Regional heterogeneity of malaria healthcare seeking and diagnosis in China (2017–2022): Implications in preventing re-establishment of malaria transmission

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2024-11-22 DOI:10.1016/j.jiph.2024.102601

Jian-hai Yin , Li Zhang , Bo-yu Yi , Shui-sen Zhou , Zhi-gui Xia

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引用次数: 0

Abstract

Background

Enhancing regional collaboration in malaria prevention and control is a pivotal strategy for malaria control and elimination in China. The objective of this study is to examine the regional heterogeneity of malaria healthcare-seeking behaviors and diagnosis across various regions in China from 2017 to 2022.

Methods

Individual case data from national malaria surveillance databases were utilized. An analysis was conducted to discern the regional variations in the healthcare-seeking behaviors and diagnosis among regions.

Results

From 2017 to 2022, a total of 10,943 malaria cases were reported in China, predominantly imported cases (10,929), with significant variations in the distribution of different Plasmodium species among regions (P < 0.001) and annually (P < 0.001). There was a notable lack of timeliness in healthcare seeking (56.1 %) and case confirmation (67.3 %) with substantial regional disparities (P < 0.001). These delays predominantly occurred in county and prefectural-level medical institutions (P < 0.001), where misidentification of Plasmodium species was also prevalent (P < 0.001). Furthermore, an initial diagnosis of malaria was observed in 76.6 % of cases (P < 0.001), yet 87.8 % of malaria cases were ultimately confirmed correctly (P < 0.001). Notably, P. ovale (21.0 %) and P. malariae (10.8 %) were easily misidentified as P. vivax (P < 0.001).

Conclusion

The development of regional-specific interventions is essential to raise public awareness regarding malaria-related knowledge and to enhance the vigilance of health workers and their capacity of malaria testing. This will strengthen the nation’s malaria surveillance and response system. Concurrently, fostering technological innovations for the rapid and precise identification of Plasmodium species, along with effective coordination of cross-regional mechanisms, is imperative to prevent re-establishment of malaria transmission in China.

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中国疟疾就医和诊断的地区异质性（2017-2022 年）：预防疟疾传播重建的意义

背景加强疟疾防控的区域协作是中国控制和消除疟疾的关键战略。本研究旨在探讨 2017 年至 2022 年中国各地区疟疾就医行为和诊断的区域异质性。方法利用国家疟疾监测数据库中的个体病例数据。结果2017-2022年，中国共报告疟疾病例10943例，以输入性病例为主（10929例），不同疟原虫种类的分布在地区间（P <0.001）和年度间（P <0.001）存在显著差异。就医及时率（56.1%）和病例确诊及时率（67.3%）明显不足，地区间差异很大（P < 0.001）。这些延误主要发生在县级和地市级医疗机构（P < 0.001），在这些医疗机构中，疟原虫种类的错误鉴定也很普遍（P < 0.001）。此外，76.6%的病例被初步诊断为疟疾（P <0.001），但87.8%的疟疾病例最终被正确确诊（P <0.001）。值得注意的是，卵形疟原虫（21.0%）和疟疾疟原虫（10.8%）很容易被误认为间日疟原虫（P < 0.001）。这将加强国家的疟疾监测和应对系统。同时，促进疟原虫快速、精确鉴定的技术创新，以及跨区域机制的有效协调，对于防止疟疾在中国的再次传播至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.