Background:The elimination of malaria requires high-quality surveillance data to enable rapid detection and response to individual cases.Evaluation of the performance of a national malaria surveillance system could id...Background:The elimination of malaria requires high-quality surveillance data to enable rapid detection and response to individual cases.Evaluation of the performance of a national malaria surveillance system could identify shortcomings which,if addressed,will improve the surveillance program for malaria elimination.Methods:Case-level data for the period 2005–2014 were extracted from the China National Notifiable Infectious Disease Reporting Information System and Malaria Enhanced Surveillance Information System.The occurrence of cases,accuracy and timeliness of case diagnosis,reporting and investigation,were assessed and compared between the malaria control stage(2005–2010)and elimination stage(2011–2014)in China's Mainland.Results:A total of 210730 malaria cases were reported in China's Mainland in 2005–2014.The average annual incidence declined dramatically from 2.5 per 100000 people at the control stage to 0.2 per 100000 at the elimination stage,but the proportion of migrant cases increased from 9.8%to 41.0%.Since the initiation of the National Malaria Elimination Programme in 2010,the overall proportion of cases diagnosed by laboratory testing consistently improved,with the highest of 99.0%in 2014.However,this proportion was significantly lower in non-endemic provinces(79.0%)than that in endemic provinces(91.4%)during 2011–2014.The median interval from illness onset to diagnosis was 3 days at the elimination stage,with one day earlier than that at the control stage.Since 2011,more than 99%cases were reported within 1 day after being diagnosed,while the proportion of cases that were reported within one day after diagnosis was lowest in Tibet(37.5%).The predominant source of cases reporting shifted from town-level hospitals at the control stage(67.9%cases)to city-level hospitals and public health institutes at the eliminate stage(69.4%cases).The proportion of investigation within 3 days after case reporting has improved,from 74.6%in 2010 to 98.5%in 2014.Conclusions:The individual case-based malaria surveillance system in China operated well during the malaria elimination stage.This ensured that malaria cases could be diagnosed,reported and timely investigated at local level.However,domestic migrants and overseas populations,as well as cases in the historically malarial non-endemic areas and hard-to-reach area are new challenges in the surveillance for malaria elimination.展开更多
Background:Understanding the global spatiotemporal pattern of seasonal influenza is essential for influenza control and prevention.Available data on the updated global spatiotemporal pattern of seasonal influenza are ...Background:Understanding the global spatiotemporal pattern of seasonal influenza is essential for influenza control and prevention.Available data on the updated global spatiotemporal pattern of seasonal influenza are scarce.This study aimed to assess the spatiotemporal pattern of seasonal influenza after the 2009 influenza pandemic.Methods:Weekly influenza surveillance data in 86 countries from 2010 to 2017 were obtained from FluNet.First,the proportion of influenza A in total influenza viruses(PA)was calculated.Second,weekly numbers of influenza positive virus(A and B)were divided by the total number of samples processed to get weekly positive rates of influenza A(RWA)and influenza B(RWB).Third,the average positive rates of influenza A(RA)and influenza B(RB)for each country were calculated by averaging RWA,and RWB of 52 weeks.A Kruskal-Wallis test was conducted to examine if the year-to-year change in PA in all countries were significant,and a universal kriging method with linear semivariogram model was used to extrapolate RA and RB in all countries.Results:PA ranged from 0.43 in Zambia to 0.98 in Belarus,and PA in countries with higher income was greater than those countries with lower income.The spatial patterns of high RB were the highest in sub-Saharan Africa,Asia-Pacific region and South America.RWA peaked in early weeks in temperate countries,and the peak of RWB occurred a bit later.There were some temperate countries with non-distinct influenza seasonality(e.g.,Mauritius and Maldives)and some tropical/subtropical countries with distinct influenza seasonality(e.g.,Chile and South Africa).Conclusions:Influenza seasonality is not predictable in some temperate countries,and it is distinct in Chile,Argentina and South Africa,implying that the optimal timing for influenza vaccination needs to be chosen with caution in these unpredictable countries.展开更多
基金supported by grants from the Ministry of Science and Technology of China(2012ZX10004-201,2012ZX10004-220,2014BAI13B05)the Ministry of Health of China(No.201202006).
