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目的分析和验证湖北省襄阳市襄州区1951-2013年疟疾流行趋势和规律,为消除疟疾路径分析提供依据。方法回顾性收集、整理襄州区1951-2013年疟疾防治资料,采用描述流行病学方法进行统计分析。结果襄州区1951-2013年疟疾年平均发病率为143.91/万。流行过程分为3个阶段,20世纪50-70年代前为疟疾流行阶段,共出现3次幅度较大的发病高峰,分别为712.62/万(1954年)、846.26/万(1967年)和2 299.98/万(1970年),处于高发流行状态,各年代年均发病率比较差异无统计学意义(χ2=-663 427 043.85,P>0.05);20世纪80年代和21世纪初10年间为控制阶段,出现3次幅度较小的周期性波动,分别为100.40/万(1980年)、2.43/万(1991年)和7.30/万(2002年),疟疾发病率呈平稳下降趋势,处于低发状态;2010年之后为消除阶段,发病率在低发病状态上继续下降,由2011的0.04/万下降到2012年的0/万,2012-2013年消除了本地感染病例。利用居民疟疾流行率、带虫率调查和发热患者疟原虫血检数据对同期疟疾年均发病率流行趋势进行验证,具有较好的一致性和吻合性。结论襄阳市襄州区疟疾流行趋势经历了由高发流行阶段、大幅度下降阶段、低发平稳阶段和消除疟疾阶段的过程。但影响疟疾发生的自然因素并没有完全改变,加强输入性疟疾防控和做好消除疟疾过程中的全面监测工作是该区当前和今后疟防工作的主要任务。
Objective To analyze and verify the malaria epidemic trends and laws from 1951 to 2013 in Xiangzhou District, Xiangyang City, Hubei Province, and provide evidences for malaria path analysis. Methods The data of malaria control in 1951-2013 in Xiangzhou District were collected retrospectively, and the descriptive epidemiological method was used for statistical analysis. Results The annual incidence of malaria in Xiangzhou District from 1951 to 2013 was 143.91 / million. The epidemic process was divided into three stages. Before the 1950s-1970s, the epidemic stage was malaria. There were three peak incidence peaks of 712.62 / million (1954), 846.26 / million (1967) and 2 299.98 / million (1970), the prevalence of high prevalence, the average annual incidence of each year was no significant difference (χ2 = -663 427 043.85, P> 0.05); the 1980s and early 21st century for the control of 10 years Period, there were three cyclical fluctuations with a small amplitude of 100.40 per million (1980), 2.43 per thousand (1991) and 7.30 per 10,000 (2002) respectively. The incidence of malaria showed a steady downward trend with low incidence State; after 2010 to eliminate phase, the incidence continues to decline in the low incidence state from 0.04 / million in 2011 fell to 0 / million in 2012, 2012-2013 eliminate the local cases of infection. The prevalence of malaria in the same period was verified by using the malaria prevalence rate, the survey of parasitic rates and the blood test data of malaria parasite in febrile patients, which showed good consistency and agreement. Conclusion The epidemiological trend of malaria in Xiangzhou District of Xiangyang City has experienced the process of high malaria epidemic phase, substantial decline phase, low incidence stable phase and malaria elimination phase. However, the natural factors that affect the occurrence of malaria have not completely changed. Strengthening malaria control in malaria and comprehensive malaria elimination monitoring are the major tasks of the malaria prevention work now and in the region.