Epidemiological analysis of imported malaria reported in Shanghai, 2016-2019

Abstract

Objective To understand epidemiological characteristics of malaria cases reported in Shanghai, so as to provide scientific evidence for better prevention and control of malaria. Methods The data of malaria reported in Shanghai during 2016-2019 were collected from the Information Management System for Infection Disease Report and Information Management System for Parasitic Disease Control and Prevention, and the clinical manifestation, diagnosis and treatment were collected and statistically analyzed by SPSS22.0. Results Totally 183 malaria cases were reported in Shanghai during 2016–2019, all of them were laboratory confirmed cases, including 139 P.falciparum cases (76.0%), 23 P.ovale cases (12.6%), 11 P. vivax cases (6.0%), and 10 P. malariae cases (5.5%). All the cases were imported from Africa ( n =178, 97.3%) and southeast Asian ( n =5, 2.73%). Most of the cases fell into the age range of 30-<40 years ( n =59, 32.2%) with a male-to-female ratio of 10.4:1. There were significant differences ( P <0.01) in the rate of misdiagnosis and the rate of over 3 days diagnosis between severe malaria (51.6%, 16/31; 38.7%, 12/31) and non-severe malaria (27.0%, 41/152; 13.8%, 21/152). One severe malaria case was finally dead. Conclusions Imported cases were still existed in Shanghai after malaria elimination. Misdiagnosis and delayed diagnosis were the main factors for the occurrence of severe malaria. It is suggested to carry out health education, active screening and skill training of diagnosis and treatment to achieve "early detection, early diagnosis and early treatment", so as to avoid the occurrence of malaria deaths. 摘要:目的 了解上海市疟疾消除后的流行病学特征, 为制订输人性疟疾的防控策略和措施提供依据。 方法 收集 2016—2019 年上海市疟疾疫情信息和疟疾病例个案调査资料, 采用SPSS22.0统计软件对疟疾病例的流行特征与感 染诊治情况进行统计分析。 结果 2016—2019 年上海市共报告疟疾183例, 均为实验室确诊病例, 其中恶性疟139 例 (占 76.0%), 卵形疟 23 例 (占 12.6%), 间日疟11例 (占6.0%), 三日疟 10 例 (占 5.5%)。所有病例均为境外输人, 分别来 自非洲 (178 例, 占 97.3%)和东南亚(5例, 占 2.7%)。病例的男女性别比为 10.4:1, 年龄 30~<40 岁 (59 例, 占 32.2%)。重 症疟疾的初诊误诊比例 51.6% (16/31) 和超过 3d 确诊比例 38.7% (12/31) 与非重症疟疾的 27.0% (41/152)、13.8% (21/152) 的差异均有统计学意义 ( P <0.01), 1 例重症病例导致死亡。 结论 疟疾消除以后上海市仍然面临境外输人的风 险, 首诊误诊和确诊时间延迟是重症疟疾发生的主要影响因素。建议有针对性地开展风险人群健康宣教、主动筛査以 及诊疗技能培训, 做到“早发现、早诊断、早治疗”, 避免疟疾死亡病例的发生。