Epidemiological characteristics of imported malaria in Shandong Province in 2017-2022
Objective To understand the epidemiological characteristics of imported malaria in Shandong Prov-ince and provide scientific basis for the prevention of re-transmission of imported malaria.Methods Data of the im-ported malaria epidemiological situation and case investigation in Shandong Province from 2017 to 2022 were collected from the Infectious Disease Reporting Information Management System and the Parasitic Disease Prevention and Con-trol Information Management System of China Disease Prevention and Control Information System.A database for analy-sis was established.SPSS 26.0 software was use to analyze the case classification,source of infection,epidemiological characteristics,and the diagnosis and treatment records of the malaria cases.The x2 test was used to compare the rates,and the nonparametric test was used to compare the time interval distribution.The spatial clustering of malaria cases was analyzed by scanning with SaTScan v10.1 software.Figures were generated using GraphPad Prism 8.3.0 soft-ware.Results From 2017 to 2022,a total of 820 imported malaria cases were reported in Shandong Province,all of which were imported from abroad.A total of 670 cases were reported before the corona virus disease 2019(COVID-19)pandemic and 150 cases during the COVID-19 pandemic.All the 820 cases were laboratory-diagnosed.falciparum malaria,ovale malaria,vivax malaria and malariae malaria accounted for 69.5％(570/820),19.0％(156/820),7.3％(60/820)and 4.1％(34/820),respectively.There were no mixed infections and unclassified cases.The main source of the in-fections was Africa(95.9％,786/820).All 16 cities in Shandong Province had cases reported,while 511 cases were re-ported in five cities,including Jining,Yantai,Weihai,Qingdao and Jinan,accounting for 62.3％(511/820).Spatial scan-ning analysis found 7 case clusters,among which 13 counties,such as Huancui in Weihai and Muping in Yantai were the primary clusters(relative risk=3.98,P＜0.01).According to the city where the case was reported,191 cases had been treated in a different region within the province,accounting for 23.3％(191/820).A total of 421 local cases(55.3％,421/762)were reported by 18 medical facilities designated for malaria treatment in the province.The median time interval from onset of symptoms to initial diagnosis and from initial diagnosis to final diagnosis was 1 and 0 days,respectively.The proportion of patients who were initially diagnosed in the provincial,municipal,county,and below-county medical facilities was 9.9％(81/820),36.1％(296/820),31.5％(258/820)and 16.6％(136/820),respectively.The malaria diagnosis accuracy was 88.9％(72/81),84.1％(249/296),76.4％(197/258)and 5.2％(7/136),respectively,with 6.0％(49/820)of the patients initially diagnosed in other institutions,such as centres for disease control,inspection and quarantine organizations,and the malaria diagnosis accuracy was 87.8％(43/49).There was a significant difference in the malaria diagnosis accuracy in different institutions(x2=321.959,P＜0.01).A total of 74 severe malaria cases were reported,accounting for 9.0％(74/820),and 5 cases decesed.Conclusion There are high number of imported ma-laria cases in Shandong Province,which are widely distributed.The risk of re-transmission exists.
MalariaEpidemiological characteristicsSpatial clusteringCross-regional medical treatmentShandong Province
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