疟疾是危害海南人民群众健康的重要寄生虫病之一,且因气温全年皆适宜按蚊生长和疟原虫子孢子在蚊体内的发育和繁殖,故当地疟疾终年传播无休止期。1956年全省疟疾调查显示,居民疟原虫带虫率及脾肿率分别为40.3%及69.6%。自1959年开始在全岛开展大规模抗疟,1969年,海南省疟疾发病率为159.2/万,此后发病率持续下降,至1977年下降至30.5/万,1978年发病率上升1倍多,为63.44/万,此后虽个别年份发病率有所上升,但总体呈下降趋势,至1999年,疟疾年发病率降至4.57/万。2010年,海南省按照国家的《中国消除疟疾行动计划(2010—2020)》开展消除疟疾工作,病例数持续减少,并在2012年首次实现无本地报告疟疾病例,至2014年,海南省连续3年无本地疟疾病例报告。2014年屯昌县、文昌市陆续通过了省级消除疟疾考核。2010—2014年,市县级政府合计拨付1 403.39万元用于开展消除疟疾工作。近几年海南省开展消除疟疾的主要工作内容是:1发热病人血检;2病例报告、治疗、个案调查及疫点处置;3技能培训;4健康教育等。2010—2014年,每年血检率达1.28%~2.05%。所有网报病例均严格按照1-3-7模式开展防控措施,防止二代病例出现。足够的经费投入保障了大规模培训专业人员及群众健康教育措施的实施,2010—2014年培训疟疾防治管理人员、临床医生及检验人员共16 854人次,发放各式健康教育资料共170多万份。虽已取得阶段性的成果,但在消除疟疾过程中我们仍然面临很多的困难与挑战。首先是部门间合作机制有待加强;第二是输入性病例造成的威胁;第三是一些关键性技术难题尚未解决;第四是基层疟防人员有所削弱;第五是宣传力度仍然不够。 Malaria is one of the important parasitic diseases endangering the health of Hainan people, and because the temperature is suitable throughout the year for the growth of anopheles and the development and multiplication of the parasite sporozoites in the mosquito, the local malaria is transmitted endlessly throughout the year. A survey of malaria in the province in 1956 showed that the parasites and sporozoite rates of the residents were 40.3% and 69.6% respectively. Since 1959, large-scale antimalarial work has been carried out across the island in China. In 1969, the incidence of malaria in Hainan Province was 159.2 / million. The incidence of malaria continued to decline afterwards in that year, dropping to 30.5 / million in 1977 and more than double the incidence in 1978, 63.44 per ten thousand. Since then, the incidence of malaria has dropped to 4.57 per thousand by 1999, although the incidence rate of individual years has risen. In 2010, Hainan Province conducted malaria elimination work in accordance with the national “China Malaria Elimination Action Plan (2010-2020)”, and the number of cases continued to decrease. In 2012, Hainan Province reported for the first time that there were no local reports of malaria cases. By 2014, Hainan Province has continuously 3 There are no local malaria cases reported. In 2014, Tunchang County and Wenchang City successively passed the examination of eliminating malaria at the provincial level. From 2010 to 2014, the city and county governments allocated a total of 13,403,900 yuan for malaria elimination. In recent years, Hainan Province to carry out the main tasks of eliminating malaria are: a hematogenous blood test; 2 case reports, treatment, case investigation and treatment; 3 skills training; 4 health education. 2010-2014 annual blood test rate of 1.28% ~ 2.05%. All cases reported in the network in strict accordance with 1-3-7 prevention and control measures to prevent the emergence of second-generation cases. Enough funding has ensured the implementation of large-scale training professionals and mass health education measures. A total of 16 854 training malaria prevention and control managers, clinicians and inspectors were trained in 2010-2014. More than 1.7 million copies of health education materials were distributed . Although phased results have been achieved, we still face many difficulties and challenges in eliminating malaria. The first is the need to strengthen interdepartmental cooperation mechanism. The second is the threat posed by imported cases. The third is that some key technical problems have not yet been solved. The fourth is that grassroots malaria prevention and control personnel have weakened. The fifth is that propaganda efforts are still not enough.