In order to effectively protect people's health, promote coordinated economic and social development, and respond to the global malaria eradication initiative put forward by the United Nations High-level Meeting on the Millennium Development Goals, our government has decided to carry out malaria eradication in an all-round way in 20 10, eliminate malaria in most areas in 20 15, and achieve the national goal of eliminating malaria in 2020. This action plan is formulated in order to define tasks and measures and implement departmental responsibilities. According to the malaria epidemic report from 2006 to 2008, the whole country is divided into the following four categories by county.
First-class counties: counties with local infection cases within three years, and the incidence rate is greater than or equal to one in ten thousand.
Class II counties: counties with local infection cases within 3 years, and the incidence rate is less than 1/10000 in at least 1 year.
Third-class counties: epidemic counties with no reports of local infection cases for 3 years.
Four types of counties: non-malaria endemic areas. (a) the overall goal.
By 20 15, there were no local malaria cases in Yunnan except some border areas. By 2020, the country will achieve the goal of eliminating malaria.
(2) Stage objectives.
1. All three counties will achieve the goal of eliminating malaria by 20 15.
2. By 20 15, there were no local malaria cases in all Class II and Class I counties except some border areas in Yunnan; By 20 18, the goal of eliminating malaria will be achieved.
3. By 20 15, the incidence of malaria in the first-class counties in the border areas of Yunnan will drop below110000; By 20 17, there were no local malaria cases; Achieve the goal of eliminating malaria by 2020.
(3) Work indicators.
Achieve the following indicators by April 38, 2065:
1. Skills training.
(1) More than 95% of the relevant personnel in provincial, prefectural and county-level disease prevention and control institutions and township health centers in Class I, II and III counties have received training on malaria prevention and control knowledge and skills and requirements for eliminating malaria.
(2) More than 95% clinicians in clinics of township medical institutions in provinces, cities, counties and first and second class counties have received training in malaria diagnosis and treatment knowledge, and laboratory inspectors have received training in microscopic examination skills of plasmodium blood smear.
(3) More than 95% clinicians in the first and second class county-level medical institutions and the third class county-level medical institutions have received basic knowledge training on malaria prevention and treatment.
(4) More than 95% of health and quarantine personnel have been trained in malaria prevention and control knowledge and skills.
2. Blood test of plasmodium in patients with fever.
(1) The proportion of general hospitals and disease prevention and control institutions that can carry out plasmodium blood tests in all provinces, prefectures and cities reaches100%; The proportion of general hospitals and disease prevention and control institutions that can carry out plasmodium blood tests in the first, second and third counties reached100%; The proportion of township medical institutions that can carry out blood tests of plasmodium in first-and second-class counties reaches 90%.
(2) The annual total number of plasmodium blood tests for patients with "three fevers" in Class I and II counties and towns (clinically diagnosed as malaria, suspected malaria and fever with unknown causes) shall not be less than 2% of the population in this area and1%; The total number of plasmodium in the blood test of patients with "three fever" in three counties every year is not less than 2‰ of the population in the jurisdiction. The number of blood tests in malaria transmission season shall not be less than 80% of the total blood tests in the whole year.
(3) The laboratory detection rate of malaria cases reached 100%, and the laboratory diagnosis rate reached 75%.
(4) Entry-exit inspection and quarantine institutions screened 100% of patients with fever who entered from overseas malaria endemic areas.
3. Case report, treatment and case investigation.
Within 24 hours after diagnosis, the reporting rate reached 100%, the standardized treatment rate of malaria cases reached 100%, and the epidemiological case investigation rate reached 100%.
4. deal with the epidemic.
The disposal rate of epidemic spots in Class I counties reached 50%, Class II counties reached 70%, and Class III counties reached 100%.
5. Media control.
During the malaria transmission season, the coverage rate of protective facilities such as long-lasting mosquito nets, impregnated mosquito nets and screen doors and screens for residents in Class I and II counties reached 80%.
