Singh Neeru, Nagpal A C, Saxena Ajay, Singh M P
Malaria Research Centre, Jabalpur, India.
Trop Med Int Health. 2004 Mar;9(3):364-71. doi: 10.1046/j.1365-3156.2003.01181.x.
Since 1986, we have been studying the changing epidemiology of malaria in a forest belt of Mandla, which has the highest number of malaria cases in central India (Madhya Pradesh) to define the epidemiological characteristics of the infection with each Plasmodium species in different seasons of the year. Our long-term objective was to determine the dynamics of Plasmodium vivax vs.P. falciparum infections.
Five villages underwent fortnightly surveillance of fever cases. Drugs were distributed within 24 h after results of blood smears became available as per Indian National Anti-Malaria Programme. Indoor resting mosquitoes were also collected fortnightly.
The only two Plasmodium species encountered were P. vivax and P. falciparum in both children and adults. Relatively more malaria infections were recorded in children (< or =14 years) than adults (>14 years) (chi2=89.94, P<0.00001). However, there were significant falling trends in P. vivax from 1986 to 2000 in both age groups (< or =14 years from 63 to 13, P<0.0001 and >14 years from 84 to 7, P<0.0001). The indoor resting density of Anopheles culicifacies, an efficient vector resistant to both dichlorodiphenyltrichloroethane (DDT) (4%) and hexachlorocyclohexane (HCH) (0.4%), was very high throughout this period in all villages (52.35 +/- 31.8, range 5-200 per man hour). Anopheles fluviatilis was present in small numbers 0.78 +/- 1.24 (range 0-7 per man hour).
Major contributors of the changing epidemiology of malaria in this area are changing drug sensitivity along with insecticide sensitivity.
自1986年以来，我们一直在印度中部（中央邦）疟疾病例数最多的曼德拉森林地带研究疟疾流行病学的变化，以确定一年中不同季节每种疟原虫感染的流行病学特征。我们的长期目标是确定间日疟原虫与恶性疟原虫感染的动态变化。
对五个村庄的发热病例进行每两周一次的监测。根据印度国家抗疟计划，在血涂片结果出来后的24小时内分发药物。每两周还收集室内栖息的蚊子。
在儿童和成人中发现的仅有的两种疟原虫是间日疟原虫和恶性疟原虫。记录到的儿童（≤14岁）疟疾感染相对多于成人（>14岁）（χ2 = 89.94，P < 0.00001）。然而，1986年至2000年期间，两个年龄组的间日疟原虫感染均呈显著下降趋势（≤14岁组从63例降至13例，P < 0.0001；>14岁组从84例降至7例，P < 0.0001）。库氏按蚊是对二氯二苯三氯乙烷（DDT）（4%）和六氯环己烷（HCH）（0.4%）均有抗性的高效传播媒介；在此期间，所有村庄的库氏按蚊室内栖息密度都非常高（52.35 ± 31.8，范围为每人每小时5 - 200只）。溪流按蚊数量较少，为0.78 ± 1.24（范围为每人每小时0 - 7只）。
该地区疟疾流行病学变化的主要因素是药物敏感性以及杀虫剂敏感性的改变。
