Risk Analysis Of Preventing Re-transmission After Malaria Elimination In Fujian Province

Objective The epidemic characteristics and prevention and control of malaria in Fujian Province were clarified.The risk assessment model of re transmission of imported malaria was established,and the risk level of re transmission of imported malaria in Fujian Province was evaluated,which provided the basis for guiding the targeted malaria control work in various regions.Methods Descriptive epidemiology was used to analyze the epidemic and control situation of imported malaria after malaria elimination in Fujian Province.The risk assessment model of re-transmission of imported malaria in Fujian Province was established by using Delphi method and analytic hierarchy process.Objective to assess the risk level of imported malaria re transmission in Fujian Province and draw the risk map.Result A total of 848 malaria cases were reported in Fujian Province from 2011 to 2019,all of which were imported cases,and imported falciparum malaria was the most,and the number of cases showed an increasing trend.Vivax malaria is next.The imported cases were mainly young and middle-aged men,and there were two small peaks in January-Februaryand June-July.Imported cases were reported in 71 counties(cities,districts)of 9 prefecture-level cities and Pingtan Comprehensive Pilot Area of Fujian Province,with the largest number of imported cases in Fuzhou,mainly distributed in Fuqing.Nanping and Ningde followed.The majority of imported malaria cases are from Africa,followed by the Western Pacific and Southeast Asia.The prevention of malaria cases before and after leaving our province is poor.Most of the outbound purposes are for work and business.The knowledge awareness rate of malaria control in Fujian Province is62.73%,most counties have not set up designated diagnosis and treatment hospitals for malaria,and individual doctors and village health rooms lack malaria training.The expert authority of Delphi method is 0.813.The coefficient of variation was 0.177.W is 0.332,χ~2=151.336,and the expert opinions are relatively coordinated.The final risk assessment model for imported malaria re-transmission in Fujian Province included four first-level indicators:receptivity,external exposure,population vulnerability and coping ability,with weights of 0.1441,0.3190,0.0376 and 0.4993,and 19 second-level indicators,respectively.The combination weight of each index is higher:"laboratory diagnostic ability","number of imported malaria cases","time to diagnosis","malaria prevention and control personnel".The top 10 counties(cities and districts)in risk index were Fuqing(0.557),Datian(0.489),Luojiang(0.465),Xiang’an(0.433),Shunchang(0.424),Hua’an(0.419),Songxi(0.407),Yongtai(0.405),Changtai(0.391)and Qingliu(0.388).After the improvement of the province’s coping ability,the province’s risk index decreased.After adjusting the number of imported cases,the time from onset of malaria cases to initial diagnosis and the time from initial diagnosis to diagnosis,the corresponding risk level decreased.Conclusion After the elimination of malaria in Fujian Province,under the condition of continuous input of malaria,the risk of re transmission of imported malaria increased with the weakening of population malaria control knowledge and grass-roots malaria control ability.The"receptivity-vulnerability"model established in this study is applicable to the practice of malaria prevention and control in our province,and provides the basis for the hierarchical prevention and control of malaria in our province.