6. Health education.
(1) The awareness rate of malaria prevention knowledge among residents in the first and second class counties is 70%, and that of primary and secondary school students is 75%; The awareness rate of malaria prevention and control knowledge of frontier ports and health and quarantine related staff reached 90%.
(2) The proportion of publicity materials on malaria prevention and control in entry-exit ports, international travel health care centers and other places reached 90%.
Achieve the following goals by 20 15:
1. Skills training.
(1) Relevant personnel of provincial, prefectural and county-level disease prevention and control institutions and township health centers of Class I, II and III counties have received training on malaria prevention and control knowledge and skills and requirements for malaria elimination, with the proportion reaching 100%.
(2) Clinicians in outpatient departments of township medical institutions in provinces, cities, counties and first-and second-class counties have received training in malaria diagnosis and treatment knowledge, and laboratory inspectors have received training in microscopic examination skills of plasmodium blood smear, reaching 65,438+000%.
(3) The proportion of clinicians receiving basic knowledge training on malaria prevention and control in the first and second class county-level medical institutions and the third class county-level medical institutions reached 100%.
(4) The proportion of health and quarantine personnel who have received training on malaria prevention and control knowledge and skills reaches 100%.
2. Blood test of plasmodium in patients with fever.
(1) The proportion of general hospitals and disease prevention and control institutions that can carry out plasmodium blood tests in all provinces, prefectures and cities remains at100%; The proportion of general hospitals and disease prevention and control institutions that can carry out plasmodium blood tests in the first, second and third counties remains at100%; The proportion of township medical institutions that can carry out plasmodium blood tests in first-and second-class counties reaches 100%.
(2) The annual total number of plasmodium blood tests for patients with "three fevers" in Class I and II counties and towns is not less than 65,438 0% and 2 ‰ of the population in the jurisdiction respectively; The total number of plasmodium in the annual blood test of patients with "three fever" in three types of counties is not less than 2‰ of the population in the jurisdiction. The number of blood tests in malaria transmission season shall not be less than 80% of the total blood tests in the whole year.
(3) The proportion of malaria cases confirmed in the laboratory reached 100%.
(4) The entry-exit inspection and quarantine institutions shall keep the proportion of malaria screening for fever patients from overseas malaria endemic areas at 100%.
3. Case report, treatment and case investigation.
Within 24 hours after diagnosis, the reporting rate remained at 100%, the standardized treatment rate of malaria cases remained at 100%, and the epidemiological case investigation rate remained at 100%.
4. deal with the epidemic.
The epidemic disposal rate reached 100%.
5. Media control.
During the malaria transmission season, the coverage rate of protective facilities such as long-lasting mosquito nets, impregnated mosquito nets and screen doors and screens for residents in Class I and II counties reached 90%.
6. Health education.
(1) The awareness rate of malaria prevention and control knowledge among residents in Class I and II counties reached 80%, and that of primary and secondary school students reached 85%; The awareness rate of malaria prevention and control knowledge of frontier ports and health and quarantine personnel reached 100%.
(2) The proportion of malaria prevention publicity materials at entry-exit ports, international travel health care centers and other places reached 65,438 0.000%.
Achieve the following goals by 2020:
1. Cancel the examination and certification.
100% of malaria-endemic counties have completed the evaluation and certification of malaria elimination.
2. Laboratory diagnosis of suspected malaria patients.
(1) Medical and health institutions and disease prevention and control institutions at or above the county level in the former endemic counties all have facilities and capabilities for plasmodium blood test.
(2) All suspected malaria patients were tested for plasmodium in the laboratory.
(3) All malaria cases whose epidemiology cannot determine the source of infection have been identified by the national laboratory. First-class counties strengthen measures to control the source of infection and vectors to reduce the incidence of malaria. Second-class counties eliminate the source of malaria infection and block the local transmission of malaria. Three types of counties strengthen the monitoring and disposal of imported cases to prevent secondary transmission. Four types of counties should handle imported cases well. All localities can adjust their prevention and control strategies in a timely manner according to the prevention and control process and changes in the epidemic situation.
