Objective: To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018.
Methods: The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases.
Results: A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season-specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported.
Conclusions: The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.
[摘要] 目的 分析 2011–2018 年广西壮族自治区疟疾疫情, 探讨有针对性的防控策略。方法 收集 2011–2018 年广西 壮族自治区疟疾监测数据, 对疟疾病例个案流行病学调查资料、虫种、病例三间分布、感染来源及病例报告主体等信息进 行描述性分析。结果 2011–2018 年广西壮族自治区共报告疟疾病例 2 944 例, 其中本地感染病例 1 例 (0.03%), 输入性 病例 2 943 例 (99.97%)。实验室确诊疟原虫阳性病例 2 933 例 (99.63%), 恶性疟 2 166 例 (73.86%)、卵形疟 388 例 (13.23%)、间日疟 276 例 (9.41%)、三日疟 40 例 (1.36%)、混合感染 62 例 (2.11%); 临床诊断病例 11 例 (0.37%)。病例分布 于全区 14 个地级市中的 91 个县 (市、区), 病例数最多的为南宁市, 有 2 515 例 (占 85.43%)。病例来源于非洲 29 个国家 (94.67%)、东南亚 7 个国家 (5.10%)、南美洲 1 个国家 (0.07%)、南亚 2 个国家 (0.07%) 和国内 (0.10%); 其中非洲区域以来 自加纳为主, 为 1 947 例 (66.13%); 东南亚以来自缅甸为主, 为 75 例 (2.55%)。病例主要以青壮年男性为主, 男性为 2 889 例 (98.13%), 20 ~ 49 岁 2 583 例 (87.74%); 病例所从事职业主要以淘金/挖矿为主 (2 561例, 占86.99%); 病例各月均有分 布, 其中 6 月份病例数最多, 为 665 例 (22.59%), 无明显季节分布。病例报告主体中, 疾控机构报告 1 431 例 (48.61%), 医 疗机构报告 1 511 例 (51.3%), 检验检疫机构报告 2 例 (0.07%)。全区报告 6 例输入性疟疾死亡病例, 无输入性继发病例 发生。结论 广西壮族自治区本地疟疾疫情已经得到有效控制, 但境外输入性疟疾防控形势严峻; 加强对出国务工人群 监测和管理是巩固消除疟疾成果的关键。.
Keywords: Control strategy; Guangxi Zhuang Autonomous Region; Imported malaria; Malaria.