Sheng Hui-feng, Zheng Xiang, Shi Wen-qi, Xu Jian-jun, Jiang Wei-kang, Wang Duo-quan, Tang Lin-hua
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2007 Jun;25(3):225-9.
To make a field investigation on the affecting factors of malaria outbreak in a village of Congjiang County, Guizhou Province.
The investigation was made in August, 2006. Filter paper dry blood samples were taken for indirect fluorescent antibody test (IFAT) from all the 495 residents above 1 year-old in the village where an outbreak of malaria was reported. Questionnairing was conducted in 423 villagers over 10 years-old, covering malaria history in the past 2 years, knowledge on malaria and its control, use of mosquito nets, and out-door sleeping habit. Data on febrile outpatients were collected from the records of the township health center for analyzing the compliance of the patients in seeking medical services. Mosquito collecting by human-bait before mid-night, and in mosquito nets and cattle pens in early morning was performed for mosquito composition and man-biting rate.
Re-examination of the 42 positive blood smears confirmed 12 positives of P. vivax infection. The malaria incidence in 18 d was 2.1%, including 4 cases clinically diagnosed. The antibody positive rate of IFAT in the population was 8.7% (43/495) with a positive GMRT of 20.6, overall GMRT of 10.6; the IFAT positive rate in the age group of under 5 was 7.5% (3/40) with a GMRT of 25.1. The rate of seeking medical advice among febrile patients was 81.3% (118/145), 78.8% (93/118) of which being in the village clinic. The average time of going to a doctor after fever was 3.9 days, 37.4% (195/521) and 3.3% (17/521) were in 4-6 days and over 10 days respectively, with the longest 26 days. The average knowledge rate on malaria was 25.5% (108/423), with 17.1%, 29.2% and 40.0% in the groups of illiteracy, primary school and high school education respectively. A statistical significance was found between primary school/high school education and the illiteracy (P<0.01). The average rate of using mosquito nets was 31.0% (131/423), out-door sleeping rate was40.7% (172/423). The radical cure rate in 2004 and 2005 was 68.2% (15/22) and 48.3% (14/29) respectively. In addition to Anopheles sinensis, An. anthropophagus and An. minimus also existed in rooms and nets with a man-biting rate of 0.0566 and 0.0755 respectively.
Three species of anopheline mosquitoes are the important transmitting vectors. Poor self-protection, outdoor sleeping habit, delayed examination and treatment, and irregular chemotherapy among the residents are the main factors resulting malaria outbreak.
对贵州省从江县某村疟疾暴发的影响因素进行现场调查。
于2006年8月开展调查。对报告有疟疾暴发的村庄中所有495名1岁以上居民采集滤纸干血样进行间接荧光抗体试验（IFAT）。对423名10岁以上村民进行问卷调查，内容涵盖过去2年疟疾病史、疟疾及其防治知识、蚊帐使用情况和户外睡眠习惯。从乡镇卫生院记录中收集发热门诊患者数据，分析患者就医依从性。于午夜前采用人饵法捕蚊，并于清晨在室内蚊帐和牛棚捕蚊，以了解蚊虫种类和叮人率。
对42份阳性血涂片复检，确诊间日疟原虫感染阳性12例。18天内疟疾发病率为2.1%，其中临床诊断4例。人群IFAT抗体阳性率为8.7%（43/495），阳性几何平均滴度（GMRT）为20.6，总体GMRT为10.6；5岁以下年龄组IFAT阳性率为7.5%（3/40），GMRT为25.1。发热患者就医率为81.3%（118/145），其中78.8%（93/118）在村卫生室就诊。发热后平均就医时间为3.9天，4 - 6天就医者占37.4%（195/521），超过10天就医者占3.3%（17/521），最长达26天。疟疾平均知晓率为25.5%（108/423），文盲组、小学文化组和高中文化组分别为17.1%、29.2%和40.0%。小学/高中文化组与文盲组之间差异有统计学意义（P<0.01）。蚊帐平均使用率为31.0%（131/423），户外睡眠率为40.7%（172/423）。2004年和2005年的根治率分别为68.2%（15/22）和48.3%（14/29）。除中华按蚊外，室内和蚊帐内还存在嗜人按蚊和微小按蚊，叮人率分别为0.0566和0.0755。
三种按蚊是重要传播媒介。居民自我防护意识差、户外睡眠习惯、检查和治疗延误以及不规范化疗是导致疟疾暴发的主要因素。
