2013 年至 2017 年期间缅甸伊洛瓦底地区疟疾减少的相关因素。
Factors associated with the decline of malaria in Myanmar's Ayeyarwady Region between 2013 and 2017.
机构信息
Clinton Health Access Initiative, Inc., Boston, MA, USA.
Myanmar Vector Borne Disease Control Program, Ministry of Health and Sports, Nay Pyi Taw, Myanmar.
出版信息
Sci Rep. 2021 Oct 14;11(1):20470. doi: 10.1038/s41598-021-99737-4.
The burden of malaria in Myanmar has declined rapidly in recent years; cases decreased from 333,871 in 2013 to 85,019 in 2017 (75% decrease). Decline of malaria in the Ayeyarwady Region of Myanmar reflects this trend with an 86% decrease in cases over this period. In this exploratory analysis, quantitative and qualitative information were assessed to explore potential factors responsible for the decline of malaria in Ayeyarwady. Data on malaria incidence, programmatic financing, surveillance, case management, vector control interventions, climate and ecological factors, and policies and guidelines spanning 2013 to 2017 were compiled. Poisson regression models that adjust for correlation were used to analyze the association between annual malaria case numbers with malaria intervention factors at the township level. Between 2013 and 2017, there was a decrease in mean township-level malaria incidence per 1000 from 3.03 (SD 4.59) to 0.34 (SD 0.79); this decline coincided with the implementation of the government's multi-pronged malaria elimination strategy, an increase of approximately 50.8 million USD in malaria funding nationally, and a period of deforestation in the region. Increased funding in Ayeyarwady was invested in interventions associated with the decline in caseload, and the important roles of surveillance and case management should be maintained while Myanmar works towards malaria elimination.
近年来,缅甸的疟疾负担迅速下降;病例数从 2013 年的 333871 例下降到 2017 年的 85019 例(下降 75%)。缅甸伊洛瓦底地区的疟疾下降反映了这一趋势,同期病例数下降了 86%。在这项探索性分析中,评估了定量和定性信息,以探讨导致伊洛瓦底地区疟疾下降的潜在因素。汇编了 2013 年至 2017 年期间有关疟疾发病率、规划供资、监测、病例管理、病媒控制干预、气候和生态因素以及政策和指导方针的数据。使用调整相关性的泊松回归模型来分析乡镇一级每年疟疾病例数与疟疾干预因素之间的关联。2013 年至 2017 年期间,乡镇一级每千人疟疾发病率的平均值从 3.03(SD4.59)下降到 0.34(SD0.79);这一下降与政府实施多管齐下的疟疾消除战略、全国疟疾供资增加约 5080 万美元以及该地区的森林砍伐期相吻合。伊洛瓦底的资金增加投资于与病例下降相关的干预措施,在缅甸努力消除疟疾的同时,监测和病例管理的重要作用应得到保持。
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