Epidemiological analysis on malaria cases reported in Shandong Province during 2015-2017

doi:10.12140/j.issn.1000-7423.2019.01.009

Abstract

Abstract:

Objective To understand epidemiological characteristics of malaria cases reported in Shandong Province, so as to provide scientific evidence for better prevention and control of malaria. Methods The data of malaria reported in Shandong Province during 2015-2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention, and the clinical manifestations of malaria cases were collected and statistically analyzed by SPSS 18.0. Results Among 676 malaria cases reported during 2015-2017, 99.85% (675/676) were imported and most of them were imported from African countries (96.75%, 654/676), mainly from Equatorial Guinea（143, 21.87%）and Angola（85, 13.00%）. All cases were laboratory confirmed with 76.04% of Plasmodium falciparum infection and 9.76% of P. vivax infection. About 1/4 patients (28.85%, 195/676) went to visit doctor on the first day with symptoms, while 38.17% (258/676) of patients went to visit doctor three or more days after they had symptoms. About 1/3 of patients were diagnosed as malaria at the first doctor visit (37.43%, 253/676) and 1/3 misdiagnosed as other diseases(31.66%, 214/676), and another 1/3 were diagnosed as malaria 3 days after the first visit (32.84%, 222/676). The accuracy for diagnoses of P. falciparum, P. vivax, P. ovale and P. malariae infections were 97.49%(504/517), 67.86% (57/84), 90.91% (50/55) and 91.67% (11/12), respectively, after being re-confirmed by provincial experts. Among 65 severe malaria patients only 17 went to see doctor on the first day with clinical symptoms(26.15%) and 18 patients were diagnosed as malaria at the first visit (27.69%). 17 cities reported malaria cases during the period (2015-2017) and 74.26% (502/676) of the total malaria cases were reported in 6 cities (Jining, Tai’an, Weihai, Yantai, Qingdao and Jinan). The imported cases were reported in all 17 cities and most of them (59.32%, 401/676) distributed in 5 cities (Tai’an, Yantai, Weihai, Jining and Qingdao). More young and middle-aged men were infected. The minimum age was 16 years old, the maximum age was 65, and the median age was 41 years old. They were mainly peasants（422,62.43%）. Conclusions Total 676 malaria cases were reported in Shandong Province during 2015-2017 and 96.75% of them were imported from Africa. The rates for going to see doctor on the first day with clinical symptoms and the accurate diagnosis with malaria on the first visit were low.

Key words: Malaria, Epidemiological analysis, Shandong Province

CLC Number:

R531.3

Yan XU, Yong-bin WANG, Chang-lei ZHAO, Xiu-qin BU, Long-jiang WANG, Xiang-li KONG. Epidemiological analysis on malaria cases reported in Shandong Province during 2015-2017[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2019, 37(1): 48-54.

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感染来源地Source of infection		恶性疟 Falciparum malaria	间日疟 Vivax malaria	卵形疟 Ovale malaria	三日疟 Quartan malaria	合计 Total
非洲Africa
	赤道几内亚 Equatorial Guinea	101	12	25	5	143
安哥拉 Angola		69	4	9	3	85
刚果（布）Republic of Congo		40	5	9	1	55
尼日利亚 Nigeria		46	2	3	0	51
几内亚 Guinea		31	2	1	1	35
刚果（金）Congo-kinshasa		24	4	3	1	32
加纳 Ghana		27	1	2	0	30
	莫桑比克 Mozambique	22	1	3	1	27
	喀麦隆 Cameroon	22	2	1	0	25
	坦桑尼亚 Tanzania	18	0	1	2	21
	利比里亚 Liberia	13	2	4	1	20
	乌干达 Uganda	16	0	2	2	20
	科特迪瓦 Cote d′lvoire	11	1	1	1	14
	埃塞俄比亚 Ethiopia	1	8	3	0	12
	塞拉利昂 Sierra Ieone	10	0	1	1	12
	南苏丹 South Sudan	7	1	2	0	10
	赞比亚 Zambia	9	0	1	0	10
	加蓬 Gabon	6	0	1	0	7
	苏丹 Sudan	3	4	0	0	7
	乍得 Chad	6	0	0	0	6
	肯尼亚 Kenya	5	0	0	0	5
	马拉维 Malawi	3	0	0	1	4
	贝宁 Benin	3	0	0	0	3
	布隆迪 Burundi	1	2	0	0	3
	马达加斯加 Madagascar	3	0	0	0	3
	马里 Mali	3	0	0	0	3
	津巴布韦 Zimbabwe	1	0	1	0	2
	卢旺达 Rwanda	1	0	1	0	2
	南非 South Africa	2	0	0	0	2
	不详Unknown countries in Africa	1	0	1	0	2
	多哥 Togo	1	0	0	0	1
	尼日尔 Niger	1	0	0	0	1
	冈比亚 Gambia	1	0	0	0	1
南美洲
	委内瑞拉 Venezuela	0	0	1	0	1
亚洲Asia
	巴基斯坦 Pakistan	0	6	0	0	6
	印度尼西亚 Indonesia	1	3	0	0	4
	缅甸 Myanmar	0	3	0	0	3
	柬埔寨 Cambodia	2	0	0	0	2
	阿联酋 The United Arab Emirates	1	0	0	0	1
	韩国 Korea	0	1	0	0	1
	伊拉克 Iraq	1	0	0	0	1
	印度 India	0	1	0	0	1
	菲律宾 The Philippines	1	0	0	0	1
合计Total		514	65	76	20	675

