Increasing incidence of Plasmodium ovale and persistent reporting of Plasmodium vivax in imported malaria cases: an analysis of 9-year surveillance data in four areas of China

Frontiers in Public Health

Public Health

Fei Luo¹  Tao Zhang²  Kangming Lin³  Linong Yao⁴  Wei Ruan⁴  Xuan Zhang⁴  Wenjie Xu⁴  Xiaoxiao Wang⁴  Jiaqi Zhang⁴  Sarah Auburn⁵  Duoquan Wang⁶ 

[1] Department of Endemic and Parasitic Diseases, Chongqing Center for Disease Control and Prevention, Chongqing, China;Department of Infectious Diseases, Anhui Center of Disease Control and Prevention, Hefei, China;Department of Infectious Diseases, Guangxi Center of Disease Control and Prevention, Nanning, China;Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China;Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia;Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China;School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

关键词: imported malaria;    China;    Western Africa;    migrant workers;    surveillance;    medical visit pattern;   

DOI  :  10.3389/fpubh.2023.1203095

 received in 2023-04-10, accepted in 2023-05-16,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThis study aimed at exploring the epidemiological pattern of imported malaria in China before malaria elimination in 2021, to provide evidence-based data for preventing malaria re-establishment in China.MethodsNine-year surveillance data on imported malaria in four provincial-level administrative divisions (PLADs) (Anhui, Chongqing, Guangxi, and Zhejiang) between 2011 and 2019 were thoroughly collected and analyzed.ResultsA quite stable trend in imported malaria cases between 2011 and 2019 was observed. In total, 6,064 imported patients were included. Plasmodium falciparum was the most frequently reported species (4,575, 75.6%). Cases of malaria were most frequently imported from Western Africa (54.4%). We identified an increasing trend in P. ovale and a persistence of P. vivax infections among the cases of malaria imported from Western Africa. Most patients (97.5%) were 20–50 years old. Among imported malaria infections, the main purposes for traveling abroad were labor export (4,914/6,064, 81.0%) and business trips (649, 10.7%). Most patients (2,008/6,064, 33.1%) first visited county-level medical institutions when they sought medical help in China. More patients were diagnosed within 3 days after visiting Centers for Disease Control and Prevention (CDCs) or entry–exit quarantine facilities (EQFs) (1,147/1609, 71.3%) than after visiting medical institutions (2,182/3993, 54.6%).ConclusionImported malaria still poses a threat to the malaria-free status of China. County-level institutions are the primary targets in China to improve the sensitivity of the surveillance system and prevent the re-establishment of malaria. Health education should focus on exported labors, especially to Western and Central Africa. Increasing trend in P. ovale and persistence of P. vivax infections indicated their underestimations in Western Africa. Efficient diagnostic tools and sensitive monitoring systems are required to identify Plasmodium species in Africa.

【 授权许可】

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Copyright © 2023 Wang, Xu, Luo, Lin, Zhang, Yao, Zhang, Zhang, Auburn, Wang and Ruan.