Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000-17: a spatial and temporal modelling study.,The Lancet

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Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000-17: a spatial and temporal modelling study.
The Lancet ( IF 98.4 ) Pub Date : 2019-06-19 , DOI: 10.1016/s0140-6736(19)31096-7
Katherine E Battle ₁ , Tim C D Lucas ₁ , Michele Nguyen ₁ , Rosalind E Howes ₁ , Anita K Nandi ₁ , Katherine A Twohig ₁ , Daniel A Pfeffer ₂ , Ewan Cameron ₁ , Puja C Rao ₃ , Daniel Casey ₄ , Harry S Gibson ₁ , Jennifer A Rozier ₁ , Ursula Dalrymple ₅ , Suzanne H Keddie ₁ , Emma L Collins ₁ , Joseph R Harris ₁ , Carlos A Guerra ₆ , Michael P Thorn ₁ , Donal Bisanzio ₇ , Nancy Fullman ₃ , Chantal K Huynh ₃ , Xie Kulikoff ₃ , Michael J Kutz ₃ , Alan D Lopez ₃ , Ali H Mokdad ₃ , Mohsen Naghavi ₃ , Grant Nguyen ₃ , Katya Anne Shackelford ₃ , Theo Vos ₃ , Haidong Wang ₃ , Stephen S Lim ₃ , Christopher J L Murray ₃ , Ric N Price ₈ , J Kevin Baird ₉ , David L Smith ₃ , Samir Bhatt ₁₀ , Daniel J Weiss ₁ , Simon I Hay ₃ , Peter W Gething ₁

Affiliation

Malaria Atlas Project, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK.
Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Seattle & King County Public Health, Seattle, WA, USA.
Public Health England, Bristol, UK.
Medical Care Development International, Silver Spring, MD, USA.
Global Health Division, RTI International, Washington, DC, USA; Epidemiology and Public Health Division, School of Medicine, University of Nottingham, Nottingham, UK.
Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Eijkman-Oxford Clinical Rearch Unit, Jakarta, Indonesia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Imperial College London, London, UK.

BACKGROUND Plasmodium vivax exacts a significant toll on health worldwide, yet few efforts to date have quantified the extent and temporal trends of its global distribution. Given the challenges associated with the proper diagnosis and treatment of P vivax, national malaria programmes-particularly those pursuing malaria elimination strategies-require up to date assessments of P vivax endemicity and disease impact. This study presents the first global maps of P vivax clinical burden from 2000 to 2017. METHODS In this spatial and temporal modelling study, we adjusted routine malariometric surveillance data for known biases and used socioeconomic indicators to generate time series of the clinical burden of P vivax. These data informed Bayesian geospatial models, which produced fine-scale predictions of P vivax clinical incidence and infection prevalence over time. Within sub-Saharan Africa, where routine surveillance for P vivax is not standard practice, we combined predicted surfaces of Plasmodium falciparum with country-specific ratios of P vivax to P falciparum. These results were combined with surveillance-based outputs outside of Africa to generate global maps. FINDINGS We present the first high-resolution maps of P vivax burden. These results are combined with those for P falciparum (published separately) to form the malaria estimates for the Global Burden of Disease 2017 study. The burden of P vivax malaria decreased by 41·6%, from 24·5 million cases (95% uncertainty interval 22·5-27·0) in 2000 to 14·3 million cases (13·7-15·0) in 2017. The Americas had a reduction of 56·8% (47·6-67·0) in total cases since 2000, while South-East Asia recorded declines of 50·5% (50·3-50·6) and the Western Pacific regions recorded declines of 51·3% (48·0-55·4). Europe achieved zero P vivax cases during the study period. Nonetheless, rates of decline have stalled in the past five years for many countries, with particular increases noted in regions affected by political and economic instability. INTERPRETATION Our study highlights important spatial and temporal patterns in the clinical burden and prevalence of P vivax. Amid substantial progress worldwide, plateauing gains and areas of increased burden signal the potential for challenges that are greater than expected on the road to malaria elimination. These results support global monitoring systems and can inform the optimisation of diagnosis and treatment where P vivax has most impact. FUNDING Bill & Melinda Gates Foundation and the Wellcome Trust.

中文翻译：

绘制间日疟原虫的全球流行情况和临床负担，2000-17 年：空间和时间建模研究。

背景技术间日疟原虫对全世界的健康造成重大损害，但迄今为止很少有人对其全球分布的范围和时间趋势进行量化。鉴于与正确诊断和治疗间日疟相关的挑战，国家疟疾规划，特别是那些追求消除疟疾战略的规划，需要对间日疟流行和疾病影响进行最新评估。本研究展示了 2000 年至 2017 年间日疟原虫临床负担的第一批全球地图。方法在这项时空建模研究中，我们针对已知偏差调整了常规疟疾监测数据，并使用社会经济指标生成间日疟原虫临床负担的时间序列。这些数据为贝叶斯地理空间模型提供了信息，该模型可以对间日疟原虫临床发病率和感染流行率随时间的推移进行精细预测。在撒哈拉以南非洲地区，间日疟原虫的常规监测并不是标准做法，我们将预测的恶性疟原虫表面与特定国家间日疟原虫与恶性疟原虫的比率结合起来。这些结果与非洲以外基于监测的输出相结合，生成全球地图。研究结果我们展示了第一个高分辨率的间日疟原虫负担图。这些结果与恶性疟原虫的结果（单独发布）相结合，形成 2017 年全球疾病负担研究的疟疾估计值。间日疟疾负担从 2000 年的 24·5 百万例（95%不确定区间 22·5-27·0）下降到 2000 年的 14·300 万例（13·7-15·0），下降了 41·6%。 2017 年。自 2000 年以来，美洲的病例总数减少了 56·8%（47·6-67·0），而东南亚则下降了 50·5%（50·3-50·6），西太平洋地区下降了 51·3% (48·0-55·4)。在研究期间，欧洲实现了间日疟原虫病例为零。尽管如此，许多国家的下降速度在过去五年中已停止，特别是在受政治和经济不稳定影响的地区，下降速度有所增加。解释我们的研究强调了间日疟原虫临床负担和患病率的重要空间和时间模式。在全球取得重大进展的同时，成果停滞不前和负担增加的领域表明，在消除疟疾的道路上可能面临比预期更大的挑战。这些结果支持全球监测系统，并可以为间日疟原虫影响最大的诊断和治疗的优化提供信息。资助比尔及梅琳达·盖茨基金会和威康信托基金。

更新日期：2019-07-26

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