Challenges in malaria elimination: the epidemiological characteristics of Plasmodium vivax in China from 2011 to 2018

doi:10.12140/j.issn.1000-7423.2019.05.005

Abstract

Abstract:

Objective To analyze the epidemiological characteristics of Plasmodium vivax in China from 2011 to 2018 so as to provide the evidence-based technical and theoretical support for the elimination of malaria in China. Methods The epidemiological data of P. vivax infection was collected from 31 provinces (municipalities, autonomous regions excluding Hong Kong, Macau and Taiwan) from 2011 to 2018. The data of epidemic situation, regional distribution, infection source were analyzed. Results A total of 7 768 P. vivax infected cases were reported in 30 provinces (municipalities and autonomous regions) except for Qinghai from 2011 to 2018, accounting for 30.0% of the total reported malaria cases (7 768/25 874). The reported of P. vivax cases have declined from 2 634 cases (accounting for 58.6% of the total malaria cases) in 2011 to 352 cases (accounting for 14.0% of the total malaria cases) in 2018. The reported P. vivax cases were mainly distributed in Yunnan (48.6%, 3 772/7 768), Anhui (7.9%, 612/7 768), Sichuan (7.8%, 604/7 768), Hunan (4.6%, 354/7 768), and Henan (3.9%, 303/7 768). Only 3 local vivax malaria cases were reported in 2016. There was no local P. vivax case reported in 2017 and 2018. The imported 6 227 P. vivax cases were reported in 30 provinces during 2011-2018, mainly in Yunnan (50.7%, 3 160/6 227), Sichuan (9.4%, 585/6 227), Hunan (5.6%, 349/6 227), Henan (4.8%, 297/6 227) and Guangxi (4.4%, 271/6 227). Totally 65 countries in 4 continents were recorded as the sources of P. vivax infection for the imported cases. 4 232 P. vivax cases (68.0%, 4 232/6 227) were imported from 16 countries in Asia including Myanmar (54.9%, 3 419/6 227), Indonesia (4.2%, 264/6 227), and Pakistan (2.9%, 182/6 227). A total of 1 556 cases (25.0%, 1 556/6 227) were imported from 44 countries in Africa including Ethiopia (9.3%, 580/6 227), Ghana (2.5%, 155/6 227) and Equatorial Guinea (1.5%, 96/6 227). Besides, 17 P. vivax cases were imported from 4 countries in South America (0.3%, 17/6 227), and 60 cases imported from 2 countries in Oceania (1.0%, 60/6 227). Conclusion P. vivax cases were reported decreasingly from 2011 to 2018. No local P. vivax cases occurred in China in 2017 and 2018. However, the imported P. vivax infection source has been identified in 65 countries from Africa, Asia, South America and Oceania. Therefore, the measures in elimination and post-elimination should continue to be strengthened to prevent re-establishment of the imported vivax malaria.

Key words: Malaria, Plasmodium vivax, China, Incidence, Elimination

CLC Number:

R531.3

Li ZHANG, Jun FENG, Hong TU, Zhi-gui XIA, Shui-sen ZHOU. Challenges in malaria elimination: the epidemiological characteristics of Plasmodium vivax in China from 2011 to 2018[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2019, 37(5): 532-538.

Figures/Tables 3

Table 1

Table 2

Table 3

The infection source distribution of abroad-imported P. vivax cases in China during 2011-2018

