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Spatiotemporal Trends of Malaria in Relation to Economic Development and Cross-Border Movement along the China–Myanmar Border in Yunnan Province

機(jī)譯：云南省中緬邊界沿線瘧疾的時(shí)空變化趨勢(shì)與經(jīng)濟(jì)發(fā)展和跨境流動(dòng)的關(guān)系

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The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011–2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.
機(jī)譯：瘧疾的異質(zhì)性和復(fù)雜性涉及政治和自然環(huán)境，社會(huì)經(jīng)濟(jì)發(fā)展，越境轉(zhuǎn)移和媒介生物學(xué)。短期內(nèi)無法改變的因素。這項(xiàng)研究旨在評(píng)估云南省在消除瘧疾前階段經(jīng)濟(jì)增長(zhǎng)和跨境流動(dòng)對(duì)消除瘧疾的影響。 2011-2016年期間的瘧疾數(shù)據(jù)來自云南的18個(gè)縣和緬甸的克欽邦第二專區(qū)的7個(gè)村莊，11個(gè)流離失所者營(yíng)地。人均國(guó)內(nèi)生產(chǎn)總值（GDP）數(shù)據(jù)來自云南省統(tǒng)計(jì)局。對(duì)數(shù)據(jù)進(jìn)行分析和映射，以確定縣和村一級(jí)的時(shí)空異質(zhì)性。共有2117例瘧疾病例，其中85.2％為進(jìn)口病例;大部分進(jìn)口病例來自緬甸（78.5％）。沿著分界線，緬甸村莊/營(yíng)地的瘧疾發(fā)病率顯著高于中國(guó)鄰近村莊的瘧疾發(fā)生率。時(shí)空趨勢(shì)表明，從宏觀水平看，人均國(guó)內(nèi)生產(chǎn)總值的增加可能對(duì)減少瘧疾病例有間接影響;但是，由于復(fù)雜，多方面的因素，包括個(gè)體層面的貧困和勞動(dòng)力的跨國(guó)流動(dòng)，瘧疾仍然存在。在邁向消除瘧疾的道路上，盡管經(jīng)濟(jì)增長(zhǎng)，與鄰國(guó)的合作努力對(duì)于中斷本地傳播并防止通過進(jìn)口病例再次引入瘧疾至關(guān)重要。應(yīng)通過有效的行為改變溝通對(duì)跨境工人進(jìn)行預(yù)防措施的教育，并且在淘汰階段需要對(duì)主動(dòng)監(jiān)視系統(tǒng)以及新穎的診斷和治療服務(wù)進(jìn)行投資。

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