2014—2023年福建省输入性疟疾疫情特征分析

doi:10.12140/j.issn.1000-7423.2024.05.011

中国寄生虫学与寄生虫病杂志 ›› 2024, Vol. 42 ›› Issue (5): 635-641.doi: 10.12140/j.issn.1000-7423.2024.05.011

2014—2023年福建省输入性疟疾疫情特征分析

肖丽贞(), 欧阳榕, 陈朱云, 林耀莹, 郑丹, 谢汉国^*()

福建省疾病预防控制中心，福建省人兽共患病研究重点实验室，福建福州 350011

收稿日期:2024-04-25 修回日期:2024-07-22 出版日期:2024-10-30 发布日期:2024-10-21
通讯作者: * 谢汉国（1972—），男，本科，主任技师，从事寄生虫病防控与研究工作。E-mail：xiehanguo@163.com
作者简介:肖丽贞（1991—），女，本科，主管医师，从事寄生虫病防控与研究工作。E-mail：463250013@qq.com
基金资助:
国家寄生虫资源库(2019-194-30);福建省卫生健康科技计划(2022QNA061)

Epidemiological characteristics of imported malaria in Fujian Province from 2014 to 2023

XIAO Lizhen(), OUYANG Rong, CHEN Zhuyun, LIN Yaoying, ZHENG Dan, XIE Hanguo^*()

Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou 350011, Fujian, China

Received:2024-04-25 Revised:2024-07-22 Online:2024-10-30 Published:2024-10-21
Contact: * E-mail: xiehanguo@163.com
Supported by:
National Parasite Resource Center of China(2019-194-30);Fujian Provincial Health Science and Technology Plan(2022QNA061)

摘要/Abstract

摘要：

目的分析2014—2023年福建省输入性疟疾病例的疫情特征，为巩固消除疟疾成果提供科学依据。方法在中国疾病预防控制中心传染病报告信息管理系统和寄生虫病防治信息管理系统中收集2014年1月1日—2023年12月31日福建省报告的疟疾病例信息，对报告病例的感染虫种、感染来源地、三间分布、就诊和诊断情况等进行统计，采用卡方检验或方差分析比较差异。结果 2014—2023年福建省共报告疟疾病例825例，均为境外输入性病例，且均为实验室确诊病例，其中恶性疟607例、间日疟129例、卵形疟62例、三日疟23例、恶性疟和卵形疟混合感染4例。新型冠状病毒感染（简称“新冠”）疫情前后（2014—2019年及2023年）恶性疟病例占比为74.7%（567/759），其他病例（间日疟、卵形疟、三日疟和混合感染）占比为25.3%（192/759）；新冠疫情期间（2020—2022年）恶性疟病例占比为60.6%（40/66），其他病例占比为39.4%（26/66）；新冠疫情期间与新冠疫情前后报告病例的诊断分类占比差异有统计学意义（χ²= 6.207，P < 0.05）。报告病例的感染来源地分布在4个洲的42个国家，其中非洲32个国家输入748例、亚洲7个国家输入51例，大洋洲1个国家输入24例，南美洲2个国家输入2例。各地市均有输入性疟疾病例报告，其中福州市占75.2%（620/825）；全省共56.0%（47/84）的县（市、区）有输入性疟疾病例报告，福州市鼓楼区报告病例数最多（占71.1%，587/825）。每个月均有输入性疟疾病例报告，月平均报告病例数为6.88例；新冠疫情期间的月平均报告病例数为1.83例，低于新冠疫情发生前后（9.04例）（t = 12.229，P < 0.05）。报告病例中男性占90.1%（743/825），女性占9.9%（82/825），男女性别比为9.1:1；年龄主要集中在30~39岁、40~49岁组（共60.4%，498/825）。病例共由89家机构报告，从发病到就诊的时间间隔中位数为2 d；74.3%（613/825）的病例在发病3 d内就诊，4.9%（40/825）的病例发病超过7 d才就诊；恶性疟病例发病3 d内就诊比例（77.3%，469/607）高于其他诊断分类病例（66.0%，144/218）（χ² = 10.547，P < 0.05）。从就诊到确诊的时间间隔中位数为0 d；83.4%（688/825）的病例在就诊3 d内确诊，5.5%（45/825）的病例在就诊7 d后确诊；恶性疟病例3 d内确诊的比例（86.3%，524/607）高于其他诊断分类病例（75.2%，164/218）（χ² = 14.262，P < 0.05）。2014—2023年共报告重症疟疾病例43例，占疟疾报告病例总数的5.2%（43/825）；其中1例为恶性疟和卵形疟混合感染病例，其余42例均为恶性疟病例。结论 2014—2023年福建省报告疟疾病例均为输入性病例。输入性疟疾是福建省今后防控工作的重点，应加强出入境人员的健康教育和医务人员的诊断能力，防止疟疾输入再传播。

