目的 了解中缅边境地区盈江县疟疾疫点处置情况并分析该县疟疾流行态势,为云南省边境地区消除疟疾提供防治对策与与措施依据。 方法 2015年6-7月在云南省盈江县那邦镇和铜壁关乡选择有疟疾本地感染病例或输入性病例的4个自然村(那邦镇景颇寨、傈僳寨和街马村,铜壁关南开山)进行调查。采集调查对象外周血,用疟疾快速诊断卡(RDT)进行检测,采用巢式PCR(nested-PCR)进行复核。采用诱蚊灯通宵诱蚊法对那邦镇患者较集中的景颇寨、傈僳寨和街马村,以及缅甸拉咱市勐相样进行捕蚊;同时用通宵人诱法在有本地感染病例的那邦镇景颇寨和傈僳寨进行捕蚊,对所捕获的部分微小按蚊(Anopheles minimus)用巢式PCR检测其疟原虫子孢子感染情况。 结果 在盈江县那邦镇和铜壁关乡以11例疟疾病例为线索共采集194人血样,现场RDT检测均为疟原虫阴性,但巢式PCR检测2份为间日疟原虫(Plasmodium vivax)阳性,均来自以本地感染病例为线索的景颇寨和傈僳寨调查点。共捕获蚊虫2 374只,分属按蚊属、库蚊属、伊蚊属和阿蚊属的22个种。库蚊属为当地优势属;其次是按蚊属,占11.33%(269/2 374)。微小按蚊是按蚊属的优势种群,占该属的49.07%(132/269),其次是中华按蚊4.09%(11/269)、多斑按蚊2.23%(6/269)和吉甫按蚊0.74%(2/269)等。景颇寨和傈僳寨户内蚊虫平均叮人率分别为5.78只/(人·h)和3.20只/(人·h),傈僳寨户外蚊虫平均叮人率为2.30只/(人·h)。巢式PCR检测微小按蚊14只,均为疟原虫子孢子阴性。 结论 云南省盈江县边境地区存在疟原虫无症状带虫者;存在主要传播媒介微小按蚊、中华按蚊、吉甫按蚊和多斑按蚊,且微小按蚊为按蚊属的优势种群。
Objective To understand the control status of malaria at hotspots in Yingjiang County and provide measures for malaria elimination in the China-Myanmar border areas of Yunnan Province. Methods A survey was made in 4 villages with indigenous malaria cases or imported cases in Nabang and Tongbiguan of Yingjiang County in Yunnan Province in June and July 2015. Peripheral blood samples were collected from the neighboring residents around patients and examined by malaria rapid diagnostic test (RDT). The results were further verified by nested-PCR. Mosquitoes were collected by overnight trapping with light traps in Jingpo, Lilisu, Jiema, and Mengxiangyang villages or by human landing catches in Jingpo and Lisu villages. Nested-PCR was performed on part of the captured Anopheles minimus to detect the malaria parasites. Results One hundred and ninety-four filter blood samples were collected from 11 malaria cases in two sites. All were detected to be negative for Plasmodium by RDT. In contrast, two samples originated from Jingpo and Lisu villages with indigenous cases were detected to be positive for Plasmodium vivax by nested-PCR. A total of 2 374 mosquitoes were captured, belonging to 22 species of 4 genera: Anopheles, Culex, Aedes and Armigeres. The mosquitoes were predominated by genus Culex, followed by genus Anopheles(11.33%, 269/2 374) which was dominated by A. minimus(49.07%, 132/269), then was A. sinensis(4.09%, 11/269), A. maculatus(2.23%, 6/269), A. jeyporiensis(0.74%, 2/269)and so on. The mean indoor man-biting rate of mosquitoes was 5.78 and 3.20 per person per hour for Jingpo and Lisu villages, and the mean outdoor man-biting rate of mosquitoes was 2.30 per person per hour for Lisu Village. The 14 A. minimus were negative for sporozoite infection as detected by nested-PCR. Conclusion Nested-PCR showed that there are asymptomatic Plasmodium carriers in Yingjiang’s border area of Yunnan Province. Four major mosquito species as malaria vectors exist with A. minimus as the dominant on