文摘Background:The elimination of malaria requires high-quality surveillance data to enable rapid detection and response to individual cases.Evaluation of the performance of a national malaria surveillance system could identify shortcomings which,if addressed,will improve the surveillance program for malaria elimination.Methods:Case-level data for the period 2005–2014 were extracted from the China National Notifiable Infectious Disease Reporting Information System and Malaria Enhanced Surveillance Information System.The occurrence of cases,accuracy and timeliness of case diagnosis,reporting and investigation,were assessed and compared between the malaria control stage(2005–2010)and elimination stage(2011–2014)in China's Mainland.Results:A total of 210730 malaria cases were reported in China's Mainland in 2005–2014.The average annual incidence declined dramatically from 2.5 per 100000 people at the control stage to 0.2 per 100000 at the elimination stage,but the proportion of migrant cases increased from 9.8%to 41.0%.Since the initiation of the National Malaria Elimination Programme in 2010,the overall proportion of cases diagnosed by laboratory testing consistently improved,with the highest of 99.0%in 2014.However,this proportion was significantly lower in non-endemic provinces(79.0%)than that in endemic provinces(91.4%)during 2011–2014.The median interval from illness onset to diagnosis was 3 days at the elimination stage,with one day earlier than that at the control stage.Since 2011,more than 99%cases were reported within 1 day after being diagnosed,while the proportion of cases that were reported within one day after diagnosis was lowest in Tibet(37.5%).The predominant source of cases reporting shifted from town-level hospitals at the control stage(67.9%cases)to city-level hospitals and public health institutes at the eliminate stage(69.4%cases).The proportion of investigation within 3 days after case reporting has improved,from 74.6%in 2010 to 98.5%in 2014.Conclusions:The individual case-based malaria surveillance system in China operated well during the malaria elimination stage.This ensured that malaria cases could be diagnosed,reported and timely investigated at local level.However,domestic migrants and overseas populations,as well as cases in the historically malarial non-endemic areas and hard-to-reach area are new challenges in the surveillance for malaria elimination.
基金We’d like to thank World Health Organization for making the FluNet data publicly available.Dr.Wenbiao Hu was supported by an Australian Research Council Future Fellowship(award number FT140101216).
文摘Background:Understanding the global spatiotemporal pattern of seasonal influenza is essential for influenza control and prevention.Available data on the updated global spatiotemporal pattern of seasonal influenza are scarce.This study aimed to assess the spatiotemporal pattern of seasonal influenza after the 2009 influenza pandemic.Methods:Weekly influenza surveillance data in 86 countries from 2010 to 2017 were obtained from FluNet.First,the proportion of influenza A in total influenza viruses(PA)was calculated.Second,weekly numbers of influenza positive virus(A and B)were divided by the total number of samples processed to get weekly positive rates of influenza A(RWA)and influenza B(RWB).Third,the average positive rates of influenza A(RA)and influenza B(RB)for each country were calculated by averaging RWA,and RWB of 52 weeks.A Kruskal-Wallis test was conducted to examine if the year-to-year change in PA in all countries were significant,and a universal kriging method with linear semivariogram model was used to extrapolate RA and RB in all countries.Results:PA ranged from 0.43 in Zambia to 0.98 in Belarus,and PA in countries with higher income was greater than those countries with lower income.The spatial patterns of high RB were the highest in sub-Saharan Africa,Asia-Pacific region and South America.RWA peaked in early weeks in temperate countries,and the peak of RWB occurred a bit later.There were some temperate countries with non-distinct influenza seasonality(e.g.,Mauritius and Maldives)and some tropical/subtropical countries with distinct influenza seasonality(e.g.,Chile and South Africa).Conclusions:Influenza seasonality is not predictable in some temperate countries,and it is distinct in Chile,Argentina and South Africa,implying that the optimal timing for influenza vaccination needs to be chosen with caution in these unpredictable countries.