BackgroundThis paper seeks to assess the function of malaria control consultation and service posts (MCCSPs) that are located on the border areas of Yunnan province, P.R. China, as a strategy for eliminating malaria among the mobile and migrant population in these areas.MethodsA retrospective descriptive analytical study was conducted. Blood smear examinations conducted at all MCCSPs in Yunnan from 2008 to 2014 were analysed. A cross-sectional survey was conducted in 2014 to understand how the MCCSPs function and to elucidate the quality of the blood smear examinations that they conduct.ResultsOut of the surveyed MCCSPs, 66 % (39/59), 22 % (13/59), and 12 % (7/59) were attached to local township hospitals, village health clinics, and the county centre for disease control and prevention or private clinics, respectively. More than 64 % (38/59) of the posts’ staff were part-time workers from township hospitals and village health facilities. Less than 31 % (18/59) of the posts’ staff were full-time workers. A total of 35 positive malaria cases were reported from seven MCCSPs in 2014. Four MCCSPs were unable to perform their functions due to under staffing in 2014. There was a small fluctuation in blood smear examinations from January 2008 to June 2009, with two peaks during the period from July 2009 to October 2010. The number of blood smear examinations has been increasing since 2011. The yearly mean number of blood smear examinations in each post increased from 44 per month in 2011 to 109 per month in 2014, and the number of positive malaria cases detected by blood smear examinations has declined (χ2 = 90.67, P = 0.000). The percentage of people from Yingjiang county getting blood smear examinations increased between 2008 and 2014, while percentages of the mobile population including Myanmar people, people from other provinces, and people from other Yunnan counties getting blood smear examinations decreased.ConclusionMCCSPs face challenges in the phase of malaria elimination in Yunnan, China. New case detection strategies should be designed for MCCSPs taking into account the current trends of migration.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0185-y) contains supplementary material, which is available to authorized users.

Background The World Health Organization (WHO) has certificated China malaria free, but imported malaria is a continuous challenge in preventing reintroduction of malaria in the border area of China. Understanding risk factors of malaria along China–Myanmar border is benefit for preventing reintroduction of malaria in China and achieving the WHO’s malaria elimination goal in the Greater Mekong Subregion (GMS). Methods This is a case–control study with one malaria case matched to two controls, in which cases were microscopy-confirmed malaria patients and controls were feverish people with microscopy-excluded malaria. A matched logistic regression analysis (LRA) was used to identify risk factors associated with malaria infection. Results From May 2016 through October 2017, the study recruited 223 malaria cases (152 in China and 71 in Myanmar) and 446 controls (304 in China and 142 in Myanmar). All the 152 cases recruited in China were imported malaria. Independent factors associated with malaria infection were overnight out of home in one month prior to attendance of health facilities (adjusted odd ratio [AOR] 13.37, 95% confidence interval [CI]: 6.32–28.28, P < 0.0001), staying overnight in rural lowland and foothill (AOR 2.73, 95% CI: 1.45–5.14, P = 0.0019), staying overnight at altitude < 500 m (AOR 5.66, 95% CI: 3.01–10.71, P < 0.0001) and streamlets ≤ 100 m (AOR9.98, 95% CI: 4.96–20.09, P < 0.0001) in the border areas of Myanmar; and people lacking of knowledge of malaria transmission (AOR 2.17, 95% CI: 1.42–3.32, P = 0.0004). Conclusions Malaria transmission is highly focalized in lowland and foothill in the border areas of Myanmar. The risk factors associated with malaria infection are overnight staying out of home, at low altitude areas, proximity to streamlets and lack of knowledge of malaria transmission. To prevent reintroduction of malaria transmission in China and achieve the WHO goal of malaria elimination in the GMS, cross-border collaboration is continuously necessary, and health education is sorely needed for people in China to maintain their malaria knowledge and vigilance, and in Myanmar to improve their ability of personal protection.

