Epidemic situation of malaria in Jiangsu Province in 2018

: ［摘要］目的 分析 2018 年江苏省疟疾疫情, 为制订全省消除疟疾后监测方案和技术措施提供科学依据。方法 收集 2018 年江苏省疟疾病例报告卡、疟疾病例流行病学个案调查表和疫点信息等资料, 对 2018 年江苏省疟疾疫情数据进行统计分析。结果 2018 年江苏省共报告疟疾病例 243 例, 较 2017 年上升 1.67%, 其中恶性疟 171 例、间日疟 14 例、三日疟 15 例、卵形疟 42 例、间日疟与卵形疟混合感染 1 例; 全部疟疾病例均为境外感染的输入性病例, 未发现本地继发感染病例。患者职业以务工人员为主, 占 76.54%; 全省报告病例数较多为南通市 (48 例)、扬州市 (33 例) 和泰州市 (22 例)。报告病例的感染地分布以非洲地区为主 (占 96.30%), 另有 8 例来自亚洲、1 例来自中美洲。患者在就诊当天和就诊后 1～3 d 即确诊分别有 125 人例 (51.44%) 和 91 例 (37.45%); 乡级、县级和市级医疗机构初次就诊确诊率分别为 48.27%、88.76% 和 97.30%, 乡 (镇) 卫生院初次就诊确诊率显著低于县级 (χ2 = 21.47, P < 0.01) 和市级医疗机构 (χ2 = 32.86, P < 0.01)。结论江苏省已无本地感染疟疾病例, 但每年境外输入性病例数仍位居全国前列。今后应继续完善消除疟疾后监测体系、加强高危人群疟疾防病意识宣传、进一步提升医疗机构疟疾诊断能力和水平、做好输入性疟疾病例管理, 以巩固消除疟疾成果。. METHODS: The malaria case report cards, epidemiological individual investigation forms of malaria cases and foci data were collected from Jiangsu Province in 2018, and the epidemic situation of malaria was descriptively analyzed. RESULTS: A total of 243 malaria cases were reported in Jiangsu Province in 2018, which increased by 1.67% in relative to in 2017 (239 cases), and these cases included 171 cases with falciparum malaria, 14 cases with vivax malaria, 15 cases with quartan malaria, 42 cases with ovale malaria and a case with mixed infection of P. vivax and P. ovale. All cases were overseas imported, and no local secondary cases were found. The malaria cases were predominantly workers (76.54%). Nantong City (48 cases), Yangzhou City (33 cases) and Taizhou City (22 cases) were the most 3 cities with the largest number of malaria cases across Jiangsu Province. The malaria infections predominantly occurred in African areas (96.30%), and the other 9 cases had infections in Asia (8 cases) and Central America (1 case). There were 125 cases (51.44%) and 91 cases (37.45%) with definitive diagnosis at the day of admission and within 1 to 3 days post-admission, respectively. The percentages of definitive diagnosis at initial diagnosis were 48.27%, 88.76% and 97.30% at township-, county- and city-level medical institutions, respectively, and the percentage of definitive diagnosis at initial diagnosis was significantly lower in township-level medical institutions than in county- (χ2 = 21.47, P < 0.01) and city-level medical institutions (χ2 = 32.86, P < 0.01). CONCLUSIONS: There are no local malaria cases in Jiangsu Province; however, the number of overseas imported malaria cases remains high in China. In the future, improving the post-elimination malaria surveillance system, enhancing the awareness of malaria prevention and control knowledge among high-risk populations, increasing the diagnostic capability of malaria in medical institutions, and improving the management of imported malaria cases should be performed to consolidate the achievements of malaria elimination.