Zhou Sheng, Zhang Jiarui, Li Chengcheng
Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Public Health. 2025 Mar 12;13:1470021. doi: 10.3389/fpubh.2025.1470021. eCollection 2025.
Malaria is a major public health issue in the Comoros. Analyzing the malaria burden will aid in designing prevention, control, and eradication strategies based on scientific evidence.
We retrieved data from the 2021 Global Burden of Disease (GBD) database to assess the malaria burden in the Comoros in 2021, stratified by sex and age. The indicators used to measure this burden included the absolute numbers and rates of incidence, prevalence, and mortality, as well as disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). Decomposition analysis was used to quantify the contributions of demographic aging, population growth, and epidemiological changes to the malaria burden from 1990 to 2021. Joinpoint regression analysis was employed to examine temporal trends in the malaria burden over this period.
In 2021, females, particularly those under 40, had a higher overall malaria burden than males, except for the age-standardized incidence rate (ASIR) and the age-standardized mortality rate (ASMR). Individuals under 30 years of age experienced approximately 52% of new malaria episodes, 68% of prevalent cases, and 62% of YLDs. Children under 5 and those aged 15 to 30 accounted for about 41% of malaria-related deaths, 54% of YLLs, and 53% of DALYs. Between 1990 and 2021, the malaria burden in the Comoros declined substantially, with age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and DALY rates (ASDR) decreasing by over 85%. Decomposition analysis indicated that epidemiological changes played a pivotal role in reducing disease burden. Over the past 32 years, the average annual percentage change (AAPC) in the ASPR was statistically significant at -7.60% (t = -2.68, < 0.05). Moreover, the annual percentage change (APC) in ASIR and ASPR showed the most significant decline from 2012 to 2015, with APCs of -70.47% (t = -3.01, < 0.05) and - 66.55% (t = -14.94, < 0.05), respectively.
This study indicates that women under 40, school-aged children, and adults under 30 in the Comoros bear a higher malaria burden. Although current malaria control measures are effective, achieving a malaria-free status will require integrated strategies.
疟疾是科摩罗的一个主要公共卫生问题。分析疟疾负担将有助于根据科学证据制定预防、控制和根除策略。
我们从2021年全球疾病负担（GBD）数据库中检索数据，以评估2021年科摩罗按性别和年龄分层的疟疾负担。用于衡量这一负担的指标包括发病率、患病率和死亡率的绝对数和比率，以及伤残调整生命年（DALYs）、生命损失年数（YLLs）和残疾生存年数（YLDs）。分解分析用于量化1990年至2021年人口老龄化、人口增长和流行病学变化对疟疾负担的贡献。采用Joinpoint回归分析来研究这一时期疟疾负担的时间趋势。
2021年，除年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）外，女性，尤其是40岁以下的女性，总体疟疾负担高于男性。30岁以下的个体经历了约52%的新疟疾病例、68%的现患病例和62%的YLDs。5岁以下儿童和15至30岁的人群分别占疟疾相关死亡人数的约41%、YLLs的54%和DALYs的53%。1990年至2021年期间，科摩罗的疟疾负担大幅下降，年龄标准化发病率（ASIR）、患病率（ASPR）、死亡率（ASMR）和DALY率（ASDR）下降了85%以上。分解分析表明，流行病学变化在减轻疾病负担方面发挥了关键作用。在过去32年中，ASPR的年均百分比变化（AAPC）在统计学上显著为-7.60%（t=-2.68，<0.05）。此外，ASIR和ASPR的年百分比变化（APC）在2012年至2015年期间下降最为显著，分别为-70.47%（t=-3.01，<0.05）和-66.55%（t=-14.94，<0.05）。
本研究表明，科摩罗40岁以下的女性、学龄儿童和30岁以下的成年人承受着更高的疟疾负担。尽管目前的疟疾控制措施是有效的，但要实现无疟疾状态将需要综合策略。
