| 曹园园,王伟明,周华云,朱国鼎,徐岁,顾亚萍,张超,刘耀宝,曹俊.江苏省2014-2016年境外输入性疟疾病例诊断情况分析[J].中华流行病学杂志,2018,39(2):218-221 |
| 江苏省2014-2016年境外输入性疟疾病例诊断情况分析 |
| Cases diagnosis of imported malaria in Jiangsu province, 2014-2016 |
| 收稿日期:2017-06-23 出版日期:2018-02-10 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.02.016 |
| 中文关键词: 疟疾 病例确诊 境外输入性 |
| 英文关键词: Malaria Case diagnosis Overseas imports |
| 基金项目:江苏省自然科学基金（BK20150001）；江苏省科技厅能力提升项目（BM2015024）；江苏省重点研发计划（BE2016631）；国家质量监督检验检疫总局科技计划项目（2016IK146）；无锡市卫生局科研项目（MS201528） |
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| 中文摘要: |
| 目的 了解2014-2016年江苏省疟疾病例就诊及确诊情况，为制订消除疟疾的防控对策提供参考依据。方法 数据来源于中国疾病预防控制信息系统的寄生虫病防治信息系统，收集整理2014-2016年江苏省报告的所有疟疾病例，收集其就诊、确诊及治疗等相关信息。采用SPSS 16.0和Stata 12.0软件分析，采用χ2检验或Fisher确切概率法进行描述性统计分析。结果 2014-2016年江苏省共报告疟疾病例1 068例，除1例为输血感染外，其余均为境外输入性疟疾病例，绝大部分为赴非洲务工归国人员。基层医疗卫生机构对卵形疟、间日疟、三日疟和混合感染虫种判定正确率偏低，分别为79.3%（107/135）、29.5%（18/61）、52.9%（18/34）和0.0%（0/2）。2015年疟疾病例的当天就诊率高于2014年和2016年（χ2=18.6，P=0.001）。3年间确诊情况的差异有统计学意义（χ2=5.4，P=0.246），疟疾病例就诊后当天确诊者占65.4%（699/1 068）。CDC初诊正确率和当天诊断能力均高于医疗机构（χ2=13.2，P=0.000；χ2=5.4，P=0.020）。72.7%（32/44）的重症恶性疟病例在发病后均未能在当天就诊。结论 在消除疟疾阶段，疟疾高流行区归国务工人员的就诊意识仍偏低，基层医务人员的疟疾诊断能力也需提高。 |
| 英文摘要: |
| Objective To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province. Methods Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016. Relevant information on health seeking behavior, diagnosis and treatment of the disease was gathered. Results A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016. Except for one malaria case that was caused by blood transfusion, the rest patients were all recognized as ‘imported’. Majority of the cases were migrant laborers working in African countries. The accurate rates on the diagnosis of ovale, vivax and quartan malaria and mixed infection were relatively low, as 79.3% (107/135), 29.5% (18/61), 52.9% (18/34) and 0.0% (0/2) at the primary health care settings, respectively. Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 (χ2=18.6, P=0.001). While only 65.4% (699/1 068) of the patients were diagnosed correctly at the primary health care settings. There appeared no statistical difference in the 3-year-study period (χ2=5.4, P=0.246). Capacity on ‘correct diagnosis’ seemed stronger at the CDC than at the hospital levels (χ2=13.2, P=0.000; χ2=5.4, P=0.020). Totally, 72.7% (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started. Conclusions Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services. Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training. |
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