Spatial and temporal distribution of falciparum malaria in China
Spatial and temporal distribution of falciparum malaria in China
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DOI：
10.1186/1475-2875-8-130
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发表时间：
2009-06-12
期刊：
影响因子：
3
通讯作者：
Liu, Qiyong
中科院分区：
文献类型：
--
作者：
Lin, Hualiang;Lu, Liang;Liu, Qiyong
背景：恶性疟疾是人类疟疾四种主要类型中最致命的一种。尽管自1955年国家疟疾防治计划启动以来取得了巨大成功，但疟疾仍然是中国的一个严重的公共卫生问题。目的：分析中国恶性疟疾的地理分布、人口学特征和时间趋势。方法：从中国疾病预防控制中心传染病信息系统中提取1992年-2003年每年恶性疟疾病例数和2004年-2005年各临床恶性疟疾病例报告。每年的病例数量和年发病率通过将它们与地理信息系统中相应的省和县两级行政单位进行匹配来绘制地图。分析恶性疟疾按年龄、性别和感染源的分布情况。采用时间序列分析方法，对2004年至2005年中国两省恶性疟疾疫情与输入性恶性疟疾的关系进行了分析。26个非流行省份报告了输入性疟疾。绘制了云南和海南两个中国流行省份的县级恶性疟疾年发病率图。云南省0~15岁儿童病例男女性别比为1.6，15岁以上成人病例性别比为5.7。云南省疟疾病例数与非流行省份同期月份输入性疟疾呈正相关。结论：中国恶性疟疾流行地区仍局限于云南和海南两省。稳定传播发生在云南边境地区和海南南部丘陵林区。流行区的年龄和性别分布特点是以成年男性病例为主。中国非流行区输入性恶性疟疾主要受云南疟疾传播的影响，在空间和时间上均呈上升趋势。有必要采取针对流动人口群体的具体干预措施。
Background: Falciparum malaria is the most deadly among the four main types of human malaria. Although great success has been achieved since the launch of the National Malaria Control Programme in 1955, malaria remains a serious public health problem in China. This paper aimed to analyse the geographic distribution, demographic patterns and time trends of falciparum malaria in China.Methods: The annual numbers of falciparum malaria cases during 1992-2003 and the individual case reports of each clinical falciparum malaria during 2004-2005 were extracted from communicable disease information systems in China Center for Diseases Control and Prevention. The annual number of cases and the annual incidence were mapped by matching them to corresponding province-and county-level administrative units in a geographic information system. The distribution of falciparum malaria by age, gender and origin of infection was analysed. Time-series analysis was conducted to investigate the relationship between the falciparum malaria in the endemic provinces and the imported falciparum malaria in non-endemic provinces.Results: Falciparum malaria was endemic in two provinces of China during 2004-05. Imported malaria was reported in 26 non-endemic provinces. Annual incidence of falciparum malaria was mapped at county level in the two endemic provinces of China: Yunnan and Hainan. The sex ratio ( male vs. female) for the number of cases in Yunnan was 1.6 in the children of 0-15 years and it reached 5.7 in the adults over 15 years of age. The number of malaria cases in Yunnan was positively correlated with the imported malaria of concurrent months in the non-endemic provinces.Conclusion: The endemic area of falciparum malaria in China has remained restricted to two provinces, Yunnan and Hainan. Stable transmission occurs in the bordering region of Yunnan and the hilly-forested south of Hainan. The age and gender distribution in the endemic area is characterized by the predominance of adult men cases. Imported falciparum malaria in the non-endemic area of China, affected mainly by the malaria transmission in Yunnan, has increased both spatially and temporally. Specific intervention measures targeted at the mobile population groups are warranted.