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目的明确中国2005-2008年报告恶性疟病例的流行病学特征,为当前恶性疟防控提供参考数据。方法本文所采用资料来源于中国疾病预防控制中心疾病监测信息报告管理系统,输入性病例仅指除云南和海南省外的其他地区报告的恶性疟病例,采用构成比等相对数描述中国恶性疟报告病例的三间分布和诊断情况,并采用χ2检验、秩和检验和Watson-Willian检验等方法对云南和海南省与其他地区的情况进行了分析比较。结果中国云南和海南省恶性疟报告发病率近年下降明显(P<0.001);而其他地区输入性恶性疟病例有上升迹象;云南和海南省的恶性疟发病高峰月份为4-6月,与其他地区的5-8月高峰不同(P<0.01);恶性疟发病以农民和民工为主,发病年龄主要集中在20～40岁年龄组;中国除云南、海南省外的其他地区恶性疟病死率(3.39%)、发病-诊断时间(中位数=5d)和病例订正报告比例(52.30%)均明显高于云南和海南省(分别为0.76%,3d和11.91%)(P<0.01),而实验室诊断比例(78.18%)低于云南和海南省(92.64%)(P<0.001)。结论近年来,中国恶性疟发病逐年下降,而云南、海南省以外的其他地区恶性疟报告病例上升,且诊断能力较低;建议在这些恶性疟非流行区,大力加强培训和宣传,提高医疗机构对恶性疟病例的诊断能力和诊断及时性,降低病死率。
Objective To clarify the epidemiological characteristics of falciparum malaria cases reported by China in 2005-2008 and to provide reference data for the prevention and control of falciparum malaria. Methods The data used in this article come from the disease surveillance information reporting management system of China CDC. The imported cases only refer to the cases of falciparum malaria reported in other regions except Yunnan and Hainan Provinces. The relative numbers such as composition ratio are used to describe the report of China’s falciparum malaria Cases and distribution of the three cases, and using χ2 test, rank sum test and Watson-Willian test and other methods to analyze the situation of Yunnan and Hainan Province and other regions. Results The incidence of falciparum malaria reported in Yunnan and Hainan Provinces in China decreased significantly in recent years (P <0.001), while the incidence of imported malaria cases in other areas showed signs of rising. In Yunnan and Hainan Province, the peak incidence of P. falciparum was between April and June, (P <0.01). The incidence of falciparum malaria was mainly peasants and migrant workers, the age of onset was mainly in the age group of 20-40 years. The mortality of falciparum malaria in other areas except Yunnan and Hainan Provinces (3.39%), incidence-diagnosis time (median = 5d) and case-corrected report (52.30%) were significantly higher in Yunnan and Hainan Provinces (0.76%, 3d and 11.91% The proportion of laboratory diagnosis (78.18%) was lower than that of Yunnan and Hainan (92.64%) (P <0.001). Conclusions In recent years, the incidence of falciparum malaria in China has been declining year by year, while the reported cases of falciparum malaria in other areas outside Yunnan and Hainan Province have risen and the diagnostic capability has been relatively low. It is suggested that training and publicity should be greatly strengthened in these non-endemic areas of falciparum malaria so as to enhance the medical institutions The diagnosis of falciparum malaria cases and timeliness of diagnosis, reduce mortality.