Epidemiological analysis of malaria in Hubei Province from 2015 to 2018

doi:10.12140/j.issn.1000-7423.2020.04.005

Abstract

Abstract:

Objective To understand the epidemiological characteristics of malaria in Hubei Province from 2015 to 2018, providing basis for adjusting strategies in malaria elimination.Methods Information of malaria cases reported from Hubei Province during 2015-2018 was collected through the Disease Reporting Information System of Chinese Center for Disease Control and Prevention, and the epidemiological characteristics were analyzed using descriptive epidemiological method.Results A total of 494 malaria cases were reported in Hubei Province during 2015-2018, all of them were imported from abroad. There were 120, 151, 96 and 127 malaria cases reported from 2013 to 2018, respectively. All cases were diagnosed by laboratory examination. Of them, 337 were infected with Plasmodium falciparum (68.2%), 65 with P. vivax (13.2%), 75 with P. ovale (15.2%), 14 with P. malariae (2.8%) and 3 with mixed infection (0.6%). The cases were mainly distributed in Wuhan (34.0%, 168/494), Yichang (15.2%, 75/494), Huanggang (7.9%, 39/494), Huangshi (7.1%, 35/494), Xiangyang (6.3%, 31/494) and Shiyan cities (5.7%, 28/494). The peak of disease onset occurred in January to February (26.1%, 129/494) and in May to July (27.7%, 137/494). The disease mainly occurred in age groups of 20-49 years (85.2%, 421/494). The 494 malaria cases comprised 473 males and 21 females, with a male-to-female ratio of 22.5 ∶ 1. Primary diagnosis was mainly made in medical institutions at county-level and higher (324, 65.6%), and 345 (69.8%) cases were confirmed of diagnosis with malaria upon visit first to doctor. Significant difference in the corrective rate of malaria diagnosis was found between different medical units making primary diagnosis (P < 0.05). In addition, 44.3% (219/494) of the cases were diagnosed as malaria on the day visiting doctor; they comprised cases infected by P. falciparum (49.3%, 166/337), P. vivax (41.5%, 27/65), P. ovale (32.0%, 24/75), and P. malariae (1/14), and those with mixed infection (1/3). There was a significant difference in the time from seeing a doctor to definitive diagnosis being made among different types of malaria (P < 0.05). A higher proportion (57.7%, 285/494) of the cases were diagnosed in medical institutions at the county level or higher. In addition, 94.1% (465/494) cases were imported from 30 African countries, with the leading number being Congo-Kinshasa (69, 14.0%) and Nigeria (61, 12.3%).Conclusion During 2015-2018, malaria cases in Hubei Province were all imported cases. Of them, 94.1% were imported from Africa, and 44.3% were diagnosed on the day seeking medical care.

Key words: Malaria, Imported cases, Epidemiological characteristics, Hubei Province

CLC Number:

R531.3

XIA Jing, ZHANG Hua-xun, LIU Si, WU Dong-ni, ZHANG Juan, LIN Wen, SUN Ling-cong, WAN Lun, CAO Mu-min, ZHU Hong. Epidemiological analysis of malaria in Hubei Province from 2015 to 2018[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2020, 38(4): 429-435.

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References 18

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特征	疟疾病例数 No. malaria case						构成比/%
Feature	恶性疟	间日疟	卵型疟	三日疟	混合感染	合计	Proportion/%
	Falciparum malaria	Vivax malaria	Ovale malaria	Quartan malaria	Mixed infection	Total
性别 Gender
男 Male	321	64	72	13	3	473	95.7
女 Female	16	1	3	1	0	21	4.3
年龄组/岁 Age groups/Years
10~19	2	0	0	0	0	2	0.4
20~29	77	12	22	1	0	112	22.7
30~39	80	20	20	5	1	126	25.5
40~49	129	21	26	6	1	183	37
50~59	48	12	7	2	1	70	14.2
≥ 60	1	0	0	0	0	1	0.2
职业 Occupation
工人Worker	116	24	26	4	3	173	35
民工Laborer-worker	41	2	6	4	0	53	10.7
农民 Farmer	55	14	10	3	0	82	16.6
商业服务Business services	19	0	3	1	0	23	4.7
家务及待业 Housekeeper and	17	5	10	2	0	34	6.9
unemployed	17	5	10	2	0	34	6.9
干部职员 Office staff	29	4	6	0	0	39	7.9
学生 Student	6	3	0	0	0	9	1.8
其他 Others	54	13	14	0	0	81	16.4

