Analysis of epidemic situation of the imported malaria and the control strategies in Lianyungang City from 2005 to 2018

doi:10.12140/j.issn.1000-7423.2019.05.007

Abstract

Abstract:

Objective To analyze the epidemic situation of imported malaria in Lianyungang, Jiangsu from 2005 to 2018, so as to formulate a better prevention and control strategy of malaria suitable for the area.Methods Information of malaria cases identified in Lianyungang from 2005 to 2018 were collected from Infectious Diseaes Report System of Disease Control and Prevention, Malaria Epidemic, Case Investigation Data, Public Helth Intervention and other related information. The malaria database was established using Epidata 3.0 and analyzed using SPSS17.0 software.Results Total 324 cases of imported malaria were reported from 2005 to 2018 in Lianyungang region with two peaks happened in 2008 (30 cases) and 2013-2015 (54, 42 and 59 cases, respectively). The incidence of imported malaria decreased since 2016 with 36 cases in 2016, 22 cases in 2017 and 20 cases in 2018. Almost all the cases (99.1%, 321/324) were imported from abroad, with only 3 cases (0.9%) were domestically imported from other provinces in China. For those imported cases, 96.9% of them were imported from Africa, of which 39.2% from Equatorial Guinea (123 cases) and 17.2% from Angola (54 cases). All cases were male, 45.1% of them were within the age of 40-49 years old (146 cases). Most of them (91.0%, 295/324) were the migrant workers returned from abroad. There was no seasonal difference of imported malaria cases. Total 75.6% (245/324) of them were infected with Plasmodium falciparum, 4.3% (14 cases) with P. vivax, 14.5% (47 cases) with P. oval, 4.6% with P.malariae (15 cases) and 0.9% (3 cases) were the mixed-infection. Donghai county contained the most cases (46.9%, 152/324), followed by Ganyu District (33.0%, 107/324). Half of the malaria cases seeked for the first medication at local CDC (156 cases) and half at the local medical institutions (156 cases), but most of the malaria cases received confirmed diagnosis at local CDC (62.0%, 201/324). Out of all imported cases, 12 were severe malaria with 2 cases died. A KAP survey (knowledge, attitudes and practices) on malaria was performed among the people who worked abroad at the high-risk malaria areas and their families members in Donghai County, Ganyu District and other places. After education and health intervention, the knowledge awareness rate for malaria prevention, the correct attitude rate and the good practice rate increased from 19.7%, 36.9% and 76.6% to 84.4%, 88.0%, and 95.8%, respectively.Conclusion The epidemic situation of imported malaria was declined in recent years in Lianyungang City. It is important to enhance the management of the infectious sources, improve the malaria diagnosis and treatment, and strengthen the health education of migrant workers and their families in order to achieve better prevention and control of imported malaria in the area.

Key words: Imported malaria, Epidemic situation, Control strategies, Lianyungang

CLC Number:

R531.3

WANG Jin-ling, WU Zhou-wei, ZHAO Si-qi, ZHAO Zhong-shun, MAO Yan-min. Analysis of epidemic situation of the imported malaria and the control strategies in Lianyungang City from 2005 to 2018[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2019, 37(5): 545-551.

Figures/Tables 8

Fig. 1

Fig. 2

Table 1

Table 2

Table 3

Table 4

Table 5

Table 6

References 21

[1]	王金玲, 毛艳敏, 吴周伟, 等. 江苏省连云港市1951-2015年疟疾流行与防治历程及消除措施[J]. 中国热带医学, 2016, 16(6): 536-540.
[2]	曹俊, 刘耀宝, 曹园园, 等. 中国消除疟疾的持续挑战: 输入性疟疾[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(2): 93-96.
[3]	张小萍, 金小林, 高琪, 等. 健康教育干预疟疾流行的研究[J]. 中国热带医学, 2002, 2(4): 460-462.
[4]	曹俊, 周水森, 周华云, 等. 中国疟疾从控制走向消除: 消除阶段的目标策略和措施[J]. 中国血吸虫病防治杂志, 2013, 25(5): 439-443.
[5]	周华云, 王伟明, 刘耀宝, 等. 江苏省疟疾疫情预警系统的建立Ⅳ 2013年江苏省消除疟疾关键措施实施情况分析[J]. 中国血吸虫病防治杂志, 2015, 27(2): 134-138.
[6]	张振宇, 吴同浩, 葛恒明, 等. 一起归国劳务人员恶性疟疾疫情的调查处理[J]. 中国血吸虫病防治杂志, 2008, 20(6): 472, 474.
[7]	周华云, 王伟明, 刘耀宝, 等. 2013年江苏省疟疾疫情流行病学分析[J]. 中国血吸虫病防治杂志, 2014, 26(5): 514-516,521.
[8]	周华云, 王伟明, 刘耀宝, 等. 2014年江苏省疟疾疫情流行病学分析[J]. 中国血吸虫病防治杂志, 2015, 27(6): 591-594.
[9]	周华云, 王伟明, 朱国鼎, 等. 2015年江苏省疟疾疫情流行病学分析[J]. 中国血吸虫病防治杂志, 2017, 29(4): 441-444.
[10]	高扬, 尹亮, 施建军, 等. 扬州市输入性恶性疟防控体系的建立与运用[J]. 中国血吸虫病防治杂志, 2013, 25(5): 524-527, 532.
[11]	许艳, 王用斌, 赵长磊, 等. 2015-2017年山东省输入性疟疾的流行病学分析[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(1): 48-54.
[12]	金嘉杰, 王伟明, 曹园园, 等. 江苏省基层专业技术人员疟疾快速诊断试纸条相关知识态度行为调查[J]. 中国血吸虫病防治杂志, 2018, 30(4): 378-382, 414.
[13]	姚立农, 张玲玲, 阮卫, 等. 浙江省5例输入性疟疾误诊病例的病原学诊断分析[J]. 中国寄生虫学与寄生虫病杂志, 2013, 31(3): 221-223, 234.
[14]	陈友平, 徐会荣. 输入性脑型恶性疟疾死亡1例[J]. 热带医学杂志, 2012, 12(11): 1413.
[15]	杨跃杰. 输入性恶性疟疾重症病例研究[J]. 中国热带医学, 2018, 18(7): 662-665.
[16]	张丽, 丰俊, 张少森, 等. 2018年全国疟疾疫情特征及消除工作进展[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(3): 241-247.
[17]	马安翔, 蒋益宝, 温勇康, 等. 2010-2014年广西上林县国外务工返乡人员疟疾监测效果分析[J]. 现代预防医学, 2016, 43(9): 1695-1698.
[18]	周晓农, 张少森, 徐俊芳, 等. 我国消除疟疾风险评估分析[J]. 中国寄生虫学与寄生虫病杂志, 2014, 32(6): 414-418.
[19]	高琪. 我国消除疟疾面临的机遇与挑战[J]. 中国血吸虫病防治杂志, 2011, 23(4): 347-349.
[20]	雷蕾, 买买提江·吾买尔, 李志宏, 等. 输入性疟疾引起继发传播的风险评估研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2016, 34(5): 468-472.
[21]	张丽, 丰俊, 张少森, 等. 2017年全国消除疟疾进展及疫情特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(3): 201-209.

