2010年至2021年科摩罗疟疾模式的变化：与撒哈拉以南非洲的比较研究

Changes in Malaria Patterns in Comoros from 2010 to 2021: A Comparative Study with Sub-Saharan Africa.

作者信息

Zhou Sheng, Yu Linxin, Liang Jianming, Xie Wei, Li Guoming, Deng Changsheng, Song Jianping, Zou Guanyang, Chen Yinhuan

机构信息

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China.

School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.

出版信息

Trop Med Infect Dis. 2025 May 19;10(5):138. doi: 10.3390/tropicalmed10050138.

DOI:10.3390/tropicalmed10050138

PMID:40423367

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12115432/

Abstract

BACKGROUND

Recent setbacks in malaria control in Comoros demand a reassessment of its evolving epidemiology.

METHODS

Using the Global Burden of Disease (GBD) Study 2021 data, we analyzed malaria trends from 2010 to 2021, stratified by sex. We quantified the contributions of demographic and epidemiological factors to these trends and identified risk factors for malaria-related disability-adjusted life years (DALYs).

RESULTS

From 2010 to 2021, malaria cases, deaths, and DALYs in Comoros fell by -90.22%, -94.44%, and -94.88%; and the corresponding age-standardized rates declined with EAPCs of -18.70% (95% CI: -33.77 to -0.20), -23.89% (95% CI: -36.58 to -8.66), and -24.49% (95% CI: -36.88 to -9.66), with steeper declines in males. Nevertheless, all indicators increased in 2018 and again in 2021. In sub-Saharan Africa, only cases increased, while other metrics declined slightly. In Comoros, incidence shifted mainly to adults ≥25 years, unlike sub-Saharan Africa, where children < 5 years were most affected. Population growth drove increases in cases, deaths and DALYs, whereas epidemiological shifts had the opposite effect. Child underweight was the leading risk factor for malaria DALYs.

CONCLUSIONS

Existing interventions can achieve malaria control in Comoros; however, rebounds in 2018 and 2021 highlight the need to identify and address drivers of resurgence.

摘要

背景

科摩罗疟疾防控工作近期遭遇挫折，需要重新评估其不断演变的流行病学情况。

方法

利用《2021年全球疾病负担研究》数据，我们分析了2010年至2021年按性别分层的疟疾趋势。我们量化了人口和流行病学因素对这些趋势的贡献，并确定了与疟疾相关的伤残调整生命年（DALY）的风险因素。

结果

2010年至2021年，科摩罗的疟疾病例、死亡人数和DALY分别下降了-90.22%、-94.44%和-94.88%；相应的年龄标准化率下降，年平均百分比变化（EAPC）分别为-18.70%（95%置信区间：-33.77至-0.20）、-23.89%（95%置信区间：-36.58至-8.66）和-24.49%（95%置信区间：-36.88至-9.66），男性下降幅度更大。然而，所有指标在2018年和2021年再次上升。在撒哈拉以南非洲，只有病例数增加，而其他指标略有下降。在科摩罗，发病率主要转移到了25岁及以上的成年人，这与撒哈拉以南非洲不同，那里5岁以下儿童受影响最大。人口增长推动了病例数、死亡人数和DALY的增加，而流行病学转变则产生了相反的效果。儿童体重不足是疟疾DALY的主要风险因素。