目的 分析2021年云南省勐腊县常住人口死因构成、死亡水平,为制定针对性预防措施和卫生策略提供科学依据.方法 收集"中国疾病预防控制信息系统"报告的死亡日期为2021年1月1日-2021年12月31日且现住址为勐腊县的死亡病例,按照《国际疾病分类第10版》(ICD-10)进行死因编码及分类,再进行描述性统计分析.结果 2021年勐腊县共报告死亡2 039例,其中男性1 254例、女性785例,男女比1.60:1,不同年龄组男女死亡构成比差异有统计学意义(x2=81.47,P＜0.01).粗死亡率为668.64/10万(男性777.60/10万、女性546.34/10万),标化死亡率为748.93/10万(男性857.48/10万,女性625.62/10万),男性标化死亡率是女性的1.37倍.全人群及分性别死亡率按年龄分布均呈"√"形趋势.按疾病分类依次为慢性病(标化死亡率为727.39/10万)、损伤和中毒(标化死亡率为84.02/10万)、传染病/母婴及营养缺乏性疾病(标化死亡率为22.93/10万)及其他(标化死亡率为5.54/10万):死亡原因前五位依次为脑血管病、心脏病、恶性肿瘤、损伤和中毒和呼吸系统疾病,占死亡总数的84.70％.结论 预防和控制慢性病及伤害仍是该县当前和近几年的工作重点,应建立健全健康教育体系,普及健康科学知识,教育引导群众树立正确健康观,规范慢性病防治健康科普管理.

Objective To compare the breeding habits and insecticide resistance level of Aedes aegypti in key areas of dengue fever in China and Laos, and to guide scientific and rational selection of insecticides. Methods The Breteau index（BI） method was used to examine all water containers in residential areas in Mengla and Menghai counties of China and Luang Prabang city of Laos. Mosquito larvae in positive containers were collected and identified. The collected Ae. aegypti larvae were reared to adult mosquitoes in the laboratory, followed by testing their resistance levels to common insecticides using the filter paper contact method. Results A total of 800 households were investigated, of which 78 households were positive for Aedes mosquitoes. A total of 1 194 water containers or ponding（hereinafter referred to as containers） of seven types were found, with 109 being positive. The mean BI was 13.63. Buckets were the most common type of water containers, accounting for 37.10%. The most common Aedes positive containers belonged to other temporary containers, accounting for 30.28%. There were 18 containers（16.51%） positive for Ae. albopictus mosquitoes, and 91（83.49%） positive for Ae. aegypti. The 24-hour mortality rates of Ae. aegypti in Mengla county exposed to 3.20% permethrin, 0.08% lambda-cyhalothrin, 0.27% beta-cypermethrin, 0.20% deltamethrin, 0.25%malathion, 0.25% fenitrothion, and 0.03% propoxur were 3.51%, 5.69%, 4.07%, 63.45%, 97.86%, 100%, and 80.65%,respectively. The 24-hour mortality rates of Ae. aegypti in Menghai county exposed to the above-mentioned insecticides were 8.57%, 2.86%, 3.23%, 8.24%, 92.51%, 100%, and 90.96%, respectively. The 24-hour mortality rates of Ae. aegypti in Luang Prabang city exposed to 3.20% permethrin, 0.08% lambda-cyhalothrin, 0.20% deltamethrin, 0.25% fenitrothion,and 0.03% propoxur were 67.53%, 25.47%, 72.63%, 100%, and 98.82%, respectively. Conclusions The main breeding sites of Ae. aegypti differ in China and Laos, which are water pools in Laos while bucket and other temporary containers in China. In both regions, adult Ae. aegypti mosquitoes have developed different levels of resistance to various pyrethroid insecticides, with higher resistance in China, while they are possibly resistant or sensitive to organophosphorus and carbamate insecticides. We suggest strengthening the surveillance of the population density and insecticide resistance of Ae. aegypti and selecting rational insecticides to control mosquitoes.

