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目的分析神农架林区疟疾流行规律与防治历程,总结评估消除疟疾策略及措施,为其他地区实施消除疟疾行动及开展评估工作提供参考和依据。方法对神农架林区1977—2015年疟疾防治疫情数据、报表、文件、工作计划、防治策略与措施等资料进行描述性分析和总结,根据国家卫生计生委《消除疟疾考核评估方案(2014年版)》,从保障措施、技术措施、防控效果3个方面对消除疟疾工作进行评估。结果神农架林区20世纪70年代曾经发生过疟疾流行,1977年发病率高达306.74/10万。从1978年到1983年疟疾发病率大多在60/10万~70/10万之间,20世纪80年代末疟疾发病率迅速下降,90年代中期疫情有所反复,2000年达到基本消除水平。2010年开展消除疟疾行动计划后,神农架林区进一步建立健全疟疾防治网络和疟疾监测系统,规范疫情报告与处置,加强发热病人疟原虫血检,强化技能培训,广泛开展健康教育,加强部门合作,圆满完成消除疟疾的各项任务。2010—2015年,全区疟原虫血检共计2 673人次,年均疟原虫血检总数均大于辖区人口数的3‰,疟疾年平均报告发病率为0.39/万,2011年起均为输入性病例,无本地感染疟疾病例发生。防治工作经历控制流行、常态化管理、消除疟疾3个阶段。结论神农架林区经过多年疟疾防治,保持连续5年无本地疟疾病例,达到消除疟疾标准,巩固工作重点是加强输入性病例监测及防控。
Objective To analyze the malaria epidemic law and prevention and cure history in Shennongjia forest area, summarize and evaluate the malaria elimination strategies and measures, and provide reference and basis for malaria elimination and assessment in other areas. Methods A descriptive analysis and summary of data on malaria control, epidemiological reports, documents, work plans, prevention and control strategies and measures from 1977 to 2015 in Shennongjia Forest Region were conducted. According to the National Health and Family Planning Commission’s “Eradicating Malaria Assessment and Assessment Program (2014 Edition)”, , To evaluate malaria elimination work from three aspects: safeguard measures, technical measures and prevention and control effects. Results The incidence of malaria in Shennongjia forest area in the 1970s was as high as 306.74 / 100,000 in 1977. From 1978 to 1983, the incidence of malaria was mostly between 60/10 and 70/10 million. The incidence of malaria dropped rapidly in the late 1980s. The epidemic was repeated in the mid-1990s and reached a level of basic elimination in 2000. After the malaria elimination plan was implemented in 2010, a further malaria prevention and control network and malaria monitoring system were set up in Shennongjia forest area to standardize the reporting and disposal of epidemic situation, strengthen the blood test of malaria parasite in febrile patients, strengthen skills training, conduct extensive health education, strengthen departmental cooperation, Successfully completed the malaria elimination tasks. In 2010-2015, a total of 2 673 blood tests were conducted on malaria parasite in the whole area. The average annual blood count of malaria parasite was more than 3 ‰ of the area’s population and the annual average incidence of malaria was 0.39 per million. All of them were imported since 2011 Cases, no local infection Malaria cases. Prevention and control work experience control popular, normalized management, elimination of malaria in three stages. Conclusion After years of malaria prevention and treatment in Shennongjia forest area, no malaria cases have been maintained for 5 years in a row and the malaria elimination standard has been met. The focus of consolidation work is to strengthen surveillance and prevention and control of imported cases.