Diagnosis of imported malaria cases in Shaanxi, 2015-2019

Objective To provide the basis for malaria surveillance to prevent re-transmission after malaria elimination by analyzing the treatment and diagnosis of imported malaria cases in Shaanxi Province during 2015-2019. Methods Data on imported malaria cases in Shannxi Province from 2015 to 2019 were collected and sorted through the National Infectious Diseases Information Reporting Management System (IDIRMS) and the Parasitic Diseases Information Reporting Management System (PDIRMS). The diagnostic methods, primary medical units, laboratory testing institutions and diagnostic timeliness of imported malaria cases were described and analyzed by Chi-square test, Fisher’s exact test and rank-sum test. Results A total of 409 imported malaria cases were reported during 2015-2019 in Shaanxi Province, and all of which were diagnosed with laboratory tests. The rate of utilization RDT increased from 48.56%(36/74) in 2015 to 82.83%(82/99) in 2019. The main primary medical unitswere found to be prefecture level medical (67.97%, 278/409) and county level medical (10.27%, 42/409). There was a significant difference in the upward trend of the correct rate of initial diagnosis of the cases ( χ 2 =15.677, P <0.001). The main laboratory testing institution was prefecture level medical(69.44%, 284/409) while the main reported institution was prefecture level medical (66.99%, 274/409).The median time from onset to diagnosis of malaria cases was 4 days, in which the median time from onset to first visit was 2 day. There was a significant difference in the time from first visit to diagnosis ( χ 2 =25.627, P <0.001), and the interquartile interval of malaria cases was shortened from the longest 4 days in 2015 to the shortest 1 days in 2019. There was a significant difference in the time from first visit to diagnosis among different species of malaria ( χ 2 =9.115, P =0.028), and P. malariae cases (7 days) were the longest than the other species malaria cases. Conclusion To strengthen the health education of key population to improve the awareness of medical treatment, continuously improve the diagnostic awareness and capabilities of medical institutions, and to play the role of sentinel hospitals in the surveillance of preventing re-transmission after malaria elimination. 摘要:目的 分析2015—2019年陕西省输人性疟疾病例诊断的情况,为消除疟疾后防止再传播的监测工作提供依 据。 方法 数据来源于传染病报告信息管理系统和寄生虫病防治信息管理系统,收集整理2015—2019年陕西省报告 的所有疟疾病例信息,对其诊断方式、初诊机构、实验室检测机构、诊断及时性等情况采用 χ 2 检验、Fisher确切概率或秩 和检验进行统计分析。 结果 2015—2019年陕西省共报告输人性疟疾病例409例,均为实验室确诊病例,快速诊断试 剂(RDT)使用率由2015年的48.56%(36/74)提高到2019年的82.83%(82/99)。病例的初诊机构主要为地市级医疗机构 (67.97%,278/409)和县级医疗机构（10.27%, 42/409)。病例的初诊诊断正确率呈上升的趋势,差异有统计学意义( χ 2 =15.677, P <0.001)。实验室检测主要为市级医疗机构(69.44%)。病例的报告机构主要为地市级医疗机构(66.99%)。病 例从发病到确诊时间中位数为4 d,其中发病-初诊时间中位数为2 d,初诊-确诊时间差异有统计学意义( χ 2 =25.627, P <001),其四分位数间距由2015年最长的4 d缩短为2019年的1 d。不同虫种的疟疾病例初诊-确诊时间差异有统计学 意义( χ 2 =9.115, P =0.028),以三日疟的初诊-确诊的中位数最长,为7 d。 结论 加强重点人群的健康教育以提高其就诊 意识,持续提高医疗机构的诊断意识和水平,发挥医疗机构在消除疟疾后防止再传播监测工作中的哨点作用。