The burden of malaria in Ahmedabad city, India: a retrospective analysis of reported cases and deaths
The burden of malaria in Ahmedabad city, India: a retrospective analysis of reported cases and deaths
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DOI：
10.1179/000349803225002642
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发表时间：
2003-12-01
影响因子：
--
通讯作者：
Sharma, VP
中科院分区：
文献类型：
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作者：
Yadav, RS;Bhatt, RM;Sharma, VP
由于缺乏关于印度城市疟疾负担的准确资料，在人口约300万的阿赫梅达巴德市进行了一项回顾性流行病学研究。1965-1998年的监测数据显示，1967 - 1976年疟疾逐渐复苏，随后出现了低发病率和高发病率的浪潮。间日疟原虫始终占主导地位，但恶性疟原虫引起的病例比例自1983年以来显著增加。对该市主要公共和私人卫生设施的监测数据和健康记录进行分析后发现，1991年至1998年期间，间日疟原虫占所有疟疾病例的69%，恶性疟原虫占其他31%。各种疟原虫感染率呈季节性变化，间日疟原虫感染率在1 ~ 9月呈上升趋势，但随着恶性疟原虫感染率的上升，间日疟原虫感染率呈下降趋势。发病率的年龄特异性差异无统计学意义（P = 0.7）。每年的疟疾死亡人数与恶性疟原虫的发病率密切相关（r = 0.88）。发现的疟疾发病率（37 431例，年平均发病率为12.2例/1 000人）是官方报告的发病率（4 119例，即每年1.3例/1 000人）的9倍。同样，每年查明的疟疾死亡率（每百万人22例死亡）也远远高于官方公布的数字（每百万人0.3例死亡）。回顾性分析的结果不仅提供了对印度城市地区疟疾负担的更准确的基线估计，而且还清楚地表明需要一个更有效的健康信息系统来记录和管理这种环境中的疟疾。
Owing to the paucity of accurate information on the burden of malaria in urban India, a retrospective, epidemiological study was carried out in Ahmedabad city, which has a population of about 3 million. Surveillance data for the years 1965-1998 showed a gradual resurgence of malaria between 1967 to 1976, followed by waves of low and high incidences. Plasmodium vivax always predominated but the proportion of cases attributed to P. falciparum increased markedly from 1983. When the surveillance data and health records of the major public and private health facilities in the city were analysed, for the period between 1991 and 1998, P. vivax was found to account for 69% of all malaria cases and P. falciparum for the other 31%. The incidence of infection with each Plasmodium species showed seasonal variation, with that of P. vivax increasing from January to September but then declining as the incidence of P. falciparum increased. The age-specific differences seen in incidence were not statistically significant (P = 0.7). The annual numbers of malaria-attributable deaths were strongly correlated with the incidence of P. falciparum (r = 0.88). The malaria incidence detected (37,431 cases, representing a mean annual incidence of 12.2 cases/1000) was nine times greater than that officially reported (4119 cases, or 1.3 cases/1000 each year). Similarly, the annual malaria-attributable mortality detected (22 deaths/million) was far higher than that officially notified (0.3 death/million). The results of the retrospective analysis not only provide a more accurate, baseline estimate of the burden of malaria in an urban area of India but also clearly indicate the need for a much more efficient health-information system, for recording and managing malaria in such a setting.