Abstract: Objective　To analyze the epidemiological characteristics of imported malaria cases in Guangxi Zhuang Autonomous Region from 2017 to 2024, so as to formulate the targeted control strategies for imported malaria. Methods　The demographic and epidemiological data of malaria cases reported in Guangxi Zhuang Autonomous Region from 2017 to 2024 were collected through the China Disease Prevention and Control Information System. The source of malaria cases acquiring infections, composition of malaria parasite species, regional distribution of malaria cases, population characteristics of malaria cases, temporal distribution of malaria cases, time of diagnosis, deaths and institutions reporting malaria cases were statistically analyzed with a descriptive statistical method.  Results　A total of 1 308 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2017 to 2024, and all cases were overseas imported cases, with no secondary cases identified. Plasmodium falciparum malaria (57.11%, 747/1 308) and P. ovale malaria (27.68%, 362/1 308) were two most common forms of malaria, and three deaths occurred among P. falciparum malaria cases. The number of malaria cases appeared an overall tendency towards a decline from 2017 to 2022, followed by a rise after 2023. The malaria cases predominantly acquired infections from Africa (1 284 cases, accounting for 98.17%), with Ghana (432 cases, accounting for 33.03%) and Cameroon (145 cases, accounting for 11.09%) as two most frequent origin countries, and P. falciparum malaria (58.02%, 745/1 284) was the predominant form of malaria among African imported malaria cases; however, P. vivax malaria cases comprised 89.58% (86/96) of all malaria cases derived from Ethiopia. In terms of regional distribution, malaria cases were highly concentrated in Nanning City (1 075 cases, accounting for 82.19%), with the most prominent situated in Shanglin County (903 cases, accounting for 69.04%), and these cases were predominantly found among individuals at ages of 20 to 59 years (1 280 cases, accounting for 97.86%), males (1 265 cases, accounting for 96.71%), and gold/coal mining workers (1 042 cases, accounting for 79.66%). In terms of temporal distribution, malaria cases were reported throughout the year, with the peak incidence in April (146 cases, accounting for 11.16%). The median duration from onset of disease to initial diagnosis was 1 (interquartile range, 2) day, and the median duration from initial diagnosis to definitive diagnosis was 1 (interquartile range, 1) day. Malaria cases were predominantly reported by medical institutions (1 075 cases, accounting for 82.19%), and the proportion of malaria cases reported by medical institutions increased from 75.92% in 2017 to 96.27% in 2024, while the proportion of malaria cases reported by disease control and prevention institutions reduced from 24.08% in 2017 to 3.73% in 2024. There was a significant difference in the proportion of malaria cases reported by medical institutions and disease control and prevention institutions from 2017 to 2024 (both P  < 0.001). The 3 dead imported P. falciparum malaria cases predominantly received initial diagnosis at township⁃ and lower⁃level institutions (66.67%, 2/3), with 1 (interquartile range, 2) day median duration from onset of disease to initial diagnosis, 2 (interquartile range, 4) days median duration from initial diagnosis to definitive diagnosis, and 1 (interquartile range, 19) day median duration from definitive diagnosis to death. Conclusions　Imported P. falciparum malaria from Africa is predominant among malaria cases in Guangxi Zhuang Autonomous Region, and malaria cases are highly concentrated in specific regions and among specific occupational groups. It is recommended to strengthen inter⁃departmental collaboration, implement refined management among labors going to Africa, improve the integration of medical treatment and disease prevention, and enhance the diagnosis and treatment of severe malaria cases. 

Key words: Imported malaria, Epidemiological characteristic, Control strategy, Guangxi Zhuang Autonomous Region

摘要： 目的　分析2017—2024年广西壮族自治区输入性疟疾病例流行病学特征，为制定针对性防控策略提供科学依据。方法　通过中国疾病预防控制信息系统收集2017—2024年广西壮族自治区报告的疟疾病例资料，采用描述性统计方法对病例感染来源、虫种构成、地区分布、人群特征、时间分布及诊断时间、死亡病例、病例报告机构等信息进行统计分析。结果　2017—2024年，广西壮族自治区共报告疟疾病例1 308例，均为境外输入性病例，无输入继发病例；病例类型以恶性疟为主（57.11%，747/1 308），其次为卵形疟（27.68%，362/1 308）；此外，共报告3例恶性疟死亡病例。2017—2022年病例数总体呈波动下降趋势，2023年后回升。病例主要来源于非洲（1 284例，占98.17%），以加纳为主（432例，占33.03%），其次为喀麦隆（145例，占11.09%）。来源于非洲的输入性病例以恶性疟为主，占比达58.02%（745/1 284）；但来自埃塞俄比亚的病例中，间日疟病例占比达89.58%（86/96）。在地区分布上，病例高度集中于南宁市（1 075例，占82.19%），以上林县为主（903例，占69.04%）；在人群分布上，病例以20～59岁（1 280例，占97.86%）、男性（1 265例，占96.71%）及淘金/挖矿从业人员（1 042例，占79.66%）为主；在时间分布上，全年均有病例报告，以4月为发病高峰，共报告病例146例（占11.16%）。病例发病至初诊中位天数为1（2） d，初诊至确诊中位天数为1（1） d。医疗机构为主要病例报告机构，共报告1 075例（占82.19%）；2017—2024年，医疗机构报告病例数占比从75.92%升至96.27%，疾病预防控制机构报告病例数占比则从24.08%降至3.73%，两类机构不同年份报告病例数占比差异均有统计学意义（P 均< 0.001）。3例输入性恶性疟死亡病例初诊机构以乡（镇）及以下机构为主（66.67%），发病至初诊中位天数为1（2） d，初诊至确诊中位天数为2（4） d，确诊至死亡中位天数为1（19） d。结论　广西壮族自治区疟疾病例以自非洲输入的恶性疟病例为主，呈现特定地区和职业人群高度集中的特征。应加强部门合作，对赴非务工人员进行精细化管理，并完善医防融合机制，提升重症病例诊疗水平。

关键词: 输入性疟疾, 流行病学特征, 防控策略, 广西壮族自治区