背景:老挝人民民主共和国政府加大了控制疟疾传播的力度,以便到2030年达到其国家消除疟疾的目标。天气会影响疟疾传播动态,在评估消除干预措施的影响时应予以考虑,但这种关系在老挝人民民主共和国尚未得到很好的表征。这项研究调查了2010年至2022年气候变量与恶性疟原虫和间日疟原虫疟疾发病率之间的时空关联。
方法:时空贝叶斯模型用于调查月度关系,和模型选择标准用于评估模型的性能和天气变量规格。由于在研究期间,疟疾控制和消除情况在空间和时间上是动态的,该协会每年在省一级进行审查。
结果:从2010年到2022年,恶性疟原虫和间日疟原虫的疟疾发病率均下降,并且集中在南部地区。在研究期间,降雨和最大湿度被确定为与疟疾最密切相关。在2010-2011年期间,北部和中部地区的降雨与恶性疟原虫的发病率有关,在2012-2015年期间,北部和中部地区的降雨与间日疟原虫的发病率有关。最大湿度与南部的恶性疟原虫和间日疟原虫的发病率持续相关。
结论:疟疾在老挝人民民主共和国仍然普遍存在,尤其是在南方,与天气的关系因地区而异,但这两个物种的降雨和最大湿度都最强。在天气条件合适的高峰期,病媒控制活动和提高公众对正确使用干预措施的认识,如室内残留喷涂和个人防护,应该优先考虑。
BACKGROUND: The government of Lao PDR has increased efforts to control malaria transmission in order to reach its national elimination goal by 2030.
Weather can influence malaria transmission dynamics and should be considered when assessing the impact of elimination interventions but this relationship has not been well characterized in Lao PDR. This study examined the space-time association between climate variables and Plasmodium falciparum and Plasmodium vivax malaria incidence from 2010 to 2022.
METHODS: Spatiotemporal Bayesian modelling was used to investigate the monthly relationship, and model selection criteria were used to evaluate the performance of the models and
weather variable specifications. As the malaria control and elimination situation was spatially and temporally dynamic during the study period, the association was examined annually at the provincial level.
RESULTS: Malaria incidence decreased from 2010 to 2022 and was concentrated in the southern regions for both P. falciparum and P. vivax. Rainfall and maximum humidity were identified as most strongly associated with malaria during the study period. Rainfall was associated with P. falciparum incidence in the north and central regions during 2010-2011, and with P. vivax incidence in the north and central regions during 2012-2015. Maximum humidity was persistently associated with P. falciparum and P. vivax incidence in the south.
CONCLUSIONS: Malaria remains prevalent in Lao PDR, particularly in the south, and the relationship with
weather varies between regions but was strongest for rainfall and maximum humidity for both species. During peak periods with suitable
weather conditions, vector control activities and raising public health awareness on the proper usage of intervention measures, such as indoor residual spraying and personal protection, should be prioritized.