Establishment Of Re-epidemic Risk Index System And Synthetical Evaluation In The Elimination Of Malaria,Fujian Province,China

Objective In the background of the elimination of malaria basically in Fujian Province,to establish the re-epidemic risk index system in the elimination of malaria areas,and to evaluate the re-epidemic risk,which provide the basis for surveillance of malaria-free in Fujian province. Methods The indexes which meet the epidemic characteristics of malaria in Fujian province were filtered by the method of literature analysis and Delphi method.Analytic hierarchy process was used to calculate the weights at two levels.The synthetical evaluation method was applied to evaluate the re-epidemic risk of 86 counties in Fujian province,and obtained the recurrence risk index of each county, then draw risk counties map according to the index risk classification of counties. Results The positive coefficient of experts was 100%, the expert authority coefficient was 0.842, and the Kendall coordination coefficient was 0.493, 2? =29.5740, P<0.001. The index system consisted of 5 first-level indexes and 11 second-level indexes.Cronbach ’s alpha coefficient of index system was 0.7725>0.7, which meet the requirements basically.Through the construction validity analysis,KMO value was 0.527, Bartlett’s test2? =80.807, P=0.013<0.05,the variances of all evaluation indexs were more than 0.74, and the cumulative proportion of the 5 principal components was 85.743%. According to the comprehensive score of experts and application of AHP to determine weights of all indexs, First-level indexes included the source of infection, malaria vector, the susceptible population, natural factors and social factors,their weights was 0.2638,0.5100,0.1296,0.0329 and 0.0636,Max? was 5.2372,the consistency index was 0.0593,random consistency ratio was 0.0529.the weight of Anopheles species index is highest, 0.3402. and weight of imported cases is second, 0.2308, which is in line with the current situation at present malaria elimination in our province. The top ten counties of risk index: Yanping district(75.59), Jianou county(75.18), Shaxian county(74.32), Yong’an city(71.70), Pucheng county(71.49), Shunchang county(70.59), Jianyang county(70.32), Qingliu county(68.66), Yongtai city(67.99), Wuyishan city(67.35), Meilie district and Sanyuan district tied for tenth(65.02).Risk level 4 counties: Yongtai county, Fuqing city and most counties in Nanping city, Sanming city, the risk level is decreased from northwest to southeast. When counties were not imported cases, the risk levels showed a trend of decline, and the coastal area decreased obviously. With the decline in the number of imported cases, risk index decreased in Fuqing city. With the decline in number of Anopheles population,risk index showed a downward trend.in Sanming City, Longyan City and other regions. Conclusion The establishment of the re-epidemic risk index system in the elimination of malaria areas layed the foundation for the assessment of malaria risk scientifically. It was important practical significance that we grasped the distribution of risk level of the Fujian province with the synthetical evaluation method, which provides the basis for surveillance of malaria-free in Fujian province.