收稿日期: 2024-04-25
修回日期: 2024-07-22
网络出版日期: 2024-10-21
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
Received date: 2024-04-25
Revised date: 2024-07-22
Online published: 2024-10-21
Supported by
National Parasite Resource Center of China(2019-194-30);Fujian Provincial Health Science and Technology Plan(2022QNA061)
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。
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 . DOI: 10.12140/j.issn.1000-7423.2024.05.011
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
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