Gao Liping, Shi Qi, Liu Zhiguo, Li Zhenjun, Dong Xiaoping
National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, China.
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, China.
Trop Med Infect Dis. 2023 Jan 16;8(1):67. doi: 10.3390/tropicalmed8010067.
Malaria remains a significant public health concern in Africa, and the emerging coronavirus disease 2019 (COVID-19) pandemic may have negatively impacted malaria control. Here, we conducted a descriptive epidemiological analysis of malaria globally, and preliminarily explored the impact of COVID-19 on the malaria elimination program in regions of Africa (AFR). The present analysis found that there was a vast heterogeneity of incidence of deaths caused by malaria globally in different continents, and the highest malaria burden was observed in AFR. In 2020, there was an obviously increasing trend in the malaria epidemic in AFR, while the other four continents exhibited stable and declining patterns. Historically, malaria has been largely concentrated in high-malaria-burden regions, such as West Africa, and there has been an obvious increasing trend in Nigeria. These data suggest that dynamic changes in the malaria epidemic situation worldwide have primarily originated from AFR, and West Africa has played an important role in the global malaria increase in recent years. Under the coercion of COVID-19, multiple factors have co-driven the increase in malaria in AFR, including insufficient financial investments, a high native malaria burden, weak surveillance systems, limited medical resources, and low socioeconomic development levels. In addition, the shift of medical resources (e.g., health workers and personal protective equipment (PPE), the manufacturing of diagnostic reagents, and drugs) from malaria control to emergency COVID-19 response in the pandemic's early stage caused disruptions, reductions, and delays in pillar malaria control measures, leading to a significant negative impact on malaria control. In particular, a funding shortfall at both the international and domestic levels led to a "significant threat," resulting in vast gaps in access to proven malaria control tools. Although there has been a declining trend in malaria control over time due to COVID-19, the effect still cannot be ignored. Hence, we recommend the implementation of medical and technical resource assistance as a priority strategy to support Africa (West Africa) in order to curb further transmission.
疟疾仍是非洲一个重大的公共卫生问题，而新出现的2019冠状病毒病（COVID-19）大流行可能对疟疾控制产生了负面影响。在此，我们对全球疟疾进行了描述性流行病学分析，并初步探讨了COVID-19对非洲地区（AFR）疟疾消除计划的影响。本分析发现，全球不同大陆因疟疾导致的死亡发病率存在巨大差异，且在AFR观察到最高的疟疾负担。2020年，AFR的疟疾疫情呈明显上升趋势，而其他四大洲则呈现稳定和下降趋势。从历史上看，疟疾主要集中在高疟疾负担地区，如西非，尼日利亚也有明显的上升趋势。这些数据表明，全球疟疾疫情的动态变化主要源自AFR，近年来西非在全球疟疾增加方面发挥了重要作用。在COVID-19的胁迫下，多种因素共同推动了AFR疟疾的增加，包括资金投入不足、本地疟疾负担高、监测系统薄弱、医疗资源有限以及社会经济发展水平低。此外，在疫情早期，医疗资源（如卫生工作者和个人防护装备（PPE）、诊断试剂和药品的生产）从疟疾控制转向应对COVID-19紧急情况，导致疟疾控制支柱措施中断、减少和延误，对疟疾控制产生了重大负面影响。特别是，国际和国内层面的资金短缺导致了“重大威胁”，造成在获取经证实的疟疾控制工具方面存在巨大差距。尽管由于COVID-19，疟疾控制随着时间推移呈下降趋势，但其影响仍不可忽视。因此，我们建议实施医疗和技术资源援助作为优先战略，以支持非洲（西非），从而遏制进一步传播。
