疟疾防控关键措施第一章——晚上不要被蚊子咬

这是达医晓护的第6458篇文章

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根据国家重点研发计划“战略性科技创新合作”项目《中坦医学大语言模型开发与智能机器人部署联合研究计划》（项目编号：2026YFE0208200）的要求，来自坦桑尼亚的Lawrence N. Mdegela博士来到中国交流访问，并与中南大学人文学院的周雯娟副教授合作创建了《全球健康笔记》子刊。

在非洲，很多朋友都会面对疟疾的困扰。

疟疾在中国的俗称是“打摆子”，这个俗称形象地描述了疟疾发作时典型的高热和寒颤症状。在新中国刚成立的时候，中国有十分之一的人口都在经历“打摆子”。为了改变新中国传染病肆虐的现实，中国共产党于1952年发起了爱国卫生运动，在此期间疟疾在中国的流行率被大大地降低了。

这也是为什么现在的中国人对疟疾十分陌生。我们从小到大，无论是自己还是身边的人，谁都没有得过疟疾。

而撒哈拉以南的非洲是全球疟疾的主要疫区。

2025年，全球估计有2.82亿例疟疾病例，约有61万人死于疟疾；全球病例的95%和死亡人数的95%都发生在撒哈拉以南的非洲。

在撒南非洲工作和生活的中国朋友，也不得不面对疟疾的威胁。我们团队近年在非洲疟疾高度流行区域进行了走访调查，取得了一些与疟疾防控有关的研究成果。接下来，我们将通过科普专栏的方式，把这些研究发现分享给有需要的朋友，希望能帮助大家在非洲有效预防疟疾。今天分享的是第一篇：晚上不要被蚊子咬。

对疟疾有所了解的人都知道，疟疾是由蚊子传播的。疟疾的传播媒介是一种叫做“按蚊”的蚊种。这种蚊子在撒南非洲分布非常广泛，种群数量也十分庞大。但是很少有人知道，传播疟疾的“按蚊”基本上只在晚上咬人。

蚊子主要有三个种类，伊蚊、库蚊和按蚊。

白天咬人的蚊子是伊蚊，就是大家俗称的“花蚊子”，它们身上全都有非常惹眼的黑白条纹。伊蚊相当凶猛，就喜欢在白天追着人叮咬，也因此它们还有个外号叫“虎蚊”，像老虎一样猛。伊蚊不仅凶猛，还能传播很多疾病，比如：登革热、黄热、基孔肯雅热，但是伊蚊不能传播疟疾。

除了伊蚊以外，另外两种蚊子——库蚊和按蚊，都是晚上咬人的蚊种。先说说库蚊，如果你在在中国的家里被蚊子咬了，基本上都是库蚊干的。因为一方面库蚊喜欢晚上在室内咬人，另一方面它们喜欢在地沟、下水道这样的人工污水通道里产卵，所以库蚊是国内人居环境里的主要蚊种，这也是它们的俗称“家蚊”的由来。不过库蚊也不能传播疟疾。

唯一能够传播人类疟疾的蚊种只有“按蚊”。按蚊是一种夜行性生物，这意味着它们基本只在夜间活动。按蚊的生活作息和太阳相反，太阳将要落山的时候它们开始活跃，夜幕深沉时它们的活动达到高峰，而当太阳初升时它们逐渐停止活动。

因此在非洲，如果你晚上能呆在室内，可以使用室内防蚊工具，如蚊帐、蚊香、电蚊液、家用杀虫剂等，预防蚊子叮咬；如果你晚上不得不呆在室外，可以随身带上驱蚊液，隔段时间给全身喷洒一次，也能达到很好的防蚊效果。

总之，在撒南非洲，如果你在日落后直至日出前（包括黄昏和清晨），尽可能防止蚊子叮咬，就能大概率地避免疟疾感染。

斯瓦西里语

Barani Afrika, watu wengi wanaugua malaria.

Nchini China, malaria ilijulikana kwa jina la utani “kutetemeka”, linaloeleza kwa uwazi dalili za kawaida za homa kali na baridi kali wakati wa shambulio la malaria. Mwanzoni mwa Jamhuri ya Watu wa China, takriban mtu mmoja kati ya watu kumi alikuwa akiugua aina hii ya “kutetemeka”. Ili kukabiliana na kuenea kwa magonjwa ya kuambukiza katika taifa hilo jipya, China ilizindua Kampeni ya Kitaifa ya Afya ya Kizalendo mwaka 1952. Katika kipindi hicho, kiwango cha maambukizi ya malaria nchini China kilipungua kwa kiasi kikubwa. Mwaka 2021, Shirika la Afya Duniani (WHO) lilitangaza kuwa China ilikuwa imetokomeza malaria.

Hali hii pia inaeleza kwa nini watu wengi nchini China leo hawaifahamu malaria vizuri.

Afrika Kusini mwa Jangwa la Sahara ndiyo eneo kuu duniani ambako malaria imeenea na ni ugonjwa unaoendelea kuwepo.

Inakadiriwa kuwa mwaka 2024 kulikuwa na visa milioni 282 vya malaria duniani, na takriban watu 610,000 walikufa kutokana na ugonjwa huo. Kanda ya Afrika ilichangia asilimia 94 ya visa vyote na asilimia 95 ya vifo vyote vilivyosababishwa na malaria.

Tutashiriki matokeo ya tafiti kuhusu malaria kupitia mfululizo wa makala za kuelimisha umma kuhusu sayansi, kwa lengo la kuwasaidia watu wanaohitaji taarifa hizi kujikinga ipasavyo dhidi ya malaria barani Afrika.

