中国湖北省 2005-2016 年疟疾从控制到消除的流行病学特征。
Epidemiological characteristics of malaria from control to elimination in Hubei Province, China, 2005-2016.
机构信息
Institute of Parasitic Disease Control, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
Key Laboratory of Monitoring and Estimate for Environment and Disaster of Hubei Province, Institute of Geodesy and Geophysics, Chinese Academy of Sciences, Wuhan, 430077, China.
出版信息
Malar J. 2018 Feb 15;17(1):81. doi: 10.1186/s12936-018-2207-7.
BACKGROUND
Hubei Province, China, has been operating a malaria elimination programme. This study aimed at investigating the epidemiologic characteristics of malaria in Hubei Province (2005-2016) to plan resource allocation for malaria elimination.
METHODS
Data on all malaria cases from 2005 to 2016 in all counties of Hubei Province were extracted from a web-based reporting system. The numbers of indigenous and imported cases during the disease control (2005-2010) and elimination (2011-2016) stages, as well as their spatiotemporal distribution, were compared.
RESULTS
A total of 8109 malaria cases were reported from 2005 to 2016 (7270 and 839 cases during the control and elimination stages, respectively). Between 2005 and 2010, indigenous malaria cases comprised the majority of total cases (7114/7270; 97.9%), and Plasmodium vivax malaria cases accounted for most malaria cases (5572/7270; 76.6%). No indigenous malaria cases have been reported in Hubei Province since 2013. Imported malaria cases showed a gradually increasing trend from 2011 to 2016, Plasmodium falciparum was the predominant species in these cases, and the number of counties with imported cases increased from 4 in 2005 to 47 in 2016. During the control and elimination stages, the most likely spatial clusters for indigenous cases included 13 and 11 counties, respectively. However, the cluster of indigenous malaria cases has not been identified since September 2011. For imported cases, the most likely cluster and three secondary clusters during both stages were identified.
CONCLUSIONS
Hubei Province has made significant achievements in controlling and eliminating malaria; however, the region now faces some challenges associated with the increasing number and distribution of imported malaria cases. Priorities for malaria elimination should include better management of imported malaria cases, prevention of secondary malaria transmission, and ensuring the sustainability of malaria surveillance.
背景
中国湖北省一直在实施疟疾消除计划。本研究旨在调查湖北省疟疾的流行病学特征（2005-2016 年），为疟疾消除计划配置资源。
方法
从基于网络的报告系统中提取 2005 年至 2016 年湖北省所有县的所有疟疾病例数据。比较疾病控制（2005-2010 年）和消除（2011-2016 年）阶段的本地和输入病例的数量及其时空分布。
结果
2005 年至 2016 年共报告 8109 例疟疾病例（控制阶段 7270 例，消除阶段 839 例）。2005 年至 2010 年，本地疟疾病例占总病例数的大多数（7114/7270；97.9%），间日疟病例占大多数（5572/7270；76.6%）。自 2013 年以来，湖北省未报告本地疟疾病例。2011 年至 2016 年，输入性疟疾病例呈逐渐上升趋势，恶性疟原虫是这些病例的主要病原体，有输入性疟疾病例的县从 2005 年的 4 个增加到 2016 年的 47 个。在控制和消除阶段，本地病例最有可能的空间聚集包括 13 个和 11 个县。然而，自 2011 年 9 月以来，未发现本地疟疾病例聚集。输入性病例在两个阶段最有可能的聚集和三个二级聚集都被发现。
结论
湖北省在控制和消除疟疾方面取得了重大成就；然而，该地区现在面临着一些与输入性疟疾病例数量和分布增加相关的挑战。疟疾消除的重点应包括更好地管理输入性疟疾病例、预防继发疟疾传播以及确保疟疾监测的可持续性。
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