Abstract:

The blood smears and basic information of 272 malaria patients in 28 Provinces (Municipalities and Autonomous regions) in 2019 were randomly selected. According to the rough estimation of the parasite density, patients with parasite density higher than 4 000/μl and/or with complications were defined as in severe conditions. Following the definition and information recorded in the National Information System for Parasitic Disease Prevention and Control, the consistency between conditions of malaria patients and their therapeutic strategies (hospitalization or outpatient treatment) and medication regimens (injection or oral medication). One hundred sixty-three patients were categorized as severe cases, including 160 with high parasite density and 3 with complications but low parasite density. The patients tended to have complications (P < 0.05) with higher parasite density. First visits and treatment of most patients were in County, Prefecture and provincial medical agencies (83.82%, 228/272; 96.32%, 262/272). Patients visited and treated in Prefecture medical agencies were the most (40.81%, 111/272; 48.90%, 133/272) among medical facilities of different levels. The proportion of hospitalized patients was 77.94% (212/272), and the proportion of patients treated with injections was 57.93% (157/271). The general trend was to hospitalize those with severe conditions (92.02%, 150/163), while patients with mild conditions were treated as outpatients (7.98%, 13/163) (χ² = 46.92, P < 0.05). The trend of treatment methods for malaria patients in the county, prefecture, and provincial tertiary medical institutions was consistent with the general trend (P < 0.05). The overall trend of the patient’s medication regimen was that patients with severe disease were administrated with therapies (66.67%, 108/162), and those with mild disease were administrated with oral antimalarial therapies (55.05%, 60/109) (χ² = 12.61, P < 0.05). Only the drug use in prefecture-level medical institutions was consistent with the overall trend (χ² = 7.17, P < 0.05), while the trend in the county and provincial medical institutions was not significant (χ² = 0.62, 1.36, P > 0.05). The proportion of patients whose treatment and drug regimens were inconsistent with the condition was 27.53% (75/272) and 37.83% (103/272), respectively. The treatment measures implemented by the primary medical facilities for the treatment of malaria are generally good.

Key words: parasite density, Injection, Oral medication, Medical agency, Blood smears