【摘要】：目的：近年來(lái)，云南省瘧疾發(fā)病主要集中在保山邊境地區(qū)。本項(xiàng)目通過(guò)對(duì)保山邊境地區(qū)瘧疾疫情特點(diǎn)進(jìn)行分析并對(duì)當(dāng)?shù)孛浇榘次美ッ靼次迷诏懠矀鞑撃苎芯浚瑸楫?dāng)?shù)丿懠卜乐喂ぷ魈峁┛茖W(xué)依據(jù)。 方法：（1）收集2011-2012年騰沖縣和龍陵縣瘧疾發(fā)病資料，采取描述性流行病學(xué)方法進(jìn)行分析，，掌握當(dāng)?shù)匾咔榱餍刑攸c(diǎn)；（2）2012年6-8月對(duì)龍陵縣媒介按蚊昆明按蚊開(kāi)展傳瘧作用定量研究，了解昆明按蚊在瘧疾流行中的效能。 結(jié)果：（1）2011-2012年騰沖縣和龍陵縣共報(bào)告瘧疾病例719例，其中騰沖縣626例，龍陵縣93例，瘧疾病例中間日瘧634例，占88.18%；惡性瘧71例，占9.88%；未分型瘧疾14例，占1.95%。發(fā)病以外源性為主，占瘧疾總發(fā)病數(shù)的88.03%，其中輸入地最高的是來(lái)自于緬甸（602例），占病例總數(shù)的83.73%。男性瘧疾病人高于女性，男性病例占發(fā)病總數(shù)的91.38%；患者職業(yè)以農(nóng)民和民工為主，占發(fā)病總數(shù)的94.02%；發(fā)病高峰為4-6月；發(fā)病年齡主要集中31-62歲（共430例），占總發(fā)病數(shù)的59.81%；瘧疾平均發(fā)病與診斷時(shí)間間隔為96h。在騰沖和龍陵縣病例地區(qū)分布上，騰沖縣報(bào)告病例數(shù)最高的是五合鄉(xiāng)(106例)，占全縣發(fā)病總數(shù)的16.96%，其中北海鄉(xiāng)發(fā)病最低(9例)，占全縣發(fā)病總數(shù)的1.44%；龍陵縣報(bào)告病例數(shù)最高的是龍江鄉(xiāng)(48例)，占全縣發(fā)病總數(shù)的51.61%，勐糯鎮(zhèn)和木城鄉(xiāng)病例數(shù)最低(1例)，占全縣發(fā)病總數(shù)的1.08%。（2）昆明按蚊全夜均有叮人活動(dòng)，夜間活動(dòng)高峰為21:00-22:00；媒介能量為0.172，基本繁殖率（Zo）為1.16（Zo＞1）。 結(jié)論：（1）保山邊境地區(qū)瘧疾疫情嚴(yán)峻，病例多以輸入性病例為主，結(jié)果提示必須加強(qiáng)對(duì)當(dāng)?shù)赝獬鰟?wù)工人員的瘧疾防治宣教和流動(dòng)人口傳染源監(jiān)測(cè)，提高當(dāng)?shù)蒯t(yī)務(wù)人員的瘧疾診療能力。（2）昆明按蚊仍然屬于該地區(qū)重要瘧疾媒介，具有較高的傳瘧效能，建議當(dāng)?shù)胤酪卟块T(mén)加媒介監(jiān)測(cè)力度，有效阻斷瘧疾傳播流行。
[Abstract]:Objective: in recent years, the incidence of malaria in Yunnan Province is mainly concentrated in Baoshan border area. Through the analysis of the malaria epidemic situation in Baoshan border area and the study on the transmission potential of the local vector Anopheles Kunming, this project provides the scientific basis for the local malaria control work. Methods: (1) data of malaria incidence in Tengchong County and Longling County from 2011 to 2012 were collected and analyzed by descriptive epidemiological method. (2) A quantitative study on the transmission of malaria from Anopheles Kunming to Anopheles Kunming in Longling County from June to August, 2012 was carried out to understand the effectiveness of Anopheles Kunming in malaria epidemic. Results: (1) 719 cases of malaria were reported in Tengchong County and Longling County from 2011 to 2012, including 626 cases in Tengchong County, 93 cases in Longling County, 634 cases of vivax malaria (88.18%) and 71 cases of falciparum malaria (9.88%). There were 14 cases of unclassified malaria (1.95%). The incidence of malaria was mainly exogenous, accounting for 88.03 of the total incidence of malaria, the highest of which was from Myanmar (602 cases), accounting for 83.73% of the total number of cases. Male malaria patients were higher than females, male cases accounted for 91.38% of the total incidence, the occupation of the patients was mainly farmers and migrant workers, accounting for 94.02% of the total incidence, with a peak of 4-6 months. The age of onset was mainly 31-62 years (430 cases), accounting for 59.81% of the total incidence, and the mean time interval between onset and diagnosis of malaria was 96 hours. In the distribution of cases in Tengchong and Longling counties, the highest number of reported cases in Tengchong County was in Wuhe Township (106 cases), accounting for 16.96% of the total incidence in the county, among which Hokhai Township had the lowest incidence (9 cases), accounting for 1.44% of the total incidence in the county. Longling County reported the highest number of cases in Longjiang Township (48 cases), accounting for 51.61% of the total incidence of disease in the county, Mengnao Town and wooden urban and rural areas have the lowest number of cases (1 case). (2) Anopheles mosquitoes in Kunming had biting activity all night, the peak of nocturnal activity was 21: 00-22: 00; The vector energy was 0.172 and the basic reproduction rate (Zo) was 1.16 (Zo > 1). Conclusion: (1) the epidemic situation of malaria in Baoshan border area is severe, most of the cases are imported cases, the results suggest that it is necessary to strengthen the malaria prevention and control education and the monitoring of the source of infection of the floating population among the local migrant workers. (2) Anopheles Kunming is still an important malaria vector in this area and has high malaria transmission efficiency. It is suggested that local epidemic prevention departments should strengthen vector monitoring to effectively block the spread of malaria.
【學(xué)位授予單位】：大理學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R531.3

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