Departamento de Análisis Epidemiológico y Bioestadísticas, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, República de Panamá.
Universidad de Panamá, Panamá, República de Panamá.
Malar J. 2020 Jul 23;19(1):265. doi: 10.1186/s12936-020-03329-y.
The present study provides a countrywide perspective of the malaria situation in Panamá over a long-term framework, with the purpose of identifying historical malaria resurgence events and their potential causes.
A descriptive-ecological study was conducted by analysing demographic and epidemiological annual malaria time series data in Panamá (1884-2019) using several data sources. Malaria intensity indicators were calculated during the study period. The effects of El Niño Southern Oscillation on malaria transmission were also analysed using a retrospective analysis of malaria cases between 1957 and 2019.
Several factors were identified responsible for malaria resurgence in Panamá, mostly related with Malaria Control Programme weakening. During the past 20 years (2000-2019) malaria has progressively increased in prevalence within indigenous settlements, with a predominance of male cases and a high proportion (15% of total cases) in children less than 5 years old. During this period, a significant and increasing proportion of the Plasmodium falciparum cases were imported. Retrospective analysis (1957-2019) evidenced that ENSO had a significant impact on malaria transmission dynamics in Panamá.
Data analysis confirmed that although authorities have been successful in focalizing malaria transmission in the country, there are still neglected issues to be solved and important intercultural barriers that need to be addressed in order to achieve elimination of the disease by 2022. This information will be useful for targeting strategies by the National Malaria Elimination Programme.
本研究提供了巴拿马在长期框架内的疟疾情况的全国性视角，旨在确定历史上疟疾反弹事件及其潜在原因。
通过使用多个数据源分析巴拿马的人口统计学和流行病学年度疟疾时间序列数据（1884-2019 年），进行了描述性-生态学研究。在研究期间计算了疟疾强度指标。还通过对 1957 年至 2019 年期间的疟疾病例进行回顾性分析，分析了厄尔尼诺南方涛动对疟疾传播的影响。
确定了导致巴拿马疟疾反弹的几个因素，这些因素主要与疟疾控制计划的削弱有关。在过去的 20 年（2000-2019 年）中，疟疾在土著居民点的患病率逐渐增加，男性病例居多，5 岁以下儿童比例很高（占总病例的 15%）。在此期间，输入性疟疾病例的比例显著增加。回顾性分析（1957-2019 年）表明，ENSO 对巴拿马的疟疾传播动态有显著影响。
数据分析证实，尽管当局已经成功地将疟疾传播集中在该国，但仍有一些被忽视的问题需要解决，并且需要解决重要的跨文化障碍，以便在 2022 年之前消除该疾病。这些信息将有助于国家疟疾消除计划制定针对性策略。
