1950-2019年云南省边境地区疟疾时空分布特征分析

Temporal and spatial distribution characteristics of malaria in border areas of Yunnan Province from 1950 to 2019

目的分析1950-2019年云南省边境地区疟疾时空分布特征,为做好边境地区防止输入疟疾再传播工作提供科学依据。方法收集1950-2019年云南省边境25个县的疟疾疫情、疟原虫虫种和人口数据,用Excel 2010建立数据库,用SPSS22.0进行频率描述性统计分析,对各年境外输入病例来源构成以及虫种构成进行χ~2检验,用Arcgis10.2绘制云南省边境地区疟疾发病情况空间变化趋势图。结果1950-2019年云南省25个边境县累计报告了164.84万例疟疾病例,发病率从1121.84/万降到0,2017年成功阻断本地病例传播;在消除疟疾阶段,云南省25个边境县共累计报告4155例,本地病例524例(占12.61%),境外输入病例3631例(占87.39%),输入地主要为缅甸(占96.31%);报告病例中以间日疟为主,报告3436例(占82.70%),其次为恶性疟,报告671例(占16.15%);从缅甸和老挝输入的病例均以间日疟为主,分别占82.64%和96.23%,从非洲输入的病例以恶性疟为主(占73.91%);报告的本地病例高峰在5~7月(占47.90%),报告的境外输入病例高峰为4-8月(占67.50%);2011-2019年,25个边境县中,盈江县报告病例最多,累计报告1205例(占29%),其次为腾冲(1070例,占25.75%)和瑞丽(730例,占17.57%);2016年盈江县为最后一个报告本地病例的县(间日疟)。结论截至2019年底云南省边境地区已连续3年无本地感染疟疾病例报告,阻断了本地疟疾在云南边境地区的传播,达到了消除疟疾标准,但边境地区的输入性疟疾继发本地传播的风险将长期存在。

Objective To analyze the temporal and spatial distribution characteristics of malaria in the border areasof Yunnan Province from 1950 to 2019,and provide a scientific basis for preventing the re transmission of imported malaria in the border areas.Method To collect malaria epidemic situation,malaria parasite species and population data of 25 border counties in Yunnan Province from 1950 to 2019,and establish a database with Excel 2010,perform frequency descriptive statistical analysis with SPSS 22.0,and analyze the source composition and parasite species composition of overseas input cases in each year withχ~2 test,using arcgis10.2 to draw the spatial change trend map of malaria incidence in border areas of Yunnan Province.Result In 1950-2019 years,25 border counties in Yunnan province reported 1.65 million malaria cases,and the incidence rate dropped from 11.22/million to 0,and successfully blocked the spread of local cases.In the stage of eliminating malaria,a total of 4155 cases were reported in 25 border counties in Yunnan Province,including 524 local cases(12.61%),3631 imported cases(87.39%),and the main import was from Myanmar(96.31%);Among the reported cases,P.vivax was the main insect species,with 3436 cases(82.70%),followed by P.falciparum,with 671 cases(16.15%);The imported cases from Myanmar and Laos are mainly P.vivax,accounting for 82.64%and 96.23%respectively.The imported cases from Africa are mainly P.falciparum(73.91%);The peak of reported local cases is from May to July(47.90%),and the peak of reported imported cases is from April to August(67.50%);From 2011 to 2019,among the 25 border counties,Yingjiang County reported the most cases,with a total of 1205 cases(29%),followed by Tengchong(1070 cases,25.75%)and Ruili(730 cases,17.57%);In 2016,Yingjiang County was the last county to report local cases(P.vivax).Conclusion By the end of 2019,there have been no reports of local malaria cases in the border areas of Yunnan Province for three consecutive years,which has blocked the malaria transmission of local malaria in the border areas of Yunnan Province and reached the standard for malaria elimination.However,the risk of secondary local transmission of imported malaria in the border areas will exist for a long time.