Malaria Situation in the People’s Republic of China in 2008
ZHOUShui-sen;WANGYi;FANGWen;TANGLin-hua
2009, 27(6):
1-457.
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In total, 26 873 malaria cases and 108 594 suspected cases with 23 deaths were reported by the annual case reporting system in 858 counties of 22 Provinces/Municipalities/Autonomous Regions （P/M/A） in 2008, and the annual incidence was 0.21/10 000. Through the internet reporting system 26 358 malaria cases were reported from 994 counties of 30 P/M/A. The number of malaria cases and the rank of P/M/A were basically in concordance in the two systems.
Among the 858 counties with reported malaria cases， 11 counties with an incidence more than 10/10 000 distributed in Yunnan （3 counties）, Hainan （2）, Anhui （4）, Guizhou （1） and Tibet （1）. There were 76 counties in which the malaria incidence was between 1/10 000 and 10/10 000.
1 034 falciparum malaria cases accounted for 3.8% of the total cases, of which 75.4% （780） were imported cases from 207 counties/cities of 17 P/M/A. Indigenous falciparum malaria was found in 27 counties/cities of Yunnan and Hainan Provinces, of which 19 counties/cities were in Yunnan （5 less than that of 2007）, and 8 counties/cities in Hainan （also 5 less than that of 2007）.
Focal outbreaks occurred in 93 villages of 10 counties in Yunnan, Anhui, Zhejiang and Hubei Provinces. 266 malaria cases resulted from the outbreaks, which accounted for 1.0% of the total reported cases.
Although a considerable decrease in malaria incidence contributed to the implementation of the National Malaria Control Program and the Global Fund Programme, Yunnan and Hainan Provinces were still the relatively high transmission areas. Yunnan ranked No.2 in the country in terms of the case number, while Hainan ranked down to No.3 by malaria incidence in 2008. 5 871 malaria cases were reported from the two provinces in 2008, accounting for 21.9% of the total reported cases in the country. There were 4 027 cases with 6 deaths reported from Yunnan, the incidence was 1.16/10 000, a reduction of 52.5% than that in the last year. Among the reported cases, 678 were falciparum malaria with 67% imported cases. The number of reported cases in Hainan was 1 844, with an incidence of 2.18/10 000, a reduction of 46.2% than the last year.
In central China, the re-emergence of malaria was considerably rolled back in 2008, but Anhui Province was still the No. 1 in the country either in the number of malaria cases or the incidence. 13 476 malaria cases were reported from Anhui in 2008, accounting for 50.1% of the total cases in the country, with an incidence of 2.42/10 000, decreased by 51.6% in comparison to that of 2007. The number of reported cases in Henan Province was 3 044, decreased by 25.8% in incidence. Hubei Province reported 1 088 malaria cases with an incidence of 0.18/10 000, decreased by 41.9%. 668 cases were reported from Jiangsu Province, decreased by 28.9% in comparison to that of 2007.
Cases reported from other P/M/A occupied about 10.1% of the total. Over a hundred cases were reported from each of Guizhou, Zhejiang, Shandong, Guangdong, Sichuan, and Shanghai. Less than 100 cases were reported in each of Guangxi, Fujian, Chongqing, Hunan, Jiangxi, Liaoning, Shaanxi, Shanxi, Gansu, and Tibet in 2008.
In summary, the re-emergence of malaria has been basically rolled back through several years′ efforts, but malaria has still been an important problem of public health in China, especially in the southern and central parts. Yunnan and Hainan still faced a critical situation of malaria endemics with the persistence of Plasmodium falciparum, especially imported malaria in the border areas. In the central parts of the country, particularly in Anhui, the malaria incidence was pressing with the highest incidence and majority of malaria cases in 2008. In addition, provinces not covered by the Global Fund Program, such as Guizhou, Zhejiang and Shandong, are confronting an increasing malaria burden, which may become a new challenge to the National Malaria Control Program.
