Cao Y Y, Wang W M, Zhou H Y, Zhu G D, Xu S, Gu Y P, Zhang C, Liu Y B, Cao J
Jiangsu Institute of Parasitic Diseases, Key Laboratory of Prevention and Control Technology of Parasitic Diseases of National Health and Family Planning Commission, Key Laboratory of Parasite and Vector Control Technology of Jiangsu Province, Wuxi 214064, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Feb 10;39(2):218-221. doi: 10.3760/cma.j.issn.0254-6450.2018.02.016.
To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province. Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016. Relevant information on health seeking behavior, diagnosis and treatment of the disease was gathered. A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016. Except for one malaria case that was caused by blood transfusion, the rest patients were all recognized as 'imported'. Majority of the cases were migrant laborers working in African countries. The accurate rates on the diagnosis of ovale, vivax and quartan malaria and mixed infection were relatively low, as 79.3% (107/135), 29.5% (18/61), 52.9% (18/34) and 0.0% (0/2) at the primary health care settings, respectively. Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 ((2)=18.6, =0.001). While only 65.4% (699/1 068) of the patients were diagnosed correctly at the primary health care settings. There appeared no statistical difference in the 3-year-study period ((2)=5.4, =0.246). Capacity on 'correct diagnosis' seemed stronger at the CDC than at the hospital levels ((2)=13.2, =0.000; (2)=5.4, =0.020). Totally, 72.7% (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started. Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services. Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training.
了解江苏省输入性疟疾的就医及诊断情况，为全省消除疟疾提供切实可行的措施。通过中国疾病预防控制信息系统（CISDCP）检索2014年至2016年江苏省输入性疟疾病例数据，收集疾病就医行为、诊断及治疗的相关信息。2014年至2016年江苏省共报告输入性疟疾病例1068例，除1例因输血感染疟疾外，其余均为“输入性”病例。病例主要为在非洲国家务工的流动务工人员。卵形疟、间日疟、三日疟及混合感染的诊断准确率在基层医疗卫生机构相对较低，分别为79.3%（107/135）、29.5%（18/61）、52.9%（18/34）和0.0%（0/2）。2015年发病当日就诊率高于2014年和2016年（χ²=18.6，P=0.001）。基层医疗卫生机构仅65.4%（699/1068）的患者得到正确诊断，3年研究期间差异无统计学意义（χ²=5.4，P=0.246）。疾病预防控制中心（CDC）“正确诊断”能力似乎强于医院（χ²=13.2，P=0.000；χ²=5.4，P=0.020）。共72.7%（32/44）的重症恶性疟病例症状出现时未立即就医。从疟疾高流行区返回的流动务工人员就医意识似乎较差。基层医疗卫生机构疟疾正确诊断能力仍不令人满意，这些机构的工作人员需要接受充分培训。
