Study on the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province / 中国血吸虫病防治杂志

Objective To analyze the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province, so as to provide insights into the evaluation of the economic burden due to imported malaria, and the guiding of malaria control and the rational allocation of medical resources. Methods The data pertaining to the hospitalization costs of imported malaria patients admitted to Shanglin County People’s Hospital in Guangxi Zhuang Autonomous Region during the period from January 1 through December 31, 2019, and Tengchong Municipal People’s Hospital in Yunnan Province from January 1, 2015 to December 31, 2019, were collected, and the epidemiological data of these imported malaria patients were extracted from the Information Management System for Parasitic Diseases Control and Prevention, China. The composition of the hospitalization expenses was analyzed using a descriptive method. In addition, the factors affecting the hospitalization expenses of imported malaria patients were identified using a univariate analysis and a recursive system model. Results A total of 206 imported malaria patients were included in this study, including 194 men (94.17%) and 12 women (5.83%). The mean length of hospital stay was 5.00 days per patient and the median hospitalization expenses were 2 813.07 Yuan per time, in which the expenses for laboratory examinations were the highest (45.31%, 1 274.62/2 813.07). Univariate analysis showed that hospital (z = 5.43, P < 0.01), type of malaria (χ2 = 34.86, P < 0.01) and type of payment (χ2 = 7.72, P < 0.05) were factors affecting the hospitalization expenses of imported malaria patients. Recursion system modeling revealed that the total effects on hospitalization expenses of imported malaria patients included length of hospital stay (0.78), selection of hospital (0.34), basic medical insurance for urban and rural residents (0.19), new rural cooperative medical care (0.17), Plasmodium falciparum malaria (0.15), gender (0.11) and P. vivax malaria (0.09). Conclusions The hospitalization expenses of imported malaria patients are affected by multiple factors in Guangxi Zhuang Autonomous Region and Yunnan Province, in which the length of hospital stay is the most predominant influencing factor. A reduction in the length of hospital stay is effective to decrease the hospitalization expenses of imported malaria patients.

[Epidemic situation and control strategy of malaria in Guangxi Zhuang Autonomous Region from 2011 to 2018].

OBJECTIVE: To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018. METHODS: The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases. RESULTS: A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season-specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported. CONCLUSIONS: The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.

Epidemic situation and control strategy of malaria in Guangxi Zhuang Autonomous Region from 2011 to 2018 / 中国血吸虫病防治杂志

Objective To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018. Methods The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases. Results A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season-specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported. Conclusions The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.

Epidemic situation and control strategy of malaria in Guangxi Zhuang Autonomous Region from 2011 to 2018 / 中国血吸虫病防治杂志

Objective To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018. Methods The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases. Results A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season-specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported. Conclusions The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.

[Analysis of imported malaria epidemic situation and implication for prevention and control strategy in Guangxi Zhuang Autonomous Region in 2014].

OBJECTIVE: To analyze the epidemic characteristics of the imported malaria cases in Guangxi Zhuang Autonomous Region in 2014, so as to assess the transmission risk and explore the prevention and control strategy. METHODS: The data of the malaria epidemic situation in the network direct report system of Guangxi in 2014 and the annual report of malaria epidemic situation in 14 cities were collected. The epidemiological information of the imported malaria cases was analyzed. RESULTS: A total of 184 malaria patients were reported in Guangxi in 2014, with a descent rate of 85.29% when compared to that in 2013 (1 251 cases), and the incidence rate was 0.35/100 000. All the cases were imported from abroad, and four species of Plasmodium were found in their blood samples. The number of falciparum malaria cases was the most (49.46%), followed by the ovale malaria cases (32.07%). All the cases were distributed in 32 counties (districts) of 11 cities, and 65.76% of them were distributed in Shanglin County. Most of the cases were male (98.37%), and those aged in 20-49 years accounted for 87.50%. The imported cases came from 14 countries of Africa (86.41%) and 2 countries of Southeast Asia (13.59%), in which, 48.37% of the cases were imported from Garner. The main occupation of the cases in abroad was gold mining work (86.96%). The cases were reported all the year around, with no obvious seasonality. The interval time of back home to attack of the patients with tertian malaria and ovale malaria was longer. CONCLUSIONS: Africa and Southeast Asia is the main source of imported malaria cases in Guangxi, and the migrant workers returning home may have the risk of malaria recurrence, which should be paid enough attention to.

[Malaria epidemiological situation in Wuzhou City, Guangxi Zhuang Autonomous Region from 1950 to 2015].