国家 Countries	2011	2012	2013	2014		2015	2016	2017	2018	合计 Total
非洲
东南部非洲Southeast Africa
埃塞俄比亚Ethiopia	16	26	41	105		114	118	78	82	580
苏丹Sudan	9	15	23	15		16	1	4	2	85
莫桑比克Mozambique	3	3	5	1		2	2	0	2	18
坦桑尼亚Tanzania	1	3	0	0		1	2	8	1	16
乌干达Uganda	1	4	0	0		3	3	1	3	15
马拉维Malawi	3	1	1	1		1	1	0	0	8
吉布提Djibouti	0	0	0	0		0	0	1	5	6
肯尼亚Kenya	0	1	0	1		1	1	0	0	4
埃及Egypt	0	1	1	0		0	1	0	0	3
卢旺达Rwanda	0	1	0	0		0	1	0	1	3
赞比亚Zambia	1	1	0	0		0	0	1	0	3
马达加斯加Madagascar	2	0	0	0		1	0	0	0	3
津巴布韦Zimbabwe	0	0	0	0		0	0	1	0	1
南苏丹South Sudan	0	0	0	0		0	1	0	0	1
厄立特里亚Eritrea	0	0	0	0		1	0	0	0	1
小计 Subtotal	36	56	71	123		140	131	94	96	747
西部非洲West Africa
加纳Ghana	11	21	93	7		7	8	5	3	155
尼日利亚Nigeria	24	21	10	2		16	7	7	7	94
利比里亚Liberia	5	12	6	5		3	3	2	4	40
几内亚Guinea	4	3	4	4		7	8	2	0	32
科特迪瓦Côte d′Ivoire	5	1	2	1		3	5	1	2	20
塞拉利昂Sierra Leone	0	3	3	3		4	2	1	1	17
马里Mali	2	2	2	0		0	1	1	1	9
多哥Togo	0	0	2	3		1	0	0	0	6
贝宁Benin	1	1	2	2		0	0	0	0	6
布基纳法索Burkina Faso	0	0	1	0		0	1	0	0	2
毛里塔尼亚Mauritania	0	0	0	2		0	0	0	0	2
塞内加尔Senegal	1	1	0	0		0	0	0	0	2
尼日尔Niger	0	0	0	0		0	0	0	1	1
小计Subtotal	53	65	125	29		41	35	19	19	386
中部非洲Central Africa
赤道几内亚Equatorial Guinea	17	26	11	9		14	13	5	1	96
安哥拉Angola	19	13	16	13		17	10	3	4	95
刚果（金）The Democratic Republic of Congo	5	8	6	5		12	16	10	8	70
喀麦隆Cameroon	2	7	2	7		18	9	6	1	52
刚果（布） The Republic of Congo	4	3	5	1		5	9	4	3	34
加蓬Gabon	3	4	5	1		2	1	1	0	17
乍得Chad	1	3	1	2		1	0	0	0	8
布隆迪Burundi	0	0	0	0		1	1	4	1	7
中非共和国The Central African Republic	1	0	1	0		0	0	0	1	3
小计Subtotal	52	64	47	38		70	59	33	19	382
南部非洲South Africa
南非South Africa	2	3	2	2		2	0	0	0	11
纳米比亚Namibia	0	0	0	1		0	0	0	0	1
科摩罗Comoros	0	0	0	1		0	0	0	0	1
小计Subtotal	2	3	2	4		2	0	0	0	13
北部非洲 North Africa
阿尔及利亚Algeria	0	2	0	0		0	0	0	0	2
利比亚Libya	0	1	0	0		0	0	0	0	1
小计Subtotal	0	3	0	0		0	0	0	0	3
其他 Others	15	7	0	1		1	1	0	0	25
小计Subtotal	158	198	245	195		254	226	146	134	1 556
亚洲Asia
东南亚Southeast Asia
缅甸Myanmar	856	554	478		422	424	306	225	154	3 419
印度尼西亚Indonesia	23	17	44		111	26	22	14	7	264
柬埔寨Cambodia	104	0	18		6	11	3	10	9	161
老挝Laos	19	32	2		0	10	26	12	4	105
泰国Thailand	0	1	3		3	1	0	0	0	8
越南Vietnam	2	1	0		1	2	1	1	0	8
马来西亚Malaysia	2	1	0		1	0	1	0	0	5
东帝汶Timor-Leste	1	3	0		0	0	0	0	0	4
孟加拉国Bangladesh	0	0	0		0	0	0	1	0	1
菲律宾The Philippines	0	0	0		0	1	0	0	0	1
小计Subtotal	1 007	609	545		544	475	359	263	174	3 976
东亚 East Asia
韩国Republic of Korea	0	1	0		1	0	1	1	1	5
朝鲜Democratic People’s Republic of Korea	0	1	1		0	1	1	0	0	4
小计Subtotal	0	2	1		1	1	2	1	1	9
南亚 South Asia
巴基斯坦Pakistan	16	25	19		15	10	17	60	20	182
印度India	5	13	13		13	6	7	2	4	63
阿富汗Afghanistan	0	2	0		0	0	0	0	0	2
小计Subtotal	21	40	32		28	16	24	62	24	247
小计Subtotal	1 028	651	578		573	492	385	326	199	4 232
南美洲 South America
圭亚那Guyana	1	0	1		1	1	0	5	1	10
委内瑞拉Venezuela	0	0	0		0	0	0	1	3	4
厄瓜多尔Ecuador	0	0	1		0	0	0	1	0	2
巴西Brazil	0	1	0		0	0	0	0	0	1
小计Subtotal	1	1	2		1	1	0	7	4	17
大洋洲Oceania
巴布亚新几内亚Papua New Guinea	4	4	4		8	0	9	15	11	55
所罗门群岛Solomon Islands	0	0	1		0	0	2	2	0	5
小计 Subtotal	4	4	5		8	0	11	17	11	60
不详国家 Unknown countries	241	47	29		21	20	0	0	4^a	399
总计 Total	1 432	901	859		798	767	622	496	352	6 227