(a) to strengthen the control and management of infectious sources.
1. Find malaria patients in time. All kinds of medical and health institutions at all levels should carry out microscopic examination of plasmodium blood slides or rapid diagnostic test paper (RDT) for patients with "three fevers". If the RDT test is positive, blood samples must be collected and stored for future reference.
2. Standardize the treatment of malaria patients. All kinds of medical and health institutions at all levels shall treat malaria patients found in accordance with the principles of using antimalarial drugs and drug use plans issued by the Ministry of Health. All malaria patients should be supervised to take medicine throughout the course.
3. Strengthen malaria epidemic reporting. All kinds of medical and health institutions at all levels shall report malaria cases in accordance with the provisions of the Law of People's Republic of China (PRC) on the Prevention and Control of Infectious Diseases and the Management Standard for Information Reporting of Infectious Diseases.
4. Case verification. County-level disease prevention and control institutions should immediately carry out microscopic examination and verification of plasmodium blood films for all malaria cases directly reported by the network, and complete the epidemiological case investigation within 3 working days. In counties where the incidence of malaria has dropped to below1100000 in the last year, provincial disease prevention and control institutions have carried out laboratory pathogen confirmation and genetic analysis on all malaria cases reported by the network.
5. deal with the epidemic. In natural villages or residential areas (epidemic spots) where malaria cases occur and have transmission conditions, county-level disease prevention and control institutions will organize case search, collect blood samples from people with fever history in the past two weeks for microscopic examination or RDT detection of plasmodium, and at the same time take corresponding media control measures for all households in epidemic spots, distribute malaria prevention and control publicity materials and provide information on malaria consultation services.
6. Radical treatment during the rest period. During the rest period of malaria transmission, the patients with vivax malaria in the previous year were treated with anti-recurrence treatment.
(2) Strengthen media control.
1. Mosquito control. During the malaria transmission season, all localities should combine the patriotic health campaign and the construction of new countryside to carry out environmental transformation and governance, reduce mosquito breeding grounds and reduce mosquito density. Measures such as spraying pesticide residues indoors and treating mosquito nets with pesticides have been taken in epidemic areas.
2. Strengthen personal protection. During the malaria transmission season, residents in epidemic areas are encouraged to use mosquito repellent, mosquito incense, mosquito nets, screen doors and screens and other protective measures to reduce human-mosquito contact.
(3) Strengthen health education.
1. Strengthen mass media publicity and education. Newspapers, radio, television, internet and other news media should combine the activities of National Malaria Day to widely publicize malaria prevention and control knowledge and national malaria elimination policies in various forms, so as to raise residents' awareness of self-protection and their enthusiasm for participating in malaria prevention and elimination.
2. Strengthen health education for entry-exit personnel. Entry-exit inspection and quarantine institutions shall set up public service billboards or electronic large screens at entry-exit ports, place publicity materials on malaria prevention and control in entry-exit passenger passages, and carry out malaria prevention and control knowledge propaganda. The tourism department shall, under the guidance of the health department, organize the training of malaria prevention and control knowledge for tour leaders, tour guides and tourists.
3. Strengthen health education for primary and secondary school students. Education departments should deploy and arrange health education in primary and secondary schools, and disease prevention and control institutions should strengthen guidance on health education in primary and secondary schools. Primary and secondary schools in Class I and II counties should carry out health education on malaria prevention and control in combination with health education classes or theme classes under the guidance of disease prevention and control institutions, and infiltrate relevant knowledge into families through the way of "holding hands with small hands".
4. Strengthen community publicity and education. In Class I and II counties, local disease prevention and control institutions organize relevant units to set up malaria prevention and control knowledge bulletin boards in hospital waiting halls, community health service centers, township hospitals, village clinics, large-scale construction sites and other places, and update the contents regularly. Prepare publicity materials suitable for the characteristics of local ethnic languages.
