| Research backgroundMalaria,AIDS and tuberculosis are the three major public health problems in the world.They have also been one of the most important mosquito-borne diseases in China,seriously jeopardizing the health of the people and restricting the development of social economy.Since the launch of the China Action Plan for the Eradication of Malaria(2010-2020),through mass control,joint prevention and control,Shandong achieved the first time in 2012 that there were no local malaria cases,imported secondary cases and active epidemic report.However,as a major labor service province,the number of imported malaria cases in Shandong,including Qingdao,has been increasing year by year in recent years.The presence of domestic mosquito vector can easily cause the spread of infection source,which will affect the realization of the goal of eliminating malaria.Therefore,in-depth discussion on the risk factors affecting malaria transmission among the entry personnel,and analysis of the advantages,disadvantages,opportunities and threats of the currently adopted port health quarantine measures in the prevention and control of imported malaria are of great significance for further effective port prevention and control measures.ObjectiveBased on the descriptive analysis of the epidemiology of imported malaria cases,the data of physical examination before leaving the country and investigation of malaria propaganda and education are sorted out to find out the possible factors affecting the infection of imported malaria.The internal advantages of port health and quarantine measures in the prevention and control of imported malaria are evaluated.Advantages and disadvantages,as well as the opportunities and threats of its external environment are analyzed and identified to provide the basis for further effective imported malaria prevention and control measures in this population.Methods and contentsCollecting malaria cases in Qingdao,which have been tested by Shandong International Travel Health Care Center for the past 5 years(hereinafter referred to as the Health Center).The general epidemiological data were analyzed by descriptive statistics according to age,occupation,origin and health status at entry.The pre-departure physical examination was traced back by the health examination system of the health care center.The malaria knowledge and education before departure was investigated by interview method.The imported data from Qingdao area detected by the health care center were obtained.The epidemiological characteristics of malaria and the effect of malaria before going abroad.Through SWOT analysis,this paper objectively summarizes and analyzes the internal strengths and weaknesses,external opportunities and threats of the port health and quarantine measures currently adopted in the prevention and control of imported malaria,and combines with four different strategies of SWOT analysis,analyzes the existing problems and puts forward countermeasures for Qingdao and even the whole province.The shore provides further reference for further optimization of imported malaria control measures.Results1.Statistical analysis of epidemiological data.From 2013 to 2017,a total of 63 imported malaria cases in Qingdao were detected by the health center,Except for one Philippine sailor,they were all Chinese,93.65%from Africa,4.76%from Southeast Asia and 1 case from Oceania.Among all the cases,falciparum falciparum accounted for 76.19%,ovary malaria accounted for 11.11%,three-day malaria accounted for 7.94%,vivax malaria accounted for 3.17%,and there was one case of mixed infection of falciparum and three-day malaria.All cases were young adults aged from 20 to 60 with a male to female ratio of 20:1.The majority of malaria cases were foreign migrant workers(57.14%),followed by enterprise employees(30.16%)and business employees(12.70%).2.Retrospective survey.From 2013 to 2017,88.89%of the imported malaria cases in Qingdao were examined in health centers before going abroad and held yellow fever vaccination certificate.100%received malaria prevention and control related knowledge education,but 61.9%still had more than one or even up to 11 malaria history or similar symptoms.3.SWOT analysis.In recent years,the port health and quarantine department have achieved certain results in the prevention and control of imported malaria by taking measures such as risk assessment,entry personnel malaria quarantine screening,entry and exit personnel malaria protection,port malaria prevention and control knowledge dissemination education,and improvement of port malaria detection level.Its advantages are the technical ability to discover and dispose of imported malaria at the port,work plan,joint prevention and control,and team materials.It has institutional and institutional guarantees.The disadvantages are that the malaria detection rate at the port is low,and the malaria surveillance work of returning labor is lagging behind,and the communication between the entry and exit of labor services is not smooth.Opportunities are institutional reforms to build a new customs new style,government agencies at all levels attach great importance to malaria prevention and control work,threatening the self-protection awareness of labor itself,and promoting the expansion of the non-labor market to bring new economic and health risks,malaria media One of the dominant species of mosquitoes,Anopheles sinensis,has always caused local transmission risks.Conclusions and suggestionsThrough the analysis,it is found that the key to prevent and control imported malaria is to obtain the information of high-risk population before entering the country,to discover the cases at the port of entry,to diagnose and treat the cases after returning home,and to avoid internal spread.2018-2020 is the key three-year period for China to maintain the state of malaria transmission before applying for WHO’s elimination of malaria certification.To achieve this goal,the following measures are recommended,taking advantage of opportunities,giving full play to advantages,overcoming disadvantages and avoiding risks:1.SO strategy.By further consolidating infrastructure construction,strengthening personnel skills training,doing a good job in port vector control,unimpeded joint prevention and control mechanism,ensure that imported malaria cases of port monitoring and post-entry supervision in place to prevent the local spread of imported malaria.2.ST strategy.By means of health care centers contacting outbound labor dispatching agencies and ports to contact travel agencies in epidemic areas,we will further strengthen the publicity and education of the key population of labor and tourism to Africa.On the basis of consolidating the awareness rate of malaria knowledge,we will conscientiously raise the awareness of outbound personnel on disease prevention.3.WO strategy.Seize the opportunity of institutional reform,expand the right of the Customs to speak in the quarantine supervision of entryand exit personnel,share information with immigration management,commerce,tourism,port operations and other departments,amend and improve the existing health and quarantine related laws,and strengthen the pertinence and effectiveness of disease surveillance for returnees.4.WT strategy.Continuously improve the port health quarantine workflow,improve the detection rate of cases at the time of entry,and continue to provide free malaria testing services at health centers and ports,provide follow-up consultation services for malaria cases detected at the port,and work with local disease control departments.Diagnosis and treatment of imported malaria cases. |
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