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Analysis of malaria epidemic characteristics and case diagnosis in Changzhou City from 2010 to 2020
GUO Yan-li, XIE Yi-qing, ZHU Shi-ying, HE Ming-zhen
2022, 20 (2):
69-75.
Objective To analyze the epidemiological characteristics of malaria in Changzhou City from 2010 to 2020, so as to provide evidence for formulating and adjusting the strategies and measures for prevention and control of malaria infection. Methods The epidemiological investigation information on the malaria cases in Changzhou City from 2010 to 2020 was collected through the sub-system of infectious disease monitoring and parasitic disease prevention and control information management under China Information System for Disease Prevention and Control. Software SPSS (version 22.0) was used to analyze malaria epidemic situation and the three-dimensional distribution, source of infection, time of onset, diagnosis and treatment. Results A total of 233 malaria cases were reported in Changzhou City from 2010 to 2020, including 230 cases imported from abroad, 2 cases of local infection and 1 case imported from another province. Imported cases were mainly from Africa (n=220, 95.65%) and Southeast Asia (n=28, 3.48%). Apart from 4 clinically diagnosed cases, 229 confirmed cases consisted of infection with Plasmodium falciparum(n=164, 71.62%), Plasmodium ovale(n=42, 18.34%), Plasmodium vivax(n=16, 6.99%) and Plasmodium malariae(n=7, 3.06%). The cases were mainly distributed in Jintan District (n=92, 39.48%) and Liyang City (n=85, 36.48%). The infection was most seen in males (n=225, 96.57%), and dominant in age ranging from 22 to 59 years old (n=230, 98.71%). The major reason for leaving the country was to work abroad (n=213, 92.61%). The median interval from entry to onset of malaria among imported cases was 8 days, and most cases (n=171, 77.03%) developed within 14 days after entry. The median interval from onset to diagnosis was 3 days, and 2, 3 and 6 days for patients confirmed on outpatient basis, inpatients and critical in patients, respectively. The difference was statistically significant (χ2=6.313, P=0.043). The primary and final diagnosis primarily occurred in medical institutions at city/county level. The overall proportion of malaria cases diagnosed at the initial visit was 73.82%(172/233), and 100.00%(52/52), 79.07%(102/129) and 34.62%(18/52) at city/county level CDCs, city/county level hospitals, township health centers or below, respectively. The difference was significant(χ2=61.636, P<0.001). Conclusion Imported malaria has become the main risk factor for the prevention and control of malaria in Changzhou City, which suggests that we should strengthen the publicity and education of malaria prevention and control knowledge for personnel leaving the country for working in malaria endemic areas such as Africa, so as to improve their awareness of malaria prevention and timely treatment. In addition, the capacity of malaria diagnosis and treatment of staff in medical and health institutions at all levels should be constantly improved to prevent the retransmission of imported cases.
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