CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES >

2021 , Vol. 39 >Issue 6: 733 - 740

DOI: https://doi.org/10.12140/j.issn.1000-7423.2021.06.003

ORIGINAL ARTICLES

Achieving malaria elimination in China: analysis on implementation and effectiveness of the surveillance-response system

  • Zhi-gui XIA ,
  • Jun FENG ,
  • Li ZHANG ,
  • Xin-yu FENG ,
  • Fang HUANG ,
  • Jian-hai YIN ,
  • Shui-sen ZHOU ,
  • Sheng ZHOU ,
  • Heng-lin YANG ,
  • Shan-qing WANG ,
  • Qi GAO ,
  • Lin-hua TANG ,
  • Jun YAN
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  • 1 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai 200025, China
    2 Chinese Center for Disease Control and Prevention, Beijing 102206, China
    3 Yunnan Institute of Parasitic Diseases, Pu’er 665000, China
    4 Hainan Center for Disease Control and Prevention, Haikou 570203, China
    5 Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China

Received date: 2021-09-22

  Revised date: 2021-09-24

  Online published: 2021-12-21

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Abstract

Objective To analyze the implementation and effectiveness of surveillance-response system in eliminating malaria in China, and to provide scientific basis for preventing re-establishment of transmission by imported malaria in the post-elimination phase. Methods The national scheme and activities records in malaria elimination program were systematically collected and sorted, and the data of individual malaria cases and indicators in 2011—2020 from web-based National Information System for Infectious Diseases Surveillance and National Information System for Parasitic Diseases Control and Prevention were analyzed using SPSS 25.0 and GraphPad Prism 8.4.3. Results From 2011 to 2020, a total of 30 278 malaria cases were reported nationwide, 93.96% (28 448 cases) of them were Chinese nationality. The total cases included 1 732(5.72%) indigenous cases reported from 2011 to 2016, 28 173(93.05%) imported cases from abroad, 9(0.03%) induced cases, 5(0.02%) long incubation malariae malaria cases, 4 (0.01%) introduced vivax malaria cases, as well as 355 (1.17%) cases with unreported origin from 2011 to 2013. The cases were mainly falciparum malaria cases (17 960 cases, 59.32%) and mainly reported by Yunnan(5 415 cases, 17.88%), Guangxi (3 193 cases, 10.55%), and Jiangsu(2 797 cases, 9.24%) provinces. The cases were reported year-round, with the majority in May and July (9 689 cases, 32.00%). The imported cases were mainly from Myanmar (4 856 cases, 17.24%), Ghana (2 957 cases, 10.50%), and Nigeria (2 693 cases, 9.56%). The positive rates of blood tests for malaria by passive case detection, proactive case detection and reactive case detection were 0.76‰ (28 452/37 500 291), 0.03‰ (35/1 215 309) and 0.30‰ (32/105 384), respectively. From 2013 to 2020, case reporting rate within 1 day after diagnosis was 100% (23 114/23 114), the rate of epidemiological investigation for individual case within 3 days after reporting was 94.49% (21 840/23 114), the rate of foci investigated and disposed within 7 days was 93.30% (20 294/21 751), and the median time from the illness onset to first diagnosis and from first diagnosis to confirmed diagnosis of the patients were both 1 d (IQR: 0~3 d). Anopheles sinensis was widely distributed and commonly resistant to deltamethrin. In vivo efficacy of dihydro-artemisinin-piperaquine against uncomplicated falciparum malaria and chloroquine and primaquine against vivax malaria was 92.31%(36/39) and 100%(21/21), respectively. Conclusion Establishment of the sensitive and effective surveillance-response system is a vital experience for the success of malaria elimination in China. In the post-elimination phase, surveillance-response should continue to be the key measure, and active cooperation between different sectors and capacity building should be strengthened, to prevent re-establishment of transmission and consolidate the accomplishments of elimination.

Key words： Malaria; Elimination; Surveillance and response; China

Cite this article

Zhi-gui XIA , Jun FENG , Li ZHANG , Xin-yu FENG , Fang HUANG , Jian-hai YIN , Shui-sen ZHOU , Sheng ZHOU , Heng-lin YANG , Shan-qing WANG , Qi GAO , Lin-hua TANG , Jun YAN . Achieving malaria elimination in China: analysis on implementation and effectiveness of the surveillance-response system[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2021 , 39(6) : 733 -740 . DOI: 10.12140/j.issn.1000-7423.2021.06.003

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