收稿日期: 2022-06-06
修回日期: 2022-07-26
网络出版日期: 2023-02-27
Epidemiological analysis on malaria cases reported in Kunming during 2006—2021
Received date: 2022-06-06
Revised date: 2022-07-26
Online published: 2023-02-27
分析始于2010年的消除疟疾行动计划(简称行动计划)前后(2006—2010年和2011—2021年)昆明市疟疾流行特征,为防止疟疾再传播工作提供科学依据。收集中国疾病预防控制中心传染病网络直报系统中2006—2021年昆明市疟疾病例信息,以2011年作为消除疟疾开始前后的时间分隔,采用IBM SPSS Statistics v26统计软件对病例的三间分布、感染地及就诊意识和诊断能力作描述性统计分析。结果显示,2006—2021年昆明市共报告疟疾病例551例,2006—2010年和2011—2021年分别报告274、277例,报告病例数呈逐年下降趋势,其中本地感染病例5例(2006年和2008年各2例、2010年1例),输入性病例546例。疟疾病例地区分布较集中,报告病例在行动计划前后均集中分布在官渡区,分别占55.8%(153/274)、82.7%(229/277)。2006—2021年,全年各月均有疟疾病例报告,行动计划前后分别以7月(41例)和6月(48例)的报告病例数较多。年龄分布以20~49岁青壮年发病人群为主(83.5%,460/551),行动计划前后分别占82.1%(225/274)、84.8%(235/277);职业分布以农民、工人为主(57.4%,316/551),行动计划前后分别占56.6%(155/274)、58.1%(161/277)。2006—2010年疟疾病例以东南亚输入为主(73.0%,200/274),间日疟占39.1%(107/274)、恶性疟占19.0%(52/274)、未分型占42.0%(115/274);2011—2021年后以非洲输入为主(57.4%,159/277),间日疟占41.2%(114/277)、恶性疟占52.4%(145/277)、混合感染占0.2%(5/277)、未分型占4.0%(11/277)、三日疟和卵形疟各1例。疟疾病例确诊率从2006—2010年的69.7%(191/274)上升至2011—2021年的93.9%(260/277)。2006—2010年、2011—2021年的病例发病-就诊时间间隔均为2 d,差异无统计学意义(H = 0.568,P > 0.05);就诊-确诊时间间隔分别为4、3 d,二者差异有统计学意义(H = 6.423,P < 0.05)。分析表明昆明市在行动计划后已无本地感染病例,如期实现消除疟疾目标。
陈志辉 , 洪劲 , 张荣兵 , 杨倩 , 叶青 , 李建荣 , 田荣 . 2006—2021年昆明市疟疾流行特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2023 , 41(2) : 233 -237 . DOI: 10.12140/j.issn.1000-7423.2023.02.018
To analyze the epidemiological characteristics of malaria in Kunming before (2006—2010) and after the malaria elimination plan (2011—2021), which had started in 2010 to provide scientific strategies for the prevention of malaria re-transmission. Data of malaria cases in Kunming from 2006 to 2021 were collected from the Infectious Disease Network Direct Reporting System of the Chinese Center for Disease Control and Prevention. The data were grouped as pre- or post-eradication campaign, which were introduced in 2011. IBM SPSS statistics v26 statistical software was used for descriptive statistical analysis for the three spatial distributions of the cases, the place of infection, the awareness of the patients and the diagnostic capacity. The results showed that a total of 551 malaria cases were reported in Kunming from 2006 to 2021, 274 and 277 cases were reported in 2006—2010 and 2011—2021 respectively, including 5 indigenous cases (2 cases in 2006 and 2008 and 1 case in 2010) and 546 imported cases. The number of reported cases decreased over the year. The distribution of cases was concentrated, and indigenous cases were sporadically distributed in the rural regions from 2006 to 2010. The imported cases were mainly distributed in Guandu District before and after the elimination plan started, accounting for 55.8% (153/274) and 82.7% (229/277), respectively. Malaria cases were distributed in all months from 2006 to 2021, and more cases reported in July (41 cases) and June (48 cases) before and after the plan of action. In 2006—2010 and 2011—2021, the age distribution was mainly young adults aged 20-49 years (83.5%, 460/551), accounting for 82.1% (225/274) and 84.8% (235/277) respectively. The occupational distribution was mainly farmers and workers (57.4%, 316/551), accounting for 56.6% (155/274) and 58.1% (161/277) respectively. From 2006 to 2010, the cases were mainly imported from Southeast Asia (73.0%, 200/274). Of all cases, Plasmodium vivax infection accounted for 39.1% (107/274), P. falciparum infection accounted for 19.0% (52/274) and unclassified accounted for 42.0% (115/274). From 2011 to 2021, most of cases were imported from Africa (57.4%). Of all cases, P. vivax infection accounted for 41.2% (114/277), P. falciparum infection accounted for 52.4% (145/277), mixed infection accounted for 0.2% (5/277), unclassified accounted for 4.0% (11/277). Only one case of P. malariae and one case of P. ovale was reported. Before and after the initiation of the action plan, the time interval between onset of symptoms and visiting a doctor was 2 days, and the difference was not statistically significant (H = 0.568, P > 0.05). The interval between attending a health facility and diagnosis was 4 days and 3 days respectively, and the difference was statistically significant (H = 6.423, P < 0.05). The analysis showed that no indigenous cases were reported in Kunming after the action plan, and the goal of eliminating malaria has achieved as scheduled.
Key words: Malaria; Epidemiological analysis; Kunming; Malaria elimination
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