特征 Feature	病例数 No. cases						构成比/% Constituent ratio/%
特征 Feature	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	构成比/% Constituent ratio/%
性别 Gender
男Male	245	14	47	15	3	324	100
女Female	0	0	0	0	0	0	0
年龄组Age group
21~29	38	2	6	2	0	48	14.8
30~39	73	3	9	3	0	88	27.2
40~49	108	6	22	8	2	146	45.1
≥ 50	26	3	10	2	1	42	13.0
职业Occupation
工人Worker	15	1	2	1	0	19	5.9
农民Peasant	40	3	1	2	0	46	14.2
民工Migrant worker	171	3	41	10	2	227	70.1
干部职员Office staff	1	1	1	1	0	4	1.2
商业服务Business services	16	2	2	1	0	21	6.5
海员及驾驶员Seafarers and drivers	1	3	0	0	0	4	1.2
家务待业Housekeeper and unemployed	0	1	0	0	0	1	0.3
其他Others	1	0	0	0	1	2	0.6

感染来源地 Infection source	国家和地区数No. countries and regions	病例数 No. cases						构成比/%Constituent ratio/%
感染来源地 Infection source	国家和地区数No. countries and regions	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	构成比/%Constituent ratio/%
非洲Africa	18	243	6	47	15	3	314	96.9
东南亚Souteast Asia	3	0	4	0	0	0	4	1.2
大洋洲Pacific	1	1	1	0	0	0	2	0.6
南美洲South America	1	0	1	0	0	0	1	0.3
省际Domestic	3	1	2	0	0	0	3	0.9
合计Total	26	245	14	47	15	3	324	100

疟疾类型	年份Year
Malaria types	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
恶性疟Falciparum malaria	14.0	3.0	4.0	1.9	4.0	2.9	5.6	3.9	1.4	1.2	2.3	2.3	1.4	1.6
间日疟Vivax malaria	4.0	33.0	0	7.0	0	0	0	7.0	2.0	5.0	2.7	0	2.0	3.0
卵形疟Ovale malaria	0	0	0	0	0	0	0	0.5	3.5	2.8	2.8	4.1	1.7	2.0
三日疟Quartan malaria	0	0	0	0	0	0	0	0	3.8	1.0	5.7	3.7	0	3.3
混合感染Mixed infection	0	0	0	0	0	0	0	0	0	1.0	0	0	0	0
合计Total	10.7	7.3	4.0	2.0	4.0	2.9	5.6	3.7	1.7	1.6	2.6	2.8	1.6	1.9

县（区） County(District)	乡（镇）数 No. township	村数 No. village	外出国家和地区数 No. foreign countries or areas visited	调查人数 No. investigation	防蚊措施 Measures for preventing mosquito		国外发病 Had malaria abroad		回国发病 Malaria occurred after return
县（区） County(District)	乡（镇）数 No. township	村数 No. village	外出国家和地区数 No. foreign countries or areas visited	调查人数 No. investigation	有Yes	占比/%Propotion/%	病例数 No. cases	占比/% Proportion/%	病例数 No. cases	占比/% Proportion/%
东海县Donghai	19	195	45	1 057	876	82.9	127	12.0	12	1.1
赣榆区Gangyu	1	21	22	195	174	89.2	15	7.7	5	2.6
连云区Lianyun	1	12	14	56	29	51.8	14	25.0	3	5.4
合计Total	21	228	47	1 308	1 079	82.5	156	11.9	20	1.5

组别Group	出国人员People returned from abroad				家属Family members
组别Group	调查人数 No. investigation	知识知晓率/% Knowledge awareness rate%	态度正确率/%Correct attitude rate/%	行为良好率/%Good practice rate/%	调查人数 No. investigation	知识知晓率/% Knowledge awareness rate%	态度正确率/% Correct attitude rate/%	行为良好率/% Good practice rate/%
干预前Before intervention	255	27.8	37.7	80.8	360	13.9	36.4	73.6
干预后After intervention	255	89.0	92.2	98.0	360	81.1	85.0	94.2