RESUMEN
The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.
RESUMEN
Objective To understand the geographical features of malaria in Yunnan Province,so as to provide the refer?ence for malaria elimination. Methods The data of malaria in Yunnan Province from 2012 to 2015 were collected and ana?lyzed. Results Totally 2 586 malaria cases were reported in Yunnan Province from 2012 to 2015,in which 274(10.60%) were local cases and 2 311(89.37%)were abroad imported,and one(0.03%)was domestic imported. The imported malaria cases and local cases were analyzed according to the sources and locations respectively,and the arithmetic means of the num?bers of imported and local cases were 96.29 and 10.96 respectively,the standard deviations of the numbers of imported and local cases were 421.18 and 19.12 respectively,and the difference of the means was not significant(Z=-0.326,P>0.10). Both the imported and local malaria cases could be clustered into five sections by the number of 5. The Herfendal?Hirshman indexes of the imported and local malaria cases were 8 121 and 1 598 respectively. Conclusions There is no significant difference of the distribution between the imported and local malaria cases,and they should be attaching equal importance. The non?uniform de?gree of imported cases is higher than that of the local cases,while both of them could be divided into five major clusters in the prevention and control work.
RESUMEN
Objective To investigate the time distribution characteristics and the epidemic trends of imported malaria cases in Yunnan Province. Methods The malaria case records and epidemiological history data of Yunnan Province were collected, and the local infection cases were excluded. The data were statistical analyzed. Results The imported malaria cases had a sig-nificantly seasonal periodicity(Q=26.574,P0.05). By using the model to predict the cases in January,February and March of 2016,the num-ber(95％CI)were 29(7-50),22(0-44)and 31(8-54),and the actual number of imported malaria cases were 29,24 and 38 cases respectively and all cases were included in the 95％CI. Conclusion The imported malaria cases in Yunnan Province had a significantly seasonal periodicity and epidemic trends,and the established model has good prediction on the recent cases.