RESUMO
Objective To analyze the characteristics of imported malaria epidemic from overseas in Wuhan, to explore the management mechanism of on-site cases, and to accumulate experience for the treatment of imported malaria in large cities after malaria elimination. Methods The epidemiological data on imported malaria from abroad during the period of malaria elimination (2010-2019) in Wuhan were collected. The gender, age and severe illness-related factors of the cases were analyzed. Based on the characteristics of the epidemic and the current situation of prevention and control, the content and experience of the “Municipal-District 24-7” case mechanism were discussed. Results The medical resources in Wuhan were the best in the central region, resulting in a large number of imported malaria cases, with a total of 474 cases reported from 2010 to 2019 (40.79% of the total number of cases in Hubei Province), including 359 cases of falciparum malaria, 36 severe cases and one death (the death rate was 0.28%). The patients were mainly young and middle-aged men aged 20 to 49 years old (97.26%). There were many referral cases (40.30%), and there was no seasonal clustering of cases reported. The undiagnosed proportion at the first visit was 44.85%, and the time of attack-diagnosis was 4 days or more in 61.00% of cases. The occurrence of severe cases was related to unconfirmed diagnosis at the first visit (χ2=35.46, P<0.001) and attack-diagnosis time (Z=-6.49, P<0.001). Conclusion Imported malaria occurs frequently in Wuhan, mainly falciparum malaria. However, “Municipal-District 24-7” case mechanism has effectively curbed the occurrence of severe and death cases and provided valuable experience for case management in similar cities in China.
RESUMO
OBJECTIVE: To investigate and analyze the capabilities of Plasmodium microscopic examinations in medical and health organizations in Dongxihu District, Wuhan City, so as to provide evidences for achieving the standard of malaria elimination and malaria control in the future. METHODS: The basic information of the laboratorians and the hardware facilities in 15 microscopic examination stations of Plasmodium were collected and analyzed from 2010 to 2015. Meanwhile, the quality of making, dyeing, cleanliness of all the negatives blood smears were evaluated, and all the positive smears were re-checked in the district during the period above mentioned. RESULTS: Totally, there were 28 laboratorians and 9 qualified microscopes in 15 microscopy stations in Dongxihu District. The age of the laboratorians in the first-level and third-level organizations was mainly from 40 to 50 years old, but the age of those in the second-level organizations was from 20 to 30 years old. The years for microscopic examination working of most of the laboratorians in the first-level and third-level organizations were more than 15 years, while the working years of those in the second-level organizations were mainly less than 10 years. The education level of the laboratorians in the first-level organization was mainly (50.00%) junior college, while the education levels of those in the second and third organizations were mainly bachelor. From 2010 to 2015, 8 561 blood smears were produced and 539 of them were reviewed, the coincidence rates of review were all 100%, and the average qualified rates of making, dyeing, and cleanliness of the negative blood smears were 82.08%, 79.92% and 83.33%, respectively. All the rates mentioned above in 2015 were higher than those in 2010 (χ2 = 26.45, 16.85, 13.93, all P ï¼ 0.01). CONCLUSIONS: The capability of microscopic examinations of Plasmodium has improved obviously in Dongxihu District, but the human resources construction and hardware input in this district should be improved, meanwhile, the check on the quality control of microscopic examinations of Plasmodium should be continued, so as to guarantee the sustainable and healthy development of malaria control work in this district.
