1980－2022年中国长三角地区疟疾季节性特征比较及关联分析

胡学锋; 陈琳; 李忠起; 邱文毅; 吴媛媛; 田玲玲; 张荣; 吴海磊

doi:10.3784/jbjc.202311160608

1980－2022年中国长三角地区疟疾季节性特征比较及关联分析

Seasonality and relativity of malaria incidence in Yangtze River Delta of China, 1980−2022

摘要

摘要:
目的回顾性分析中国长三角地区1980—2022年疟疾分布的季节性特征和关联性，为巩固和维持消除疟疾成果提供科学依据和参考。
方法收集江苏省、浙江省、上海市、安徽省1980—2022年疟疾年度逐月发病数据，采用Joinpoint 5.02软件进行时间趋势分析，采用Excel 2019软件对数据资料进行整理并计算集中度M值和发病高峰日，查阅临界值表进行雷氏检验。运用DPS 19.05软件进行Watson-Williams检验和相关分析，分析长三角地区疟疾季节性特征和关联性。
结果 1980—2022年长三角地区年病例数及发病率总体呈下降趋势，有一定波动性，病例全国占比波动较大。各省份年发病率下降差异有统计学意义（P<0.05），但时间拐点不一致。各地年度、月度病例数及发病率相关性检验差异有统计学意义（P<0.05）。 2020年前月病例数集中度M值有下降趋势，有明显波动性。消除本土疟疾前长三角各地区疟疾发病有集中趋势，发病高峰日分布于6月12日至9月23日之间。消除本土感染疟疾后，除2020—2022年外，长三角地区疟疾季节性特征不显著。 1980—2022年各地年平均角Watson-Williams检验差异有统计学意义（P<0.001）。
结论不同历史阶段长三角地区疟疾季节性特征变化明显。在消除本土疟疾后，输入病例后再传播风险持续存在，要采取综合性一体化措施做好防控。

Abstract:
Objective To analyze the retrospective seasonality and relativity of malaria incidence in Yangtze River Delta of China from 1980 to 2022, and provide scientific evidence and reference to maintain the achievement of malaria elimination.
Methods The annual and monthly incidence data of malaria in Jiangsu, Zhejiang, Shanghai, and Anhui provinces (municipality) were collected. The time-trend was analyzed by Joinpoint 5.02, and the data were processed with Excel 2019 for the calculations of concentration ratio(M), average angle and incidence pesk day. Rayleigh test was conducted with criticality value table. Watson-Williams test and relativity analysis were conducted with software DPS 19.05 to understand the seasonality and relativity of malaria in Yangtze River Delta.
Results The annual case count and incidence of malaria declined with fluctuation in Yangtze River Delta from 1980 to 2022. The proportion of annual malaria case count in Yangtze River Delta in national total was highly fluctuant. The differences in annual incidence decline of malaria were significant among the four provinces(municipality) (P<0.05), but the time-points were different. There were relativities in annual and monthly case count and incidence of malaria among different area(P<0.05). There were declining trend in M values before 2020. The M values were fluctuant. Before the elimination of indigenous malaria, there were seasonal concentration trend of malaria incidence in Yangtze River Delta and the peak days were between June 12^th and September 23^rd. After the elimination of indigenous malaria, the seasonality of malaria were not obvious except the period from 2020 to 2022. There were statistical significances in different area from 1980 to 2022 indicated by Watson-Williams test (P<0.001).
Conclusion There were significant changes in the seasonality of malaria incidence in Yangtze River Delta during different periods. The risk of re-transmission by imported malaria still exists after the elimination of indigenous malaria. It is necessary to take comprehensive and integrated measures to prevent and control malaria epidemic.

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