Epidemiological characteristics of imported malaria in Fujian Province from 2014 to 2023

doi:10.12140/j.issn.1000-7423.2024.05.011

Abstract

Abstract:

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

CLC Number:

R531.3

XIAO Lizhen, OUYANG Rong, CHEN Zhuyun, LIN Yaoying, ZHENG Dan, XIE Hanguo. Epidemiological characteristics of imported malaria in Fujian Province from 2014 to 2023[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2024, 42(5): 635-641.

Figures/Tables 3

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病例诊断分类 Diagnostic classification of cases	新冠疫情前后 Before or after the COVID-19 epidemic		新冠疫情期间 During the COVID-19 epidemic
病例诊断分类 Diagnostic classification of cases	病例数/例 No. case/case	占比/% Proportion/%	病例数/例 No. case/case	占比/% Proportion/%
恶性疟 Falciparum malaria	567	74.7	40	60.6
间日疟 Vivax malaria	112	14.8	17	25.8
卵形疟 Ovale malaria	54	7.1	8	12.1
三日疟 Quartan malaria	22	2.9	1	1.5
混合感染 Mixed-infection	4	0.5	0	0
合计 Total	759	100	66	100