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目的挖掘和总结疟疾风险管理的经验及存在问题,为疟疾消除阶段的疟疾风险管理工作提供策略建议。方法借鉴扎根理论(GTM),于2015年6月—2016年3月随机抽取广西、湖北、安徽三省疟疾防控系统的24名相关人员分别进行时长为半小时的面对面半结构式访谈,并补充访谈了河南和山东两省疾病预防控制中心的2名一线疟疾防控专家,对收集的定性资料进行整理和分析。结果样本地区疟疾风险管理工作的顺利开展主要受政府的重视,规范的疟疾预防、监测筛查、病例处置以及注重科研探索等因素的影响;然而当前疟疾风险管理面临的主要问题为:疟疾经费不足、居民及基层防控工作人员疟疾防控意识淡薄、流动人口加剧输入性疟疾传播风险、二代病例与疟原虫变异使监测更加困难等。结论疟疾消除阶段政府需要继续重视疟疾风险管理工作,适当增加和调整疟防经费及科研经费投入,协调建立多部门的疟疾防控机制。
Objective To explore and summarize the experience and existing problems of malaria risk management in order to provide strategic advice on malaria risk management in the phase of malaria elimination. Methods Based on grounded theory (GTM), twenty-four hour-long face-to-face semi-structured interviews were randomly selected from 24 malaria prevention and control systems in Guangxi, Hubei and Anhui provinces from June 2015 to March 2016 and supplemented with interviews Two front-line malaria prevention and control experts from the Centers for Disease Control and Prevention in Henan and Shandong provinces were collected to sort out and analyze the collected qualitative data. Results The smooth implementation of malaria risk management in the sample area was mainly affected by the government’s attention, normative malaria prevention, surveillance screening, case handling, and research focusing on scientific research. However, the main problems facing the current malaria risk management are: insufficient malaria funding Residents and grass-roots prevention and control staff have a low awareness of malaria prevention and control, floating population exacerbates the risk of imported malaria transmission, and the second-generation cases and the variation of malaria parasites make monitoring more difficult. Conclusions During the phase of malaria elimination, the government needs to continue to attach importance to malaria risk management, appropriately increase and adjust funding for malaria prevention and scientific research, and coordinate the establishment of a multi-sectoral malaria prevention and control mechanism.