| Objective According to the actual situation to eliminate malaria in Fujian Province,combining with the current malaria elimination action plan formulated by the country,we conducted the analysis and research of Fujian Province elimination stage monitoring measures effect and cost effectiveness analysis,providing the basic data for the related health economic evaluation,and providing a theoretical basis for the development of scientific and effective measures during the post monitoring.Methods Descriptive epidemiological analysis on the epidemic status of malaria elimination in Fujian Province was applied.Defining three different stages of malaria elimination.The incidence rate,constituent ratio,positive rate of blood test,and the 3 and 1 day visit rate were calculated.The rate and the composition ratio were compared with the chi-square test,and the trend of the overall incidence was examined by Cox-Stuart trend test.Using the theory and method of health economics to analyze cost effectiveness and incremental cost effectiveness of elimination of the early stage(2005-2009),the elimination of late stage(2015-2010)and the elimination phase(2016-).Results A total of 835 cases of malaria were reported from 2005 to 2016 in Fujian,with an average annual incidence rate of 0.19/10 million,the overall incidence of the disease showed an upward trend(P=0.016),and the positive rate was 0.24%.The type of malaria was mainly Plasmodium falciparum and Plasmodium vivax(48.62% and 35.05%),and the number of reported cases in summer was more(33.05%).The average incidence rate of male(0.33/10 million)was higher than that of female(0.04/10 million),with a sex ratio of 7.7: 1,mainly concentrating in the age of 20 to 50 years old(93.17%).Occupation of housework and unemployment is unknown and the majority(28.26%);the household registration accounted for 79.52%,Fuzhou accounted for 59.40% of reported cases of imported ones,the main source was Africa(49.40%).The elimination of the incidence of late stage of the disease within 3 days was higher than those of the other two stages(P<0.01).After the elimination of the positive rate of blood test,the average annual incidence of the disease and the incidence of the disease within 1 days of the treatment rate was higher than those of the first two stages(P<0.01).Annual total cost of investment was as following: the elimination of the early stage(64 235 144.8 yuan)was to eliminate the latter stage(11 250 248 yuan)of 5.7 times,and was to eliminate the latter stage(11 075 228.8 yuan)of 5.8 times.One case of each blood test to eliminate the early stages of the unit cost was 7.6 times after two stages and 5 times;one case of each blood test,eliminate the stage to reduce 3 260.5 yuan,an increase of 6 496 yuan after the elimination stage.One case of each report,eliminate the early stage of the unit cost was 7.6 times after two stages and 11.2 times;one case of each report,after the two stages were reduced by 2 788 678.8 yuan and 1 022 306.1 yuan.The incidence of 3 days per treatment in 1 cases,the elimination of the early stage of the unit cost was two phase after 10.1 times and 14.4 times;1 cases of each treatment,eliminate stage and elimination after the stage were reduced by 3 311 556.1 yuan and 1 714 836 yuan.The incidence of 1 day per treatment in 1 cases,the elimination of the early stage of the unit cost was 12.7 times after two stages and 20.6 times;One cases per treatment,after two stages were reduced by 4 816 808.8 yuan and 2 311 300.7 yuan.Conclusion For the stage of malaria elimination in Fujian Province,reported cases in Fuzhou,male,young adults,imported cases,and detection of Plasmodium falciparum are the characteristics,the average annual reported incidence rate was increased.The elimination effect monitoring measures after stage was optimal,cost the least,and might be the most effective.The study provides basic data for Fujian Province to strengthen the monitoring of imported cases of malaria on the construction of the management mechanism,scientific and effective evaluation of monitoring measures,which has very important practical value and significance. |
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