关键词: 疟疾, 输入性病例, 福建省

Abstract:

Objective To analyze the epidemiological characteristics of imported malaria in Fujian Province from 2014 to 2023, so as to provide scientific evidence for consolidating the achievements of malaria elimination. Methods The information of reported malaria cases in Fujian Province from January 1, 2014 to December 31, 2023 were collected from the data system of National Information System for Infectious Disease Surveillance and the National Information System for Parasitic Disease Control and Prevention. Of the collected information, malaria species, infection sources, three-dimentional distribution, medical consultation and diagnosis were analyzed statistically. Chi-square test or ANOVA were used for comparison of differences. Results A total of 825 imported malaria cases were reported in Fujian Province during 2014-2023, all of them were imported cases from abroad. The laboratory diagnosis found that 607 cases were infected with Plasmodium falciparum, 129 P. vivax, 62 P. ovale, 23 P. malariae and 4 mixed infection of P. falciparum and P. ovale. From 2014 to 2019 and 2023 (before or after the COVID-19 epidemic) and from 2020 to 2023 (during the COVID-19 epidemic), the proportion of falciparum malaria cases was 74.7% (567/759) before and after the COVID-19 epidemic, and 60.6% (40/66) during the COVID-19 epidemic. The proportion of other cases (vivax malaria, ovale malaria, quartan malariae and mixed infection) was 25.3% (192/759) before and after the COVID-19 epidemic and 39.4% (26/66) during the COVID-19 epidemic. The difference of diagnosis classification proportion of reported cases was statistically significant between the COVID-19 epidemic period and before or after the COVID-19 epidemic (χ² = 6.207, P < 0.05). The reported cases were imported from 42 countries in four continents. The malaria cases originated from 32 countries in Africa (748 cases), 7 countries in Asia (51 cases), 1 country in Oceania (24 cases) and 2 countries in South America (2 cases). Malaria cases were reported from all 9 cities, mainly from Fuzhou (75.2%, 620/825). A total of 56.0% (47/84) of the counties (cities and districts) reported imported malaria cases, with Gulou District of Fuzhou accounting for 71.1% (587/825). There were cases reported in every month, with an average of 6.88 cases per month. The monthly average number of reported cases during the COVID-19 epidemic was 1.83, which was lower than that before or after the COVID-19 epidemic (9.04 cases) (t = 12.229, P < 0.05). Among the reported cases, males accounted for 90.1% (743/825), females for 9.9% (82/825), with a male-to-female ratio being 9.1 : 1. The cases were mainly at the age of 30-39 years and 40-49 years (60.4%，498/825). Cases were reported from 89 institutions. The median interval between onset and initial visit was 2 days. Most of the malaria cases (74.3%, 613/825) visited doctor 3 days after outset of disease, but 4.9% (40/825) of the cases consulted doctor over 7 days after outset. The proportion of patients seeking treatment within 3 days of onset of falciparum malaria (77.3%, 469/607) was higher than that of other classified cases (66.0%, 144/218) (χ² = 10.547, P < 0.05). The median time interval between initial diagnosis and diagnosis was 0 days. 83.4% (688/825) of the cases were diagnosed as malaria within 3 days; 5.5% (45/825) of the cases spent more than 7 days of time span from initial visit to confirmed diagnosis. The proportion of falciparum malaria cases diagnosed within 3 days (86.3%, 524/607) was higher than that of other classified cases (75.2%, 164/218) (χ²= 14.262, P < 0.05). A total of 43 severe malaria cases were reported in Fujian Province from 2014 to 2023, accounting for 5.2% (43/825) of the total reported malaria cases. Among them, 1 case was a mixed infection of P. falciparum and P. ovale, and the other 42 cases were infected with P. falciparum. Conclusion All malaria cases reported in Fujian Province from 2014 to 2023 were imported cases. Imported malaria is the key target in prevention and control work in Fujian Province in the future. It is inperative to further strengthen health education for inbound and outbound persons, and the technical capability of medical personnel in diagnosis.

