2010年启动《国家消除疟疾行动计划》后,江苏省本土疟疾感染率明显下降。与此同时,输入的疟原虫感染大幅增加,特别是卵形疟原虫和疟疾疟原虫。鉴于疟疾死灰复燃的风险,随着中国努力实现全国消除疟疾的努力,迫切需要了解进口的卵卵圆虫和疟原虫感染的增加。
江苏省输入性疟疾病例观察研究,中国在2011-2014年期间执行。
2011-2014年江苏省共报告1268例疟疾病例。虽然输入性恶性疟原虫病例(n=1058)占江苏报告病例的83.4%,在这4年中,所有疟疾病例(14、19、30和46)及其比例(3.7、9.6、8.8和13.0%)增加。同样,疟原虫病例(7例,两个,九,和10),在此期间,所有疟疾病例的比例(1.9、1.0、2.6和2.8%)略有增加。共发现98例卵形疟原虫(47/98,48%)和卵形疟原虫(51/98,52%)。在这些疟原虫感染中,潜伏期显着(p=0.00)。此外,这项研究发现,卵卵圆虫的潜伏期。,疟原虫和间日疟原虫明显长于恶性疟原虫。然而,对于卵形疟原虫和卵形疟原虫感染,潜伏期分析不显著(p=0.81).卵形菌和Malariae的误诊均大于71.5和71.4%,分别。卵卵圆周炎误诊为恶性疟原虫(35例,32.1%),间日疟原虫(43例,39.4%)由较低水平的CDC或医院组成。And,malariae病例被误诊为恶性疟原虫(10例,35.7%),间日疟原虫(9例,32.1%)和卵卵圆虫。(一个案例,3.6%)。进口卵圆藻的地理分布。江苏省的疟原虫病例主要来自赤道几内亚等撒哈拉以南非洲地区,尼日利亚,安哥拉。
尽管绝大多数输入性疟疾病例是由恶性疟原虫引起的,来自撒哈拉以南非洲和东南亚的其他稀有疟原虫物种的增加应在各级卫生提供者中密切监测,重点是疟疾的诊断和治疗。除了接受载体环境,长潜伏期和误诊。增加了中国疟疾再传入的风险。
Following initiation of China\'s National Malaria Elimination Action Plan in 2010, indigenous malaria infections in Jiangsu Province decreased significantly. Meanwhile imported Plasmodium infections have increased substantially, particularly Plasmodium ovale and Plasmodium malariae. Given the risk for malaria resurgence, there is an urgent need to understand the increase in imported P. ovale and P. malariae infections as China works to achieve national malaria elimination.
An observational
study of imported malaria cases in Jiangsu Province, China was carried out for the period of 2011-2014.
A total of 1268 malaria cases were reported in Jiangsu Province from 2011 to 2014. Although imported Plasmodium falciparum cases (n = 1058) accounted for 83.4 % of all reported cases in Jiangsu, P. ovale cases (14, 19, 30, and 46) and their proportion (3.7, 9.6, 8.8, and 13.0 %) of all malaria cases increased over the 4 years. Similarly, P. malariae cases (seven, two, nine, and 10) and proportion (1.9, 1.0, 2.6, and 2.8 %) of all malaria cases increased slightly during this time. A total of 98 cases of Plasmodium ovale curtisi (47/98, 48 %) and Plasmodium ovale wallikeri (51/98, 52 %) were identified as well. Latency periods were significant among these Plasmodium infections (p = 0.00). Also, this
study found that the latency periods of P. ovale sp., P. malariae and Plasmodium vivax were significantly longer than P. falciparum. However, for both P. ovale curtisi and P. ovale wallikeri infections, the latency period analysis was not significant (p = 0.81). Misdiagnosis of both P. ovale and P. malariae was greater than 71.5 and 71.4 %, respectively. The P. ovale cases were misdiagnosed as P. falciparum (35 cases, 32.1 %), P. vivax (43 cases, 39.4 %) by lower levels of CDCs or hospitals. And, the P. malariae cases were misdiagnosed as P. falciparum (ten cases, 35.7 %), P. vivax (nine cases, 32.1 %) and P. ovale sp. (one case, 3.6 %). Geographic distribution of imported P. ovale sp. and P. malariae cases in Jiangsu Province mainly originated from sub-Saharan Africa such as Equatorial Guinea, Nigeria, and Angola.
Although the vast majority of imported malaria cases were due to P. falciparum, the increase in other rare Plasmodium species originating from sub-Saharan Africa and Southeast Asia should be closely monitored at all levels of health providers focusing on diagnosis and treatment of malaria. In addition to a receptive vector environment, long latency periods and misdiagnosis of P. malariae and P. ovale sp. increase the risk of re-introduction of malaria in China.