1950—2014年广西横县疟疾疫情流行病学分析及Markov模型预测
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摘要
目的分析横县1950—2014年疟疾疫情监测数据,探讨该时期疟疾流行特点,为今后防控疟疾提供科学依据。方法收集横县1950—2014年疟疾疫情报告数据,应用Excel2007、SPSS18.0和Matlab2016a统计软件分析疟疾疫情的流行特征。用Markov模型对横县2012—2014年疟疾发病率进行预测,并验证预测效果。结果横县1950—2014年共报告疟疾发病数65 259例,年均发病率为119.74/10万。发病率趋势可分为4个阶段,各阶段年均发病率差异有统计学意义(χ2=365 257.034、P<0.05)。其中,1953年疟疾为发病率最高(4 490.14/10万),1996—2014年疟疾发病率则保持在0.77/10万以下,疟疾发病率总体呈下降趋势。2002—2014年无本地疟疾发生,但输入性疟疾病例占比逐步增大(1984—2014年间输入性疟疾病例占疟疾病例总数的93.75%)。同时,Markov模型预测模型用于发病率预测效果良好。结论广西横县经过60多年疟疾防治,原发性疟疾流行已经得到有效控制。但近年出现的输入性疟疾不可忽视,可能造成疟疾死灰复燃,应该把输入性疟疾的流行病学特征作为研究的重点工作。
Objective To analyze the malaria epidemic monitoring data and to investigate the epidemiological characteristics of malaria from 1950 to 2014 in Heng County,so as to provide a scientific basis in prevention and control of malaria in the future.Methods The reported data for malaria epidemic was collected and analyzed by using Excel2007,SPSS18.0 and Matlab 2016 a-statistical software.The Markov model was used in prediction of the malaria incidence,and the related effect was verified.Results A total of 65 259 malaria cases were reported,with an average annual incidence of 119.74/105.The incidence trend could be divided into four stages,and the annual incidence of each stage was in statistical significant(χ2= 365 257.034,P<0.05).Among them,the highest incidence was in 1953(4 490.14/105),then the incidence maintained below 0.77/105 in 1996-2014.The incidence trend generally showed in a downward.There was no local malaria occurrence in 2002-2014,but the proportion of imported malaria cases increased gradually,with 93.75% of the total malaria cases from 1984 to 2014.At the same time,the Markov model prediction model was effective in prediction of the incidence.Conclusion The epidemic of primary malaria has been effectively controlled in passed years in Heng County,however,it is not be neglected that the imported malaria emerged in recent years,which may cause the recurrence of malaria.The epidemiological characteristics of imported malaria should be further investigated.
Objective To analyze the malaria epidemic monitoring data and to investigate the epidemiological characteristics of malaria from 1950 to 2014 in Heng County,so as to provide a scientific basis in prevention and control of malaria in the future.Methods The reported data for malaria epidemic was collected and analyzed by using Excel2007,SPSS18.0 and Matlab 2016 a-statistical software.The Markov model was used in prediction of the malaria incidence,and the related effect was verified.Results A total of 65 259 malaria cases were reported,with an average annual incidence of 119.74/105.The incidence trend could be divided into four stages,and the annual incidence of each stage was in statistical significant(χ2= 365 257.034,P<0.05).Among them,the highest incidence was in 1953(4 490.14/105),then the incidence maintained below 0.77/105 in 1996-2014.The incidence trend generally showed in a downward.There was no local malaria occurrence in 2002-2014,but the proportion of imported malaria cases increased gradually,with 93.75% of the total malaria cases from 1984 to 2014.At the same time,the Markov model prediction model was effective in prediction of the incidence.Conclusion The epidemic of primary malaria has been effectively controlled in passed years in Heng County,however,it is not be neglected that the imported malaria emerged in recent years,which may cause the recurrence of malaria.The epidemiological characteristics of imported malaria should be further investigated.
引文
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[14]张丽,丰俊,张少森,等.2016年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志.2017(6):515-519.
[15]易燕飞.基于时间序列模型的传染病流行趋势及预测研究[D].长春:长春工业大学,2016.
[16]NAIMARK D,RAHN M D,NAGLIE G,et al.Primer on medical decision analysis:Part 5--Working with Markov processes[J].Med Decis Making,1997,7(2):152-159.
[2]耿贯一.流行病学[M].北京:人民卫生出版社,1980:174-176.
[3]HUANG Q,HU L,LIAO Q B,et al.Spatiotemporal analysis of the malaria Epidemic in mainland China,2004-2014[J].Am JTrop Med Hyg,2017,97(2):504-513.
[4]中国消除疟疾行动计划(2010-2020年)[EB/OL].(2010-05-26)[2018-09-23].http://www.gov.cn/zwgk/2010-05/26/content_1614176.htm.
[5]付长贺,邓甦.马尔科夫链在传染病预测中的应用[J].沈阳师范大学学报(自然科学版),2009(1):28-30.
[6]ANDERSEN F,DOUGLAS N M,BUSTOS D,et al.Trends in malaria research in 11 Asian Pacific countries:an analysis of peerreviewed publications over two decades[J].Malar J,2011,10(1):131.
[7]MILLER L H,SU X.Artemisinin:discovery from the Chinese herbal garden[J].Cell,2011,146(6):855-858.
[8]DONDORP A M,YEUNG S,WHITE L,et al.Artemisinin resistance:current status and scenarios for containment[J].Nat Rev Microbiol,2010,8(4):272-280.
[9]PHYO A P,NKHOMA S,STEPNIEWSKA K,et al.Emergence of artemisinin-resistant malaria on the western border of Thailand:a longitudinal study[J].Lancet,2012,379(9830):1960-1966.
[10]CHEN S B,JU C,CHEN J H,et al.Operational research needs toward malaria elimination in China[J].Adv Parasitol,2014,86(86):109-133.
[11]CHEN J H,WANG H,CHEN J X,et al.Frontiers of parasitology research in the People's Republic of China:infection,diagnosis,protection and surveillance[J].Parasit Vectors,2012,5(1):221.
[12]林康明,黎军,杨益超,等.2014年广西壮族自治区输入性疟疾流行病学分析及防控策略探讨[J].中国血吸虫病防治杂志,2016(6):692-695.
[13]ZHANG Q,SUN J,ZHANG Z,et al.Risk assessment of malaria in land border regions of China in the context of malaria elimination[J].Malar J,2016,15(1):546.
[14]张丽,丰俊,张少森,等.2016年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志.2017(6):515-519.
[15]易燕飞.基于时间序列模型的传染病流行趋势及预测研究[D].长春:长春工业大学,2016.
[16]NAIMARK D,RAHN M D,NAGLIE G,et al.Primer on medical decision analysis:Part 5--Working with Markov processes[J].Med Decis Making,1997,7(2):152-159.