(4) Strengthen malaria prevention and control of floating population.
1. Establish and improve the information notification system. Health, quality inspection and other departments regularly release malaria epidemic situation and related information to the public at home and abroad. The tourism department shall, in accordance with the unified deployment of the health department, regularly or irregularly release malaria epidemic situation at home and abroad and related information to tourists. Departments regularly exchange work information.
2. Strengthen malaria protection for entry-exit personnel. Entry-exit inspection and quarantine institutions shall publicize malaria prevention knowledge and provide consulting services to exit personnel, conduct malaria screening for fever patients entering from overseas malaria endemic areas, and report malaria epidemic situation; Cooperate with the tracking of malaria cases of entry-exit personnel and provide malaria case information to relevant departments in a timely manner. Tourism, commerce and other departments shall require relevant units to cooperate with the health department to publicize and train the knowledge of malaria prevention and control for entry-exit personnel; Cooperate to provide relevant personnel information and assist related work.
3. Do a good job in malaria prevention and control of floating population in China. Units that implement large-scale construction projects in malaria-endemic areas shall provide necessary malaria protection articles for construction personnel and cooperate with local disease prevention and control institutions to do a good job in malaria prevention and control. The malaria cases of floating population shall be managed territorially, and the disease prevention and control institutions in the places where the cases are imported and exported shall communicate with each other in a timely manner. Public security and health departments should cooperate closely to do a good job in tracking malaria cases of floating population, screening key populations and communicating relevant information.
(5) Improve the malaria monitoring and testing network.
1. Strengthen the capacity building of malaria diagnosis laboratories. China Center for Disease Control and Prevention is responsible for laboratory identification and traceability of cases; Provincial disease prevention and control institutions are responsible for pathogen identification and genetic testing of malaria cases in counties where the incidence rate dropped below 100,000 last year; County-level disease prevention and control institutions are responsible for reviewing the blood films of all malaria patients reported by the network, and taking at least 5% negative blood films of fever patients. Laboratories at all levels should conduct regular skill evaluation and quality control to ensure the normal operation of the laboratory network.
2. Monitoring in malaria-free areas. For areas and non-endemic provinces that have reached the goal of elimination, it is necessary to continue to carry out training on malaria diagnosis and treatment techniques for relevant medical personnel, focusing on strengthening case monitoring of people from malaria-endemic areas to prevent secondary cases. (1) Strengthen government leadership and improve management mechanism.
The establishment of a departmental coordination meeting system, led by the relevant departments of the Ministry of Health, with the participation of relevant departments of the relevant departments (bureaus), is responsible for the coordination of malaria elimination and the formulation and implementation of relevant policies.
People's governments at all levels should incorporate malaria eradication into the local economic and social development plan, into the government's target management assessment content, clarify responsibilities and tasks, strengthen organization and coordination, improve policies and measures, solve outstanding problems, and ensure that the work is in place. Key provinces (regions) should set up a leading group to eliminate malaria, strengthen leadership, make plans and implement tasks. Other regions have established corresponding leadership and coordination mechanisms according to local conditions. The work of eliminating malaria in the military system is organized and implemented according to the military management system, and is implemented simultaneously with the work plan of eliminating malaria of the resident people's government. Malaria prevention and control work of armed police and public security forces in active service is under the unified leadership of local governments in accordance with the principle of territorial management.
(two) clear departmental responsibilities, strengthen the implementation of measures.
