1990年至2009年拉丁美洲和加勒比地区疟疾流行病学：系统评价与荟萃分析

Epidemiology of Malaria in Latin America and the Caribbean from 1990 to 2009: Systematic Review and Meta-Analysis.

作者信息

Bardach Ariel, Ciapponi Agustín, Rey-Ares Lucila, Rojas Juan Ignacio, Mazzoni Agustina, Glujovsky Demián, Valanzasca Pilar, Romano Marina, Elorriaga Natalia, Dantur Juri María Julia, Boulos Marcos

机构信息

Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.

出版信息

Value Health Reg Issues. 2015 Dec;8:69-79. doi: 10.1016/j.vhri.2015.05.002. Epub 2015 Jul 28.

DOI:10.1016/j.vhri.2015.05.002

PMID:29698174

Abstract

OBJECTIVE

The objective of this study was to evaluate the burden of malaria in Latin America and the Caribbean countries through a systematic review and meta-analysis of published literature, gray literature, and information from countries' public health authorities for the period 1990 to 2009.

METHODS

The random-effects meta-analysis of the prospective studies, carried out in very highly endemic areas, showed an annual incidence rate of 409.0 malaria episodes/1000 person-years (95% confidence interval [CI] 263.1-554.9), considering all ages, which was 40-fold the one estimated from areas with passive surveillance only.

RESULTS

Overall, the most prevalent species was Plasmodium vivax (77.5%; 95% CI 75.6-79.4) followed by Plasmodium falciparum (20.8%; 95% CI 19.0-22.6) and Plasmodium malariae (0.08%; 95% CI 0.07-0.010). Data from regional ministries of health yielded an estimated pooled crude annual mortality rate of 6 deaths/100,000 people, mainly associated with P. falciparum.

CONCLUSION

This study represents the first systematic review of the burden of malaria in Latin America and the Caribbean, with data from 21 countries.

摘要

目的

本研究的目的是通过对1990年至2009年期间已发表文献、灰色文献以及各国公共卫生当局提供的信息进行系统评价和荟萃分析，评估拉丁美洲和加勒比国家的疟疾负担。

方法

对在高度流行地区开展的前瞻性研究进行随机效应荟萃分析，结果显示，考虑到所有年龄组，年发病率为每1000人年409.0例疟疾病例（95%置信区间[CI]263.1 - 554.9），这是仅通过被动监测地区估计发病率的40倍。

结果

总体而言，最常见的疟原虫种类是间日疟原虫（77.5%；95%CI 75.6 - 79.4），其次是恶性疟原虫（20.8%；95%CI 19.0 - 22.6）和三日疟原虫（0.08%；95%CI 0.07 - 0.10）。来自地区卫生部的数据显示，估计汇总的年粗死亡率为每10万人6例死亡，主要与恶性疟原虫有关。