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目的通过对万宁市原高疟地区疟疾病人及时就医治疗及其在消除疟疾中的作用进行调查分析,以揭示海南高疟区近年疟疾迅速下降的原因和机制,为评估海南疟疾消除提供参考。方法收集统计万宁市南桥镇和南林农场2000—2012年间发热病人血检率、疟疾病人发病至就诊治疗的平均间隔天数和疟疾发病率,以及该地区媒介按蚊监测资料,同时,结合疟疾传播动力学进行理论分析。结果万宁市原高疟地区通过日益健全的基层卫生组织,在达到10%以上较高的发热病人血检率的同时,将疟疾病人发病至就诊治疗的平均间隔天数缩短为2天以内,从而在疟疾媒介能量显著降低的基础上,又缩短了病人的传染性期限,提高了疟疾恢复率,提高了媒介能量的临界值,从而加速疟疾基本繁殖率迅速降至临界值以下,因而对于控制和阻断传播起到了重要作用。结论该地区近年疟疾消除进展迅速,这是由于多年来在媒介能量显著下降的同时,通过日益健全的基层卫生组织及时发现和治疗疟疾病人这两方面综合作用的结果。
Objective To investigate the causes of malaria in malaria endemic areas of Manning and its role in eliminating malaria in order to reveal the causes and mechanisms of the rapid decline of malaria in high malaria endemic areas in Hainan and to provide reference for the assessment of malaria elimination in Hainan. Methods Collect blood samples from 2000 to 2012 in Nanqiao Town and Nanlin Farm of Wanning City. The average number of days between onset and treatment of malaria and the incidence of malaria, as well as the surveillance data of Anopheles vectors in the area, The malaria transmission dynamics is analyzed theoretically. Results The original malaria area of Wanning City, through an increasingly sound primary grass-roots health organization, shortened the average interval between onset of symptoms and treatment of malaria patients to within 2 days while achieving a blood test rate of over 10% On the basis of a significant reduction in the energy of the malaria vector, it also shortens the patient’s infectious period, raises the malaria recovery rate and increases the critical value of the media energy so that the malaria breeding rate will be rapidly reduced below the critical level, Disruption has played an important role. Conclusion Malaria elimination has progressed rapidly in the region in recent years as a result of the combined effect of the growing availability of grass-roots health organizations to timely detection and treatment of malaria patients, over the years, with a significant reduction in the energy of the media.