Key words: Malaria, Imported cases, Fujian Province

中图分类号:

R531.3

肖丽贞, 欧阳榕, 陈朱云, 林耀莹, 郑丹, 谢汉国. 2014—2023年福建省输入性疟疾疫情特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(5): 635-641.

XIAO Lizhen, OUYANG Rong, CHEN Zhuyun, LIN Yaoying, ZHENG Dan, XIE Hanguo. Epidemiological characteristics of imported malaria in Fujian Province from 2014 to 2023[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2024, 42(5): 635-641.

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病例诊断分类 Diagnostic classification of cases	新冠疫情前后 Before or after the COVID-19 epidemic		新冠疫情期间 During the COVID-19 epidemic
病例诊断分类 Diagnostic classification of cases	病例数/例 No. case/case	占比/% Proportion/%	病例数/例 No. case/case	占比/% Proportion/%
恶性疟 Falciparum malaria	567	74.7	40	60.6
间日疟 Vivax malaria	112	14.8	17	25.8
卵形疟 Ovale malaria	54	7.1	8	12.1
三日疟 Quartan malaria	22	2.9	1	1.5
混合感染 Mixed-infection	4	0.5	0	0
合计 Total	759	100	66	100

2014—2023年福建省输入性疟疾疫情特征分析

Epidemiological characteristics of imported malaria in Fujian Province from 2014 to 2023

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感染来源地 Infection source	恶性疟 Falciparum malaria	间日疟 Vivax malaria	卵形疟 Ovale malaria	三日疟 Quartan malaria	混合感染 Mixed- infection	合计 Total
非洲 Africa
尼日利亚 Nigeria	100	11	10	5	1	127
刚果民主共和国 The Democratic Republic of the Congo	85	3	9	2	0	99
喀麦隆 Cameroon	64	6	12	4	0	86
加纳 Ghana	55	4	10	0	0	69
安哥拉 Angola	41	3	1	2	0	47
莫桑比克 Mozambique	41	2	2	0	0	45
科特迪瓦 Côte d'Ivoire	42	0	0	1	1	44
乌干达 Uganda	20	4	4	2	0	30
几内亚 Guinea	20	3	1	0	0	24
埃塞俄比亚 Ethiopia	2	18	1	0	0	21
坦桑尼亚 Tanzania	15	2	0	2	1	20
赤道几内亚 Equatorial Guinea	15	3	0	0	0	18
赞比亚 Zambia	16	0	1	0	0	17
利比里亚 Liberia	10	3	2	0	0	15
加蓬 Gabon	11	1	2	0	0	14
塞拉利昂 Sierra Leone	9	0	2	1	0	12
其余16个国家 16 other countries	52	2	2	3	1	60
亚洲 Asia
缅甸 Myanmar	1	15	1	0	0	17
柬埔寨 Cambodia	2	10	0	0	0	12
印度尼西亚 Indonesia	2	9	0	0	0	11
印度 India	0	5	0	0	0	5
巴基斯坦 Pakistan	0	3	0	0	0	3
菲律宾 Philippines	1	0	0	0	0	1
老挝 Laos	0	2	0	0	0	2
大洋洲 Oceania
巴布亚新几内亚 Papua New Guinea	2	19	2	1	0	24
南美洲 South America
巴西 Brazil	1	0	0	0	0	1
圭亚那 Guyana	0	1	0	0	0	1
合计 Total	607	129	62	23	4	825

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