Table 3

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年份Year	总病例 Total case			本地感染病例 Indigenous case			输入性病例 Imported case
年份Year	病例数 No. of malaria case	间日疟病例数 No. of P. vivax case	间日疟占比/% Proportion of P. vivax case/%	病例数 No. of malaria cases	间日疟病例数 No. of P. vivax case	间日疟占比/% Proportion of P. vivax case/%	病例数 No. of malaria case	间日疟病例数 No. of P. vivax case	间日疟占比/% Proportion of P. vivax case/%
2011	4 498	2 634	58.6	1 308	1 202	91.9	3 190	1 432	44.9
2012	2 718	1 080	39.7	244	179	73.4	2 474	901	36.4
2013	4 128	930	22.5	86	71	82.6	4 042	859	21.3
2014	3 078	846	27.5	56	48	85.7	3 022	798	26.4
2015	3 116	805	25.8	39	38	97.4	3 077	767	24.9
2016	3 143	625	19.9	3	3	100	3 139	622	19.8
2017	2 675	496	18.5	0	0	-	2 672	496	18.6
2018	2 518	352	14.0	0	0	-	2 511	352	14.0
合计Total	25 874	7 768	30.0	1 736	1 541	88.8	24 127	6 227	25.8

省（直辖市、自治区） Provinces(Municipalities/Autonomous Regions)	间日疟病例数 No. of P. vivax case	本地感染间日疟病例 No. of local P. vivax case	境外输入性间日疟病例 No. of imported P. vivax case
云南 Yunnan	3 772	612	3 160
安徽 Anhui	612	564	48
四川 Sichuan	604	19^a	585
湖南 Hunan	354	5	349
河南 Henan	303	6^a	297
湖北 Hubei	283	92	191
广西 Guangxi	273	2	271
浙江 Zhejiang	205	15^a	190
广东 Guangdong	203	4^a	199
贵州 Guizhou	188	137	51
福建 Fujian	154	7^a	147
山东 Shandong	147	22^a	125
江苏 Jiangsu	114	24^a	90
江西 Jiangxi	93	8^a	85
甘肃 Gansu	71	0	71
陕西 Shannxi	63	2^a	61
北京 Beijing	58	0	58
重庆 Chongqing	51	0	51
河北 Hebei	47	0	47
上海 Shanghai	37	5^a	32
辽宁 Liaoning	34	2	32
海南 Hainan	23	6	17
山西 Shanxi	17	0	17
天津Tianjin	17	0	17
西藏 Tibet	11	9	2
黑龙江 Heilongjiang	10	0	10
吉林 Jilin	9	0	9
内蒙古 Inner Mongolia	5	0	5
新疆 Xinjiang	8	0	8
宁夏 Ningxia	2	0	2
合计 Total	7 768	1 541	6 227