Inafahamika kuwa malaria husambazwa na mbu. Mbu wanaosambaza malaria ni wa jenasi ya Anopheles. Mbu hawa wanapatikana kwa wingi katika eneo lote la Afrika Kusini mwa Jangwa la Sahara. Hata hivyo, watu wachache wanajua kwamba mbu wa Anopheles huwauma watu hasa nyakati za usiku.

Kuna makundi makuu matatu ya mbu yanayotajwa hapa: Aedes, Culex na Anopheles.

Mbu wanaouma wakati wa mchana ni wa kundi la Aedes, ambao hutambulika kwa mistari ya rangi nyeusi na nyeupe inayoonekana wazi kwenye miili yao. Mbu wa Aedes huwa na tabia ya kuwatafuta na kuwauma watu wakati wa mchana. Hawasambazi malaria, lakini wanaweza kusambaza magonjwa kadhaa, yakiwemo homa ya dengue, homa ya manjano na homa ya chikungunya.

Makundi mengine mawili ya mbu, Culex na Anopheles, huwauma watu hasa usiku. Ukiumwa na mbu ukiwa nyumbani nchini China, kuna uwezekano mkubwa kuwa ni mbu wa kundi la Culex. Hii ni kwa sababu mbu wa Culex hupendelea kuwauma watu ndani ya nyumba usiku na kutaga mayai katika mifereji ya maji iliyotengenezwa na binadamu, kama vile mitaro na mifereji ya maji taka. Kwa hiyo, mbu wa Culex ndio wanaopatikana zaidi katika makazi nchini China; hali hii pia inaeleza jina lao la utani, “mbu wa nyumbani”. Hata hivyo, mbu wa Culex hawasambazi malaria.

Malaria ya binadamu husambazwa na mbu wa Anopheles pekee. Mbu hawa huwa hai usiku: huanza shughuli zao wakati wa machweo, hufikia kilele baada ya giza kuingia, na shughuli zao hupungua alfajiri.

Kwa hiyo, ukiwa barani Afrika, ni vyema kubaki ndani ya nyumba usiku kila inapowezekana. Njia za kupunguza mbu ndani ya nyumba ni pamoja na kutumia vyandarua vilivyotiwa dawa ya kuua wadudu, koili za kufukuza mbu, vifaa vya umeme vya kufukuza mbu na dawa za kunyunyizia ndani ya nyumba. Njia hizi husaidia kupunguza hatari ya kuumwa na mbu. Ikiwa ni lazima uwe nje usiku, paka dawa ya kufukuza mbu kwenye ngozi iliyo wazi na urudie kupaka kulingana na maelekezo ya bidhaa.

Kwa ufupi, katika eneo la Afrika Kusini mwa Jangwa la Sahara, unaweza kupunguza kwa kiasi kikubwa hatari ya kupata malaria kwa kuchukua tahadhari dhidi ya kuumwa na mbu kuanzia machweo hadi alfajiri.

英语

In Africa, many people suffer from malaria.

In China, malaria is commonly known as "shaking", a nickname that vividly describes the typical symptoms of high fever and chills during a malaria attack. At the very beginning of the People's Republic of China, one-tenth of the population was suffering from this kind of "shaking". To address the reality of rampant infectious diseases in the new country, China launched the Patriotic Health Campaign in 1952. During this period, the prevalence of malaria in China was significantly reduced. In 2021, the WHO declared China free of malaria.

This also explains why contemporary Chinese people are largely unfamiliar with malaria.

Sub-Saharan Africa is the primary endemic region for malaria worldwide.

There were an estimated 282 million cases of malaria in 2024 in the world, with approximately 610,000 deaths attributable to malaria. And the African Region was home to 94% and 95% of malaria cases and deaths, respectively.

We will share the findings about malaria through a science popularization column, aiming to help people in need effectively prevent malaria in Africa.

It is well known that malaria is transmitted by mosquitoes. The vector for malaria is a specific species of mosquito called Anopheles. These mosquitoes are widely distributed across sub-Saharan Africa and exist in vast numbers. However, few people are aware that these Anopheles mosquitoes primarily bite people at night.

There are three main species of mosquitoes: Aedes, Culex, and Anopheles.

Mosquitoes that bite during the day are Aedes mosquitoes which are characterized by striking black-and-white stripes across their bodies. Aedes mosquitoes prefer to chase people and bite them during daytime. Aedes mosquitoes cannot transmit malaria, but they can transmit several diseases, including dengue, yellow fever, and chikungunya fever.

The other two mosquito species, Culex and Anopheles, mainly bite at night. If you get bitten by a mosquito in your home in China, it is almost certainly a Culex mosquito. This is because, on one hand, Culex mosquitoes prefer to bite people indoors at night; on the other hand, they prefer to lay eggs in artificial sewage channels such as gutters and sewers. Consequently, Culex mosquitoes are the predominant mosquito species in living environments in China, which also explains their common nickname "house mosquitoes". However, Culex mosquitoes do not transmit malaria.

Human malaria is spread exclusively by Anopheles mosquitoes. They are active at night: starting at sunset, peaking after dark, and stopping at dawn.

Therefore, in Africa, you should stay indoors at night whenever possible. Indoor mosquito control methods, such as insecticide-treated nets, mosquito coils, electric repellents, or indoor sprays, are highly effective for preventing bites. If you must be outdoors at night, apply a mosquito repellent to exposed skin and reapply as needed; this offers reliable protection against mosquito bites.

In short, in Sub-Saharan Africa, you can greatly reduce your risk of malaria by taking precautions against mosquito bites from dusk to dawn.

作者：中南大学人文学院

周雯娟 副教授

上海市同济医院急诊创伤救治中心

甘迪 副主任医师

纳尔逊·曼德拉非洲科学技术研究所（NM-AIST）

Lawrence N. Mdegela 博士

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所有人名和地名均为化名，如有雷同，纯属巧合。