A successful control programme for falciparum malaria in Xinyang, China

Abstract

This paper describes a large scale control programme for falciparum malaria in Xinyang prefecture, China, from the early 1980s to 1992. Falciparum malaria, transmitted mainly by Anopheles anthropophagus, was epidemic in Gusi, Huangchuan, Shangcheng and Huaibin counties in the prefecture in the early 1980s, 2922 cases being reported in 1984. From 1985 to 1992, DDT residual spraying and the use of bed nets impregnated with pyrethroid insecticide were introduced for 2 consecutive years in areas at higher risk of P. falciparum infection, and then gradually extended to cover all the endemic areas over a period of 8 years. Malaria control was also carried out through the primary health care system in 4 counties, as had been done since the 1970s. As a result, no falciparum malaria case has been found since 1988 in spite of extensive surveillance, and vivax malaria has also decreased greatly. Repeated cross-sectional surveys showed that A. anthropophagus could not be found in most sites after 2 consecutive years of the vector control programme. Vector control was a major factor in the successful elimination of falciparum malaria and decreasing the incidence of P. vivax in the 4 counties.

Community engagement and population coverage in mass anti-malarial administrations: a systematic literature review

“…The purpose of the chemoprophylaxis was explained to them (but no details on how was it conducted) and they volunteered to cooperateMacCormack 1983, Tanzania [47]Health education through meetings was delivered in tier approach to key community persons who in turn educated familiesNRAnti-malarial supplied by WHO, government committed to the Malaria control plan and health structures present at the rural site coordinated with the projectThe direction and operation of the project was taken care by the medical director of the hospital in the study area. Officials and staffs at local hospital were involvedAs many as 28% of children complained of vomiting and 56% complained of itching, and other unfavourable qualities of chloroquines were indicated for the reluctance to adhere to the medicineDapeng 1996, China [38]Before introducing the malaria control program in the community, health education through the primary health care system, by means of meetings, films, posters, and videos were conducted thus encouraging villagers to participateNRMalaria control program was carried out through the existing primary health care system already in placeAdditional experts from the provincial and central level were involved in field research, guidance and evaluation. Village doctors were responsible for the chemoprophylaxis and the clinical care of the patientsThe control program involving malaria treatment and chemoprophylaxis was less successful than the vector control.…”

“…Information dissemination was conducted through newspapers [32], pamphlets and news bulletins [36]. In two studies [37, 38] audio-visual materials were employed to explain the planned intervention [37]. In China, the health education was delivered through the primary health care system by the means of meetings, films, posters and videos [38].…”

“…Inhabitants of rural rice growing area of Negri Sembilan stateProguanilNRGabaldon 1959, Venezuela [39]0.24%Before and afterPopulation of eastern and western Venezuela. All persons aged >1 monthPyrimethamineIRS with DDTClyde 1961a, Tanzania [32]Morbidity rate: 76.1%Parasitemia in european children: 11.5%Before and afterEuropeans living in TangaQuinineBed netsCharles 1962, Ghana [33]55.3%Before and afterAll aged residents of Akrofu villagesPyrimethamineNRSehgal 1968, India [37]1.8%Before and afterAll individuals except the very sick, old and the pregnant womenNRIrs with ddtOmer 1978, Sudan [85]40.5%Non-RCTAll residents of 4 villages in Gezira ecological area of Northern SudanChloroquineNRMaccormack 1983, Tanzania [47]NRNon-RCTThe age range of the participants was 0–15 yearsChloroquineNRDapeng 1996, China [38]0.8/1000 population/month in 1984Before and afterAll residents within high incidence areas in 4 counties in Xinyang prefectureChloroquine + primaquineIrs with ddt, itnsSong 2010, Cambodia [43]2–50%Before and afterAll residents above 1 year from 17 villages with parasite rates 20% or higher in Kampong Speu ProvinceArtemisinin + piperaquine + primaquineNR …”

Impact of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria

“…All the studies were conducted in African countries except for three studies, one each from China, India, and Thailand. Interventions were non-integrated in 23 [10,12-14,16-18,20-22,28-33,37,39-42,45,47] of the studies, while in 17 [8,9,19,23-27,34-36,43,44,46,48-50] studies intervention was integrated with routine community-based antenatal care (ANC), primary healthcare (PHC), child health days or measles, and polio campaigns. The primary comparison was between the community-based delivery strategy versus routine or facility-based care.…”

Indoor Residual Spraying Delivery Models to Prevent Malaria: Comparison of Community- and District-Based Approaches in Ethiopia

“…A recent review suggested that community-based malaria interventions, including bed net distribution, IRS, intermittent preventive therapy, and education, may be more efficient than routine or facility-based modes of implementation 11 . However, the review found only one study that assessed IRS—a study in China evaluating a program that implemented IRS while delivering insecticide-treated nets at the same time 12 . Preliminary evidence from Tanzania suggests that community-based approaches for IRS show promise both in terms of coverage and costs, but a full evaluation has not yet been completed 13 .…”