ObjectiveTo analyze the epidemic characteristics and trend of mosquito vectors related to Japanese encephalitis （JE） in Mengla County， and to provide scientific evidence for JE prevention and control.MethodsThe JE related mosquito vector monitoring data in Mengla County from 2016 to 2020 were collected and subjected to further statistical analysis.ResultsA total of 1 689 mosquitoes were captured at the JE mosquito vector monitoring sites in Mengla County， 36.3% of which were captured in 2020 and 13.3% in 2017. The density of Culex tritaeniorhynchus was the highest （3.04 per lamp per day）， and that of Anopheles sinensis was the lowest （1.03 per lamp per day）. The distribution of mosquito species showed significant difference in the same year. The mosquito density in pig house was 12.93 per lamp∙day， and that in human house was 4.67 per lamp∙day. The mosquito density of different mosquito species in pig house was higher than that in human house. There was no significant difference in the site distribution of Anopheles sinensis， but there were significant differences in the site distribution of Culex tritaeniorhynchus， Culex pipiens quinquefasciatus and other mosquito species. The mosquito density peaked in May （12.78 per lamp per day） and July （10.28 per lamp per day）. The temporal distribution showed that the vector density decreased gradually from May to October， however， the species population structure also varied significantly， and the trends of each mosquito species also varied greatly. In Mengla， Culex tritaeniorhynchus peaked in May.ConclusionThe JE epidemic situation in Mengla County is still severe. It is recommended to strengthen prevention and control in the peak season of mosquito activities， such as actively carrying out patriotic health campaigns， and effective public education. At the same time， we should also strengthen the JE vaccination for school-age children and the training of medical personnel.

目的 了解2006-2020年云南省西双版纳傣族自治州(西双版纳州)登革热流行特征和媒介伊蚊分布特点.方法 采用描述性流行病学方法对登革热病例资料进行分析.采用布雷图指数(BI)法对伊蚊幼蚊密度进行监测并对部分捕获蚊虫进行种类鉴定.Excel 2010和ArcGIS 10.2软件用于建立病例和媒介伊蚊数据库并制图,采用SPSS 17.0软件进行相关性分析.结果 2006-2020年西双版纳州共确诊登革热8 583例,其中输入性病例767例(8.94％),本地病例7 816例(91.06％),年平均发病率为118.77/10万,2019年发病率最高,为327.44/10万.西双版纳州景洪、勐腊和勐海县(市)几乎每年均有登革热疫情,分别占全州报告发病数的84.97％(7 293/8 583)、10.42％(894/8 583)和4.61％(396/8 583).其中,景洪市年平均发病率为223.74/10万,2019年发病率高达614.02/10万.全州93.75％的乡镇(30/32)有登革热病例报告,其中景洪市和勐腊县10个乡镇发生本地流行.全年各月均有登革热输入性病例,本地病例发生在6-12月,高峰期为8-10月.病例年龄最小为5月龄,最大93岁,以20～59岁年龄组为主.病例男女性别比例为1.01∶1,职业主要为商业服务者、农民、离退休人员、家务及待业者.2013-2020年西双版纳州4个幼蚊密度监测点6-10月BI为10～50,其他月份BI＜10,景洪市历年各月BI高于其他县.景洪、勐腊和勐海县(市)所有32个乡镇均有白纹伊蚊分布,其中21个乡镇有埃及伊蚊分布.采获的9066只幼蚊和成蚊中,埃及伊蚊、白纹伊蚊和其他蚊种构成比依次为33.65％(3 051/9 066)、35.24％(3 195/9 066)和31.11％(2 820/9 066).结论 2006-2012和2020年西双版纳州仅有登革热输入性病例,2013、2015-2019年每年都发生登革热输入性病例和本地病例的共同流行,来自老挝、缅甸的输入性病例是引起本地流行的主要原因,登革热季节分布与蚊虫密度升高密切相关.西双版纳州未发现全年和跨年传播登革热现象,该地区的登革热仍属输入性疾病.登革热输入性病例的监测、管理和防蚊灭蚊是防止该地区登革热本地流行的重要措施.