首诊单位	报告病例数	构成比/%	诊断为疟疾病例数	正确率/%
Initial diagnosis units	No. case	Proportion/%	No. case diagnosed as malaria	Correct diagnostic rate/%
检验检疫机构Inspection and quarantine institution	7	1.4	7	100
省级疾控机构Provincial CDC	1	0.2	1	100
地市级疾控机构Municipal CDC	13	2.6	13	100
县级疾控机构County CDC	41	8.3	40	97.6
省级医疗机构Provincial hospital	51	10.3	41	80.4
地市级医疗机构Municipal hospital	149	30.2	118	79.2
县级医疗机构County hospital	124	25.1	93	75
乡镇卫生院Town clinic	53	10.7	23	43.4
村卫生室Village clinic	28	5.7	4	14.3
个体医生Individual doctor	20	4.1	2	10
其他 Other institutions	7	1.4	3	42.9
合计Total	494	100	345	69.8

疟疾类型 Malaria type	24 h		2~3 d		> 4 d		合计 Total
	病例数	构成比/%	病例数	构成比/%	病例数	构成比/%
	No. case	Proportion/%	No. case	Proportion/%	No. case	Proportion/%
恶性疟Falciparum malaria	166	49.3	78	23.1	93	27.6	337
间日疟Vivax malaria	27	41.5	8	12.3	30	46.2	65
卵型疟Ovale malaria	24	32	9	12	42	56	75
三日疟Quartan malaria	1	7.1	4	28.6	9	64.3	14
混合感染Mixed infection	1	33.3	0	0	2	66.7	3
合计Total	219	44.3	99	20	176	35.6	494

国家 Country	感染虫种 Species infected					合计 Total
国家 Country	恶性疟原虫 P. falciparum	间日疟原虫 P. vivax	卵型疟原虫 P. ovale	三日疟原虫 P. quartan	混合感染 Mixed infection	合计 Total
非洲Africa
刚果（金）Congo-Kinshasa	55	1	13	0	0	69
尼日利亚Nigeria	47	1	11	1	1	61
安哥拉Angola	36	0	8	3	0	47
埃塞俄比亚Ethiopia	2	32	1	0	1	36
刚果布Republic of Congo	24	1	7	2	1	35
喀麦隆Cameroon	17	0	5	2	0	24
赞比亚Zambia	20	0	2	0	0	22
乌干达Uganda	13	1	4	1	0	19
加纳Ghana	13	0	4	1	0	18
坦桑尼亚Tanzania	15	0	2	1	0	18
几内亚Guinea	14	0	2	1	0	17
科特迪瓦Ivory Coast	12	0	3	0	0	15
利比里亚Liberia	10	0	3	1	0	14
莫桑比克Mozambique	12	0	2	0	0	14
赤道几内亚Equatorial Guinea	3	2	3	0	0	8
加蓬 Gabonese	6	0	2	0	0	8
塞拉利昂 Sierra Leone	6	0	0	0	0	6
乍得 Chad	4	0	1	0	0	5
南苏丹South Sudan	5	0	0	0	0	5
其他非洲国家Other African countries	21	3	0	0	0	24
亚洲Asia
巴基斯坦Pakistan	0	16	0	0	0	16
印度尼西亚Indonesia	0	4	0	0	0	4
柬埔寨Cambodia	1	1	0	0	0	2
老挝Laos	0	1	0	0	0	1
孟加拉国Bangladesh	0	0	1	0	0	1
土耳其Turkey	0	0	1	0	0	0
大洋洲Oceania
巴布亚新几内亚 Papua New Guinea	0	1	0	1	0	2
南美洲South America
圭亚那Guyana	1	1	0	0	0	2
合计 Total	337	65	75	14	3	494