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Background: Plasmodium vivax malaria with the widest geographic distribution is also capable of causing severe disease and death. Primaquine is the main licensed antimalarial drug that can kill hypnozoites. The dose-dependent acute haemolysis in individuals with glucose-6-phospate dehydrogenase (G6PD) deficiency is the main safety concern in use of primaquine. The recommended treatment regimen for P. vivax malaria is chloroquine plus primaquine over 14 days (CQPQ14) in Myanmar. The study aimed to evaluate the therapeutic efficacy, safety and adherence of the regimen of artemisinin-naphthoquine plus primaquine over 3 days (ANPQ3) in patients of P. vivax infections compared to those of CQPQ14. Methods: A patient in group ANPQ3 was given fixed-dose artemisinin-naphthoquine (a total 24.5mg per kilogram) plus a lower total primaquine dose (0.9 mg per kilogram)over 3 days (group ANPQ3). The patient in group CQPQ14 were given a total chloroquine dose of 30 mg per kilogram of body weight over 3 days plus a total primaquine dose of 4.2 mg per kilogram over 14 days. All patients were followed up for 365 days. Results: A total of 288 patients were completed follow up, 172 in group ANPQ3 and 116 in group CQPQ14. No recurrences were observed till day 57. By day 182, a total 31 recurrences were recorded: 12 (7.0%) in Group ANPQ3 and 4 (3.4%) patients in Group CQPQ14. The difference of recurrence-free patients was 3.5 (-8.6 – 1.5) percentage points between group ANPQ3 and group CQPQ14 (P=0.2946). By day 365, the percentage of recurrence-free patient was not significant between the two groups (P=0.2257). Mean fever and parasite clearance time of group ANPQ3 were shorter than those of group CQPQ14 (P≤0.001). No any severe adverse effect was observed in group ANPQ3, but 5 (3.9%) patients with acute haemolysis in group CQPQ14 (P=0.013).Medication percentage of group ANPQ3 was significantly higher than that of group CQPQ14 (P<0.0001). Conclusions: The radial cue efficacy is no non-inferiority between the ANPQ3 and the CQPQ14. The ANPQ3 clears fever and parasites faster than the CQPQ14. The ANPQ3 is a safer and better adherence treatment regimen for P. vivax malaria along China-Myanmar border.

Background Appropriate malaria treatment-seeking behavior (MTSB) is critical to timely detect malaria for prompt treatment and prevent onward transmission of the diseases in a community. The aim of this study was to compare treatment-seeking behaviours between malaria patients and non-malaria febrile patients, and analyse factors associated with appropriate MTSB along China-Myanmar border. Methods This case-control study matched one malaria case patient confirmed by microscopy to two controls (non-malaria febrile patients). Factors associated with appropriate MTSB was identified by a matched logistic regression analysis (LRA). Results Among 223 malaria case patients and 446 controls, 129 (57.8%) of the cases sought treatment first in health facilities without laboratory test compared to 163 (36.5%) of the controls (P<0.0001). A total of 85(38.1%) of the malaria case patients sought treatment in health facilities with laboratory test within 48 hours as compared with 278 (62.3%) of the controls (P<0.0001). Multivariate LRA identified that the malaria cases with Chinese nationality were less likely to seek treatment for malaria in health facilities with laboratory testwithin 48 hours compared to malaria cases with other nationalities (adjusted odds ratio [AOR]: 0.21, 95%CI: 0.07-0.68, P=0.0097), and malaria case patients residing in urban areas were more likely to seek treatment in health facilities with laboratory test within 48 hours compared to those living in rural areas (AOR: 2.16, 95%CI: 1.06-4.39, P=0.0337). Conclusions Malaria treatment-seeking behaviors were inappropriate. Chinese citizenship and rural residence are two independent factors associated with inappropriate MTSB. It is continuously necessary to improve appropriate MTSB through effective campaigns of information, education and communication.