CAJ | 학술논문

目的：提出疟疾由控制走向消除的关键措施，为我国实施消除疟疾工作提供依据。方法收集2004-2010年《全国血吸虫病、疟疾和包虫病防治工作年报》数据，选取疟疾疫情较重的典型流行省份，建立发病率变化与干预措施间的面板数据回归模型。结果2004-2010年全国87.56%的疟疾发病集中在安徽、云南、海南和河南4省。以Y为间日疟发病率，X1为有疟疾病史者休止期服药人数的自然对数（F=14.53，P<0.01，R2=0.72），X2为重点人群休止期服药人数的自然对数（F=15.90，P<0.01，R2=0.71），X3为镜检培训人数（F=11.53，P<0.01，R2=0.61），分别建立了地区固定效应模型，X1、X2和X3均对Y具有负向影响作用；以Y为恶性疟发病率，X1为镜检培训累计人数（F=11.06，P<0.01，R2=0.87），X2为媒介培训人数的自然对数（F=15.28，P<0.01，R2=0.89），分别建立了地区时间双向固定效应模型，X1和X2均对Y具有负向影响作用。结论有疟疾病史者休止期服药、重点人群休止期服药和镜检培训等是控制间日疟疫情的关键干预措施，镜检培训和媒介培训则对恶性疟发病率下降有重要作用。
목적：제출학질유공제주향소제적관건조시，위아국실시소제학질공작제공의거。방법수집2004-2010년《전국혈흡충병、학질화포충병방치공작년보》수거，선취학질역정교중적전형류행성빈，건립발병솔변화여간예조시간적면판수거회귀모형。결과2004-2010년전국87.56%적학질발병집중재안휘、운남、해남화하남4성。이Y위간일학발병솔，X1위유학질병사자휴지기복약인수적자연대수（F=14.53，P<0.01，R2=0.72），X2위중점인군휴지기복약인수적자연대수（F=15.90，P<0.01，R2=0.71），X3위경검배훈인수（F=11.53，P<0.01，R2=0.61），분별건립료지구고정효응모형，X1、X2화X3균대Y구유부향영향작용；이Y위악성학발병솔，X1위경검배훈루계인수（F=11.06，P<0.01，R2=0.87），X2위매개배훈인수적자연대수（F=15.28，P<0.01，R2=0.89），분별건립료지구시간쌍향고정효응모형，X1화X2균대Y구유부향영향작용。결론유학질병사자휴지기복약、중점인군휴지기복약화경검배훈등시공제간일학역정적관건간예조시，경검배훈화매개배훈칙대악성학발병솔하강유중요작용。
Objective To determine the key interventions transferring from the control to elimination of malaria in China so as to provide the basic information for achieving malaria elimination. Methods Based on the data collected from the document entitled of The National Annual Report on Schistosomiasis,Malaria and Echinococcosis,published by the National Institute of Parasitic Diseases of Chinese Center for Disease Control and Prevention,the malaria incidence and intervention data were se?lected only in the typical endemic provinces during the period of 2004-2010. The correlation between the incidence and interven?tions in the target provinces was analyzed based on the Panel Data Regression Model,and the key interventions were deter?mined. Results Four provinces namely Anhui,Yunnan,Hainan and Henan were targeted with 87.56%of the national malaria figures from 2004 to 2010. When Y was given as vivax malaria incidence,X1 as the log of the number of historical cases receiving radical treatment in the pre?transmission stage(RTPT)(F=14.53,P<0.01,R2=0.72),X2 as the log of risk population receiv?ing RTPR(F=15.90,P<0.01,R2=0.71)and X3 as the number of technicians trained in microscopy(F=11.53,P<0.01,R2=0.61),three space?fixed effect models were established respectively,and X1,X2,as well as X3 had negative effects on Y value. When Y was given as falciparum malaria incidence,X1 as the accumulated technicians trained in microscopy(F=11.06,P<0.01,R2=0.87),X2 as the log of technicians trained in entomology(F=15.28,P<0.01,R2=0.89),two two?way(space and time)fixed effect models were established respectively,and both X1 and X2 had negative effects on Y value. Conclusion RTPT among historical patients and at?risk populations as well as microscopy training influences the variation of vivax malaria inci? dence,while the significant interventions of microscopy training and vector control training indicate that the integrated measures with strengthened capacity in diagnosis and vector control are of importance in the control of falciparum malaria transmission.