	初诊结果（占比/%） First diagnosis results (Proportion/%)			确诊时间初诊结果（占比/%） Confirmed diagnosis day (Proportion/%)
诊疗机构Diagnosis institution	疟疾 Malaria	其他疾病 Other diseases	合计 Total	当日 On the first day	3 d内 Within 3 d	超过3 d After 3 d	合计 Total
医疗机构Medical institution	413（66.40%）	209（33.60%）^a	622（100%）	222（36.16%）	183（29.80%）	209（34.04%）^b	614（100%）
省级医疗机构Province-level hospital	72（84.71%）	13（15.29%）^a	85（100%）	30（18.75%）	59（36.88%）	71（44.38%）^a	160（100%）
地市级医疗机构City-level hospital	219（89.75%）	25（10.25%）	244（100%）	136（40.72%）	100（29.94%）	98（29.34%）	334（100%）
县级医疗机构County-level hospital	112（63.64%）	64（36.36%）	176（100%）	56（46.67%）	24（20.00%）	40（33.33%）	120（100%）
县级以下医疗机构Clinic	5（4.50%）	106（95.50%）	111（100%）	-	-	-
疾控机构CDC	41（91.11%）	4（8.89%）	45（100%）	26（47.27%）	16（29.09%）	13（23.64%）	55（100%）
检验检疫机构Inspection and quarantine institution	8（88.89%）	1（11.11%）	9（100%）	5（71.43%）	2（28.57%）	0（0）	7（100%）

报告情况Reported malaria	病例数 No. case	恶性疟 Falciparum malaria		间日疟 Vivax malaria		卵形疟 Ovale malaria		三日疟 Quartan malaria
报告情况Reported malaria	病例数 No. case	病例数 No. cases	占比/% Proportion/%	病例数 No. cases	占比/% Proportion/%	病例数 No. cases	占比/% Proportion/%	病例数 No. cases	占比/% Proportion/%
恶性疟Falciparum malaria	517	504	97.49	4	0.77	6	1.16	3	0.58
间日疟Vivax malaria	84	3	3.57	57	67.86	18	21.43	6	7.14
卵形疟Ovale malaria	55	1	1.82	4	7.27	50	90.91	0	0
三日疟Quartan malaria	12	1	8.33	0	0	0	0	11	91.67
混合感染Mixed infection	1	0	0	0	0	1	100	0	0
未分型Unclassfied	7	5	71.43	1	14.29	1	14.29	0	0
合计Total	676	514	76.04	66	9.76	76	11.24	20	2.96

特征Feature	重症病例Severe cases		非重症病例Non-severe cases		合计 Total
特征Feature	病例数No. cases	占比/% Proportion/%	病例数No. cases	占比/% Proportion/%	合计 Total
就诊情况Doctor visit
当日On the first day	17	26.15	178	29.13^a	195
3 d内Within 3 d	19	29.23	204	33.39	223
超过3 d After 3 d	29	44.62	229	37.48	258
确诊情况Diagnosis
当日On the first day	18	27.69	235	38.46^b	253
3 d Within 3 d	14	21.54	187	30.61	201
超过3 d After 3 d	33	50.77	189	30.93	222
网报结果Reported results
准确 Accurate	59	90.77	563	92.14^a	622
不准确Inaccurate	6	9.23	48	7.86	54

特征 Feature	境内输入Imported from other province		境外输入 Overseas imported		合计 Total
	病例数No. cases	构成比/% Proportion/%	病例数 No. cases	构成比/% Proportion/%	合计 Total
性别 Gender
男 Male	1	0.15	670	99.11	671
女 Female	0	0	5	0.74	5
年龄组/岁 Age group/Year
10~19	0	0	3	0.44	3
20~29	0	0	113	16.72	113
30~39	1	0.15	183	27.07	184
40~49	0	0	267	39.50	267
50~59	0	0	105	15.53	105
≥ 60	0	0	4	0.59	4
职业 Occupation
农民 Peasant	1	0.15	421	62.28	422
工人 Worker	0	0	138	20.41	138
干部职员 Office staff	0	0	39	5.77	39
家务及待业 Housekeeper and unemployed	0	0	35	5.18	35
商业服务 Business services	0	0	22	3.25	22
其他 Others	0	0	20	2.96	20