人次的本地小学生进行疟疾抗体检测,未发现抗体阳性者。2005-2011年开展蚊媒监测216点次,在城区观察点未发现按蚊,郊区观察点监测到按蚊蚊种为中华按蚊。按蚊叮人率季节高峰为7月底至8月底,郊区、近郊区和远郊区的按蚊叮人率未发现地区分布差异。结论上海市已全方位地开展了疟疾监测工作,并已进入消除疟疾阶段,今后的疟疾监测以有境外疟疾流行病学史的人群为重点监测对象,维持并提高二、三级医疗机构的疟疾血检能力,确保能及时、准确发现疟疾病例。
Objective To understand the changes of malaria surveillance and epidemic situation in Shanghai and provide a scientific basis for evaluating and advancing malaria elimination. Methods The malaria surveillance reports, malaria epidemic data and population data from 2005 to 2012 in Shanghai were collected. The blood samples of the malaria parasites, the positive rate of blood tests, the seropositive rate of malaria parasites and the population malaria antibodies in fever patients were analyzed. Mosquito vector population and density. Results From 2005 to 2012, there were 400 177 blood test fever patients in Shanghai, the blood test was 0.36% and the blood test was 0.15% -0.83% in all years. The annual blood test rates before 2010 were less than 0.20 %, After the blood test was significantly higher. In the past 8 years, a total of 604 positive cases of Plasmodium were found, the positive rate of blood test was 0.15%. The positive rate of them was more in 2006-2008, decreased year by year after 2009, only 26 cases in 2012 and all the cases after 2011 Infected for foreign countries. The positive rate of blood tests in each year gradually decreased from 0.61% to 0.03%. The city residents in the blood test subjects accounted for 79.02%, while the blood test positive persons accounted for 83.44% of foreign migrants. During the 8-year period, 15,759 active cases were screened, and 5 parasites were found in 2007 and 2008 respectively. A total of 1 239 440 migrants were tested for malaria antibodies. The positive rate was 0.04%. No malaria parasites were found in the antibody-positive cases. Malaria antibodies were detected in 7 065 primary school pupils and no antibody positive was found. Mosquito vectors were monitored 216 times from 2005 to 2011. Anopheles mosquitoes were not found in urban areas and mosquitoes were detected in suburban areas. The seasonal peak of Anopheles bite rate was from the end of July to the end of August. There was no regional distribution of Anopheles burglae in the suburbs, the suburbs and the outer suburbs. Conclusion Shanghai has carried out malaria surveillance in all aspects and has entered the stage of malaria elimination. In the future, malaria surveillance will focus on the monitoring of people with overseas malaria epidemiology, maintain and improve malaria in secondary and tertiary medical institutions Blood tests to ensure timely and accurate detection of malaria cases.