背景:在南非(SA),疟疾在九个省中的三个省-夸祖鲁-纳塔尔省流行,姆普马兰加和林波波。在2010年至2014年期间,SA报告说,所有疟疾病例中约有47.6%是输入性的。对林波波省五个地区疟疾流行的当代估计是有限的,未知比例的输入性疟疾病例。我们估计了疟疾的患病率,以及林波波五个地区输入性疟疾病例的比例,2015年1月至2017年12月。
目的:为了测量林波波省的疟疾患病率,2015年1月至2017年12月期间输入的疟疾病例比例,并确定与疟疾相关的因素。
方法:我们回顾了通过国家卫生实验室服务的疟疾信息系统和实验室信息系统常规收集的数据,并评估与年龄的关联,性别和地区,使用多变量逻辑回归模型。
结果:从2015年到2017年,共报告了43199例疟疾病例,其中3.5%(n=1532)是进口的。2017年,林波波省的疟疾患病率最高,为每10万人口331.0例。疟疾流行率最高的地区是Vhembe,2015年为647.9,2016年为220.3,2017年为659.4,每10万人口。然而,沃特伯格的输入性疟疾病例比例最高,为28.5%(437/1532)。在调整后的分析中,与年龄≥65岁相比,年龄15~49岁(校正比值比(aOR)1.58,95%置信区间(CI)1.48~1.68,p<0.001)和<1岁(aOR1.55,95%CI1.37~0.74,p<0.001)的疟疾发病几率较高.
结论:这些发现突出了林波波省输入性疟疾的重大负担。有必要在邻国(如莫桑比克,津巴布韦和博茨瓦纳)减少该地区疟疾的输入和传播。
BACKGROUND: In South Africa (SA), malaria is endemic in three of nine provinces - KwaZulu-Natal, Mpumalanga and Limpopo. During 2010 - 2014, SA reported that ~47.6% of all malaria cases were imported. Contemporary estimates for the prevalence of malaria in the five districts of Limpopo Province are limited, with unknown proportions of imported malaria cases. We estimated the prevalence of malaria, and the proportion of imported malaria cases in the five districts of Limpopo, from January 2015 to December 2017.
OBJECTIVE: To measure the prevalence of malaria in Limpopo Province, the proportion of malaria cases that are imported and to determine factors associated with malaria from January 2015 to December 2017.
METHODS: We retrospectively reviewed data routinely collected through the Malaria Information System and Laboratory Information System of the National Health Laboratory Services, and assessed associations with age, sex and district, using a multivariable logistic regression model.
RESULTS: From 2015 to 2017, a total of 43 199 malaria cases were reported, of which 3.5% (n=1 532) were imported. The prevalence of malaria in Limpopo Province was the highest in 2017, at 331.0 per 100 000 population. The highest malaria prevalence district was Vhembe, with 647.9 in 2015, 220.3 in 2016 and 659.4 in 2017 per 100 000 population. However, Waterberg had the highest proportion of imported malaria cases 28.5% (437/1 532). In adjusted analyses, ages 15 - 49 years (adjusted odds ratio (aOR) 1.58, 95% confidence interval (CI) 1.48 - 1.68, p<0.001) and <1 year (aOR 1.55, 95% CI 1.37 - 0.74, p<0.001) were at higher odds of having malaria compared with ages ≥65 years.
CONCLUSIONS: These findings highlight the significant burden of imported malaria in Limpopo Province. There is a need for strengthened surveillance and control programmes in neighboring countries (such as Mozambique, Zimbabwe and Botswana) to reduce the importation and spread of malaria in this region.