Chin J Schisto Control ›› 2014, Vol. 26 ›› Issue (6): 598-.

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Determination of key interventions for the transition from control to elimination of malaria in China

XIA Zhi-gui 1 |XU Jun-fang2△|ZHANG Shao-sen1 |WANG Ru-bo1 |QIAN Ying-jun1 |ZHOU Shui-sen1 |YANG Wei-zhong3 |ZHOU Xiao-nong1*   

  1. 1 National Institute of Parasitic Diseases|Chinese Center for Disease Control and Prevention;Key Laboratory of Parasite and Vec? tor Biology|Ministry of Health;WHO Collaborating Centre for Malaria|Schistosomiasis and Filariasis|Shanghai 200025|Chi? na;2 Department of Preventive Medicine|Hubei University for Nationality|China;3 Chinese Center for Disease Control and Pre? vention|China
  • Online:2014-12-22 Published:2014-12-23
  • Contact: ZHOU Xiao?nong
  • About author:夏志贵| 男| 硕士| 副研究员。研究方向: 疟疾流行病学 △共同第一作者

我国疟疾由控制走向消除的干预措施分析

夏志贵1|徐俊芳2Δ|张少森1|王汝波1|钱颖骏1|周水森1|杨维中3|周晓农1*   

  1. 1 中国疾病预防控制中心寄生虫病预防控制所| 卫生部寄生虫病原与媒介生物学重点实验室| 世界卫生组织疟疾、 血吸虫病和丝虫 病合作中心 (上海 200025); 2 湖北民族学院医学院预防医学教研室; 3 中国疾病预防控制中心
  • 通讯作者: 周晓农
  • 基金资助:
    国家自然科学基金 (81273192); 国家重大传染病科技专项 (2012ZX10004?220); 中英全球支持项目 (GHSP?CS?OP1、 OP3)

Abstract: Objective Objective To determine the key interventions transferring from the control to elimination of malaria in China so as to provide the basic information for achieving malaria elimination. Methods Methods Based on the data collected from the document entitled of The National Annual Report on Schistosomiasis,Malaria and Echinococcosis,published by the National Institute of Parasitic Diseases of Chinese Center for Disease Control and Prevention,the malaria incidence and intervention data were se? lected only in the typical endemic provinces during the period of 2004-2010. The correlation between the incidence and interven? tions in the target provinces was analyzed based on the Panel Data Regression Model,and the key interventions were deter? mined. Results Results Four provinces namely Anhui,Yunnan,Hainan and Henan were targeted with 87.56% of the national malaria figures from 2004 to 2010. When Y was given as vivax malaria incidence,X1 as the log of the number of historical cases receiving radical treatment in the pre?transmission stage(RTPT) (F=14.53,P < 0.01,R2 = 0.72),X2 as the log of risk population receiv? ing RTPR(F =15.90,P < 0.01,R2 =0.71)and X3 as the number of technicians trained in microscopy(F = 11.53,P < 0.01,R2 = 0.61),three space?fixed effect models were established respectively,and X1,X2,as well as X3 had negative effects on Y value. When Y was given as falciparum malaria incidence,X1 as the accumulated technicians trained in microscopy(F = 11.06,P < 0.01,R2 = 0.87),X2 as the log of technicians trained in entomology(F = 15.28,P < 0.01,R2 = 0.89),two two?way(space and time)fixed effect models were established respectively,and both X1 and X2 had negative effects on Y value. Conclusion Conclusion RTPT among historical patients and at ? risk populations as well as microscopy training influences the variation of vivax malaria incidence,while the significant interventions of microscopy training and vector control training indicate that the integrated measures with strengthened capacity in diagnosis and vector control are of importance in the control of falciparum malaria transmission.

Key words: Malaria; Control;Elimination; Intervention;Model

摘要: 目的 目的 提出疟疾由控制走向消除的关键措施, 为我国实施消除疟疾工作提供依据。方法 方法 收集2004-2010年 《全国血吸虫病、 疟疾和包虫病防治工作年报》 数据, 选取疟疾疫情较重的典型流行省份, 建立发病率变化与干预措施间 的面板数据回归模型。结果 结果 2004-2010年全国87.56%的疟疾发病集中在安徽、 云南、 海南和河南4省。以Y为间日疟 发病率, X1为有疟疾病史者休止期服药人数的自然对数 (F = 14.53, P < 0.01, R2 = 0.72), X2为重点人群休止期服药人数的 自然对数 (F = 15.90, P < 0.01, R2 = 0.71), X3为镜检培训人数 (F = 11.53, P < 0.01, R2 = 0.61), 分别建立了地区固定效应模 型, X1、 X2和X3均对Y具有负向影响作用; 以Y为恶性疟发病率, X1为镜检培训累计人数 (F = 11.06, P < 0.01, R2 = 0.87), X2 为媒介培训人数的自然对数 (F = 15.28, P < 0.01, R2 = 0.89), 分别建立了地区时间双向固定效应模型, X1和X2均对Y具有 负向影响作用。结论 结论 有疟疾病史者休止期服药、 重点人群休止期服药和镜检培训等是控制间日疟疫情的关键干预措 施, 镜检培训和媒介培训则对恶性疟发病率下降有重要作用。

关键词: 疟疾; 控制; 消除; 干预措施; 模型

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