All departments should cooperate closely, carry out their duties and work together to eliminate malaria. Under the unified leadership of the State Council, the Ministry of Health coordinates relevant departments to study and formulate guidelines, policies, plans and measures for malaria eradication, and is responsible for overall coordination. The development, reform and finance departments are responsible for incorporating malaria elimination into national economic and social development plans, arranging special funds for malaria prevention and elimination, and strengthening fund supervision. Entry-exit inspection and quarantine, public security, tourism, commerce and other departments cooperate with the health department to do a good job in malaria health education, case monitoring and entry-exit disease prevention management of relevant entry-exit personnel, and communicate relevant information with the health department in time. Radio and television departments are responsible for arranging various forms of malaria prevention and control knowledge publicity. The education department is responsible for the publicity and education of malaria prevention and control knowledge in primary and secondary schools. Science and technology departments will incorporate malaria prevention and eradication research projects into the national science and technology plan. The Ministry of Industry and Information Technology is responsible for organizing and coordinating the production and supply of antimalarial drugs and reagents. The Ministry of Health of the General Logistics Department is responsible for the organization, implementation, supervision and management of malaria eradication in the military system.
(three) in accordance with laws and regulations, to carry out the work of eliminating malaria.
All regions and relevant departments should conscientiously implement the Law on the Prevention and Control of Infectious Diseases in People's Republic of China (PRC), the Emergency Regulations on Public Health Emergencies, the Frontier Health and Quarantine Law of People's Republic of China (PRC), the National Emergency Plan for Public Health Emergencies, the Emergency Plan for Malaria Outbreaks, and the Emergency Plan for Public Health Emergencies and Infectious Diseases.
(four) to strengthen the team building, improve the technical level.
All provinces, cities and counties should establish and improve professional teams for malaria prevention and control. In the first-class and second-class counties with heavy tasks, county-level disease prevention and control institutions set up special departments and equipped with effective personnel, and township hospitals have special personnel responsible for malaria prevention and control. In other second-class counties and third-class counties, county-level disease prevention and control institutions are equipped with full-time malaria prevention professionals who are suitable for the prevention and control tasks, and township hospitals have special personnel responsible for malaria prevention and control. It is necessary to carry out professional and technical training step by step and in batches to ensure the training effect and improve the professional level of personnel.
(5) Increase financial input and raise funds through multiple channels.
According to the principle of graded burden, local people's governments at all levels will include the funds needed for malaria eradication in their financial budgets according to the local malaria epidemic situation and the actual situation of malaria eradication. The central government supports malaria control in poverty-stricken areas. At the same time, it is necessary to mobilize and strive for funds and materials from all walks of life to support malaria eradication.
(six) to carry out scientific research and provide technical support.
Through the national science and technology plan and other channels to support the research on key technologies to eliminate malaria, organize interdisciplinary joint research, study malaria transmission dynamics, drug resistance monitoring of plasmodium, eliminate vivax malaria, and develop new and effective rapid diagnostic reagents and pathogen traceability technology.
(7) Strengthening international exchanges and cooperation.
Actively carry out international exchanges and cooperation, introduce and popularize advanced and applicable technologies, and make full use of internationally funded projects such as the Global Fund for Malaria Eradication. Establish a cross-border malaria prevention and control cooperation mechanism to accelerate the pace of malaria control and elimination in the border areas of China. (1) Target responsibility system and accountability system.
According to the requirements of this action plan and the actual situation, all localities should formulate their own implementation plans and programs. All relevant regions should decompose the work objectives and tasks at different levels and sign the target responsibility book. For those who fail to achieve the work objectives, the administrative responsibilities of the relevant responsible persons shall be investigated.
(2) supervision and inspection.
All localities should, in accordance with the principle of "scientific, quantitative and random", formulate detailed supervision and inspection plans, and conduct comprehensive assessment and evaluation of the work content and implementation effect through self-examination and spot checks that combine regular and irregular work. It is necessary to timely feedback the supervision and inspection situation to the inspected unit. The Ministry of Health will, in conjunction with relevant departments, organize inspections and briefings on the implementation of action plans in relevant areas from time to time.
(3) evaluation.
The epidemic provinces (autonomous regions and municipalities directly under the Central Government) should pay close attention to the organization to evaluate the counties (cities, districts) that have reached the stage goal and complete the confirmation of malaria elimination in this province in 2020.
Annex Classification of malaria endemic areas in China