OBJECTIVE: To review and investigate the malaria control history of Wuzhou City, Guangxi Zhuang Autonomous Region from 1950 to 2015, so as to provide the evidence for future malaria control and surveillance. METHODS: The data of malaria control in Wuzhou City from 1950 to 2015 were collected and analyzed. RESULTS: In 1950 decade, the malaria incidence in Wuzhou City was 1 435.55/100 000, higher than the average level in Guangxi, and the mortality of malaria was 0.95/100 000. The malaria incidence of local residents was reduced to 3.61/100 000 in 1979 and no local malaria case was found since. The imported malaria cases were found in Wuzhou City since 1980, and were more than local cases since 1981. In recent five years, 87.50% (7/8) of imported malaria cases were from south-east Asia. CONCLUSIONS: Wuzhou City has reached the national criterion of malaria elimination, but the imported malaria is the recent threat. The surveillance and control work of malaria should be strengthened.

[Analysis of malaria epidemiological characteristics in Hechi City, Guangxi Zhuang Autonomous Region from 2005 to 2015].

OBJECTIVE: To analyze the epidemiological characteristics of malaria in Hechi City, Guangxi Zhuang Autonomous Region from 2005 to 2015, so as to provide the evidence for formulating and adjusting measures of malaria elimination. METHODS: The data of malaria cases in 11 counties of Hechi City from 2005 to 2015 were collected and analyzed by using Micro-soft Office Excel 2003 and SPSS 17.0. RESULTS: A total of 160 malaria cases were reported in Hechi City from 2005 to 2015, and the annual average malaria incidence was 3.6 per million. There were 10 local recurrence cases (accounting for 6.25％, 10/160) and 150 imported cases (accounting for 93.75％, 150/160). For the etiology, Plasmodium vivax accounted for 51.87% (83/160) in these cases, P. falciparum accounted for 34.38% (55/160), P. ovale accounted for 1.25% (2/160), P. malariae accounted for 5.00% (8/160), and the indeterminate accounted for 7.50% (12/160). During the period of 11 years, the malaria incidence first dropped and then rose. There were no local cases after 2009. However, an imported falciparum malaria death case was reported in 2010, a severe imported falciparum malaria case was reported in 2013 and another in 2015. A severe case of maternal-neonatal vivax malaria was reported in 2014. These cases were mainly distributed in 10 counties of Hechi City, with more young male adults who engaged in digging mining. More cases concentrated from April to August. Most of the reported malaria cases were imported, 60.00% (96/160) of them returned from Africa and Southeast Asia, and 33.75% (54/160) from other domestic provinces. The median of the interval from symptom appearance to diagnosis was 5 d, and there was a significant difference among the above years (χ2= 33.40, P＜0.05). CONCLUSIONS: Malaria is still an important public health problem in Hechi City, and the appropriate control measures and effective tools should be strengthened for malaria elimination. The key to consolidate the achievements of malaria control is strengthening the malaria monitoring management of the floating population.

[Analysis of epidemic situation of malaria in Longlin Various Nationalities Autonomous County in Guangxi from 1951 to 2014].

OBJECTIVE: To analyze the data of epidemic situation of malaria in Longlin Various Nationalities Autonomous County, Guangxi Zhuang Autonomous Region, China from 1951 to 2014 and discuss the distribution characteristics and epidemic law, so as to provide the evidences for developing the prevention and control strategies of the disease. METHODS: The data about the epidemic situation of malaria in Longlin Various Nationalities Autonomous County were collected and analyzed statistically with Excel 2007. RESULTS: Totally 93 460 malaria cases were reported from 1951 to 2014 in the county. There were two morbidity peaks of malaria during this period, namely 1950s and 1970s, and the annual average incidence rates were 3 237.94/100 000 and 1 572.12/100 000, respectively, but it began to flatten after 1980s. Before 2000, the local cases were the main type, however, there were no endogenous cases since 2008. In 1950s, falciparum malaria was the main type of the disease, and the cases with falciparum malaria, tertian malaria and quartan malaria were accounted for 45.01% (2 392/5 314), 33.72% (1 792/5 314) and 19.55% (1 039/5 314), respectively; while in 1960s, the proportion of cases with tertian malaria increased, that of the cases with quartan malaria decreased, and there were no quartan malaria cases reported since 1980s. There were imported malaria cases reported since 1990s, and a total of 51 cases were found in this period, among which, 50 cases (98.04%) were tertian malaria, and the main infection sources were the cases from epidemic areas in other provinces of China. After 2000, the imported malaria cases with falciparum malaria increased, with a proportion of 60.00% (21/35), and the infection sources were mainly from Africa and Southeast Asia. CONCLUSIONS: The local endemic of malaria in Longlin Various Nationalities Autonomous County has been effectively controlled, but the situation of imported malaria is still severe in this county. Therefore, strengthening the surveillance of floating population, especially the workers backing from overseas, is still the key of malaria prevention and control in the future.