目的 分析勐腊县疟疾流行及媒介按蚊监测情况,为今后疟疾防控策略调整提供依据.方法 运用Excel对勐腊县疟疾流行状况及按蚊监测数据进行汇总和描述性分析,应用SPSS 22.0进行统计学分析.结果 1965-2018年,勐腊县共发现疟疾45798例,平均发病率为392.5/10万,最高发病率为1985年的1161.4/10万,2005年开始疟疾疫情持续大幅下降.2005-2018年报告疟疾病例705例,年平均发病率为21.0/10万,发病率逐年下降(x2=1408.563,P＜0.001),2013年最后1例本地病例后,未再出现本地病例报告,之后散在发现输入性病例.疟疾病例男女性别比2.42∶1,职业前3位为农民274例(占38.9％)、民工142例(20.1％)和工人85例(12.1％);地区上呈散发态势.疟疾分型为间日疟585例(83.0％)、恶性疟95例(13.5％)和未分型25例(3.5％).2013-2016年共开展按蚊监测86次,平均密度为0.7只/(灯·夜),中华按蚊占78.7％(174/221),监测按蚊种类逐年减少.结论 勐腊县疟疾流行取得了明显的防控效果,初步达到消除疟疾的目标,但输入性疟疾的威胁将长期存在.

目的 分析2018年勐腊县城区登革热暴发时的流行病学特征、媒介生物学特性等变化情况,为登革热的防控提供依据. 方法 对勐腊城区疑似登革热病例进行流行病学调查,并开展登革病毒NS1抗原快速检测,首例病例用RT-PCR进行登革病毒核酸检测及型别鉴定;采用背负式吸蚊器法和布雷图指数法分别开展媒介伊蚊成蚊和幼虫的监测;采用三间分布法对疫情特征进行描述,计算成蚊密度和幼虫密度,采用x2检验对不同类型孳生阳性率进行比较分析. 结果 本次疫情共发现病例59例,罹患率为161.38/10万,流行历时77 d.8月份为发病高峰,患者男女比为0.68∶1,以青壮年为主,从事职业以商业服务、离退休和家中待业居多;捕获埃及伊蚊和白纹伊蚊成蚊1 340只,其中埃及伊蚊占80.15％.幼虫监测,13 148户,阳性784户,积水容器13 387个,阳性1 067个,总BI为8.12、总HI为5.96、总CI为7.97％.积水容器类型构成以水桶为主,其次为花瓶.水缸、花瓶、废旧轮胎、竹筒、菜坛、水桶、废弃瓶/罐、其他暂时性容器的伊蚊幼蚊阳性率分别为7.17％、6.07％、24.79％、15.15％、10.12％、6.51％、16.62％、和6.42％. 结论 2018年勐腊城区登革热暴发流行的特征与既往比较无明显变化.埃及伊蚊和白纹伊蚊在城区均有分布,以埃及伊蚊为优势蚊种,其种群密度进一步扩大.废旧轮胎、竹筒和水桶等常见伊蚊幼虫孳生地,应及时清除,并开展居民区室内外灭蚊清除工作,同时加大宣传,提高居民的自我防护和家庭防护能力,提升居民参与防控的积极性,以达到群防群控.

目的 调查2017年云南省西双版纳傣族自治州(西双版纳州)登革热暴发疫情的流行病学特征和登革病毒(DENV)流行株血清型和遗传进化特征.方法 收集登革热病例资料,采集2017年该地登革热患者急性期血清标本,用反转录-聚合酶链式反应扩增DENV C/PrM和E基因核苷酸序列,用MEGA 5.0软件构建系统发生树.结果 2017年西双版纳州共确诊登革热1 348例,包括本地感染病例1 231例和输入病例1 17例.景洪市、勐腊县和勐海县均有来自老挝和缅甸的输入性病例,其中景洪市和勐腊县发生本地流行,病例数分别为1 030例和201例.流行期为5-12月,病例年龄以20～54岁为主,男女性别比为1∶1.16.从患者血清中获得48株DENV的C/PrM区基因核苷酸序列进化分析结果表明,其中46株为登革1型病毒(DENV-1;景洪市33株、勐腊县10株和勐海县3株),2株为登革2型病毒(DENV-2;勐腊县和勐海县各1株).2017年西双版纳州的老挝输入病例和本地感染病例的DENV-1流行株间高度同源,与近几年德宏州瑞丽市和临沧市耿马县及东南亚国家的DENV-1流行株具有较近的遗传进化关系.DENV-1的E基因进化分析结果与C/PrM一致.结论 DENV-1是引起2017年西双版纳州登革热暴发疫情的主要病原.来自老挝的登革热输入性病例是导致2017年西双版纳州本地登革热流行的主要原因,应加强中国-老挝和中国-缅甸边境地区登革热跨境传播的防控.