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武汉市2012-2019年输入性疟疾流行病学与临床特征分析OA北大核心CSTPCD

Epidemiological and Clinical Characteristics of Imported Malaria in Wuhan,China,2012-2019

中文摘要英文摘要

目的 武汉市自2013年以来已经消除了本地疟疾,但输入性疟疾作为本地疟疾传播的传染源仍然是一个潜在的威胁.了解输入性疟疾的流行病学和临床特征在已被消除本地疟疾的地区尤为重要.分析武汉市2012-2019年输入性疟疾的流行病学和临床特征,为进一步做好输入性疟疾防控工作提供依据.方法 收集2012年1月1日至2019年12月31日在武汉诊断为输入性疟疾的患者信息,并对病例的流行病学和临床特征进行描述.采用病例对照研究,分析重症疟疾患者的特征;同时采用单因素和多因素Logistics回归来识别住院时间的影响因素.结果 武汉市2012-2019年累计报告输入性疟疾病例229例.221例为男性(96.5%),男女性别比为28:1,病例年龄段主要集中在18~50岁(89.1%).82.1%的患者是境外务工人员,212例(92.6%)自非洲国家输入,主要来源国为尼日利亚36例(15.7%)、安哥拉27例(11.8%)、刚果金17例(7.4%).病例以恶性疟为主(185例,80.8%),其次为间日疟24例(10.5%)和卵形疟16例(7.0%).重症病例53例,重症率为23.1%.首次患疟疾(P=0.008)、感染恶性疟原虫(P=0.009),以及在最初诊断时被误诊(P<0.001)的患者发展为重症的比例要更高(均P<0.05).患者的中位住院时间为6 d,病例类型(恶性疟)、抗疟药物(采用氯喹伯氨喹)、退热时间(超过3 d)和血涂片镜检转阴时间(超过3d)都与较长的住院时间有关(均P<0.05).结论 本地疟疾已被消除多年,但输入性病例仍构成威胁.应加强对出境人员特别是前往非洲东南亚等疟疾流行地区的务工人员进行疟疾知识宣教.同时提高医疗机构的疟疾诊治能力,遵循规范化的治疗过程,减少患者的住院时间,降低疟疾给患者家庭和社会带来的负担.

Although indigenous malaria has been eliminated in Wuhan since 2013,imported malaria remains a potential threat as an infectious source of local malaria transmission.The epidemiological and clinical characteristics of imported malaria are particularly important in areas where local malaria has been eliminated.This study was aimed at analyzing the epidemiological and clinical characteristics of imported malaria in Wuhan from 2012 to 2019,to provide a basis for further improving the preven-tion and control of imported malaria.Patients in Wuhan diagnosed with imported malaria from January 1,2012,to December 31,2019,were included in this study.A case-control study was con-ducted to analyze the features of patients with severe malaria.Uni-variate and multivariate logistic regression was used to identify risk factors for prolonged hospital length of stay(LOS).Among 229 imported malaria cases,212(92.6%)were in Chinese citizens,and most cases were in men(96.5%).The gender ratio is 28:1,and the age of cases is mainly concertrated between 18 and 50 years old(89.1%).More than 80%of patients were mi-grant workers,and most cases were infections from African countries(92.6%).Plasmodium falciparum(80.8%)was the dominant species.Fifty-three severe malaria cases were identified during the study period.Compared with uncomplicated cases,severe cases tended to occur in patients with no history of malaria(P=0.008),patients infected with Plasmodium falciparum(P=0.009),and patients who were initially misdiagnosed(P<0.001).The median LOS was 6 days,and the species of infec-tion(Plasmodium falciparum),the use of antimalarial drugs(group B),antipyretic time(longer than 3 days),and the turn-around time of blood smear microscopy(longer than 3 days)were significantly associated with longer LOS(all P<0.05).Al-though malaria has been eradicated in Wuhan for many years,imported cases continue to pose a threat.Efforts should be made to strengthen malaria knowledge education for outbound personnel.Additionally,medical institutions must enhance diagnosis and treatment capabilities for malaria,and adhere to standardized treatment processes,and the development of drug resistance and occurrence of severe malaria must be prevented.

余树坤;张首楠;张力;王雨欣;谭雅心;魏晟;石梓薇;吴凯;陶志阳

武汉市东西湖区疾病预防控制中心,武汉 430040华中科技大学同济医学院公共卫生学院流行病与卫生统计系,武汉 430030湖北省公安县杨家厂镇卫生院,荆州 434303

基础医学

输入性疟疾恶性疟重症疟疾住院时间影响因素境外务工人员

imported malariaPlasmodium falciparumsevere malariamigrant workerslength of stayrisk factors

《中国人兽共患病学报》 2024 (006)

583-589 / 7

湖北省卫生健康委2019年度第三批联合基金立项项目(No.WJ2019H406)和武汉市医学科研项目(No.WG19Q09)联合资助. Supported by the Hubei Provincial Health Commission Joint Fund Project in 2019(No.WJ2019H406),and the Wuhan Medical Research Project(No.WG19Q09)

10.3969/j.issn.1002-2694.2024.00.078

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