Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Road, Lixia District, Jinan, 250012, People's Republic of China.
Directorate of Surveillance and Response to Epidemics, Ministry of Public Health, Niamey, Niger.
Malar J. 2024 Jan 19;23(1):30. doi: 10.1186/s12936-024-04835-z.
Malaria remains a significant public health concern in Niger, with the number of cases increasing from 592,334 in 2000 to 3,138,696 in 2010. In response, a concerted campaign against the disease has been initiated. However, the implementation of these malaria interventions and their association with epidemiological behaviour remains unclear.
A time-series study was conducted in Niger from 2010 to 2019. Multiple data sources concerning malaria were integrated, encompassing national surveillance data, Statistic Yearbook, targeted malaria control interventions, and meteorological data. Incidence rate, mortality rate, and case fatality ratio (CFR) by different regions and age groups were analysed. Joinpoint regression models were used to estimate annual changes in malaria. The changes in coverage of malaria interventions were evaluated.
Between 2010 to 2019, the incidence rate of malaria decreased from 249.43 to 187.00 cases per 1,000 population in Niger. Niamey had a high annual mean incidence rate and the lowest CFR, while Agadez was on the contrary. Joinpoint regression analysis revealed a declining trend in malaria incidence for all age groups except the 10-24 years group, and the mortality rate and the CFR initially decreased followed by an increase in all age groups. Niger has implemented a series of malaria interventions, with the major ones being scaled up to larger populations during the study period.
The scale-up of multi-interventions in Niger has significantly reduced malaria incidence, but the rise in mortality rate and CFR addresses the challenges in malaria control and elimination. Malaria endemic countries should enhance surveillance of malaria cases and drug resistance in Plasmodium, improve diagnosis and treatment, expand the population coverage of insecticide-treated bed nets and seasonal malaria chemoprevention, and strengthen the management of severe malaria cases.
在尼日尔，疟疾仍然是一个严重的公共卫生问题，病例数量从 2000 年的 592334 例增加到 2010 年的 3138696 例。为此，已发起了一场针对该病的协同运动。然而，这些疟疾干预措施的实施及其与流行病学行为的关联尚不清楚。
在尼日尔进行了一项时间序列研究，时间跨度为 2010 年至 2019 年。整合了多个有关疟疾的数据来源，包括国家监测数据、统计年鉴、有针对性的疟疾控制干预措施和气象数据。按不同地区和年龄组分析发病率、死亡率和病死率。使用 Joinpoint 回归模型估计疟疾的年变化。评估疟疾干预措施覆盖率的变化。
2010 年至 2019 年间，尼日尔的疟疾发病率从每 1000 人 249.43 例降至 187.00 例。尼亚美年平均发病率高，病死率最低，而阿加德兹则相反。Joinpoint 回归分析显示，除 10-24 岁年龄组外，所有年龄组的疟疾发病率均呈下降趋势，所有年龄组的死亡率和病死率最初下降后又上升。尼日尔实施了一系列疟疾干预措施，在研究期间，主要措施的覆盖范围扩大到了更多人群。
尼日尔多干预措施的扩大显著降低了疟疾发病率，但死亡率和病死率的上升表明疟疾控制和消除工作面临挑战。疟疾流行国家应加强疟疾病例和疟原虫耐药性监测，改善诊断和治疗，扩大驱虫蚊帐和季节性疟疾化学预防的人口覆盖面，并加强重症疟疾病例的管理。
