Achieving malaria elimination in China

Cao, Jun; Newby, Gretchen; Cotter, Chris; Hsiang, Michelle S.; Larson, Erika; Tatarsky, Allison; Gosling, Roly; Xia, Zhigui; Gao, Qi

doi:10.1016/s2468-2667(21)00201-2

Cited by 23 publications

(16 citation statements)

References 7 publications

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“…Malaria elimination in the international border areas is one of the challenges that countries face today in their path to malaria elimination. Interruption of malaria transmission and continuous maintenance of malaria free in the Yunnan border area allowed the WHO’s certification of malaria elimination for China [ 2 , 7 ]. This case study presented the story of malaria from hyperendemicity to elimination in the Yunnan border area.…”

Section: Discussionmentioning

confidence: 99%

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Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

Liu

2022

Infect Dis Poverty

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Background Border malaria is one of the most intractable problems hindering malaria elimination worldwide. Movement of both the human population and anopheline mosquitoes infected with Plasmodium spp. can cause cross-border malaria transmission. The Yunnan border area was still hyperendemic for malaria in the early part of this century. The objective of this case study was to analyze the strategies, interventions and impacts of malaria control and elimination in the Yunnan border area. Main text A total of 10,349 malaria cases and 17.1 per 10,000 person-years of annual parasite incidence (API) were reported in the border area in 2003. Based on natural village-based stratification, integrated interventions, including mass drug administration for radical cures and preventive treatment, clinically presumptive treatment of all febrile patients for malaria and indoor residual spraying or dipping bed nets with insecticides were successfully carried out from 2003 to 2013. The overall API was reduced to 0.6 per 10,000 person-years by 2013, while effective cross-border collaboration interventions dramatically reduced the malaria burden in the neighbouring border areas of Myanmar. From 2014 forward, the comprehensive strategy, including universal coverage of surveillance to detect malaria cases, a rapid response to possible malaria cases and effective border collaboration with neighbouring areas, successfully eliminated malaria and prevented reintroduction of malaria transmission in the Yunnan border area. Conclusions In Yunnan malaria burden has successfully reduced by dynamically accurate stratification and comprehensive interventions; and then the region achieved elimination and prevented reintroduction of malaria transmission through intensive surveillance, rapid response and border collaboration. Other border areas should perform their own intervention trials to develop their own effective strategy. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

“…The World Health Organization (WHO) certified China malaria-free status on June 30, 2021 [ 1 , 2 ]. Yunnan Province in southwestern China shares 4060 km of border with Myanmar (1997 km), Laos (710 km) and Vietnam (1353 km).…”

Section: Introductionmentioning

confidence: 99%

Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

Liu

2022

Infect Dis Poverty

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“…The last indigenous malaria case in China was reported from Yingjiang County in the Yunnan border area in April 2016 [ 41 ]. Malaria elimination in the Yunnan border area has strongly contributed to the remarkable achievement that the WHO certified China malaria-free status on June 30, 2021 [ 5 , 11 ]. The results of this study helped public health decision-makers planning cost-effective strategies of malaria elimination gearing to the high-risk locations and populations [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The investigation of risk factors of border malaria can provide scientific evidences in planning malaria elimination in the GMS. After the national malaria programme and its partners dedicated efforts for seven decades, the WHO certified China malaria-free status on June 30, 2021 [ 5 ]. However, Yunnan Province shares 4060 km of border with Myanmar (1997 km), Laos (710 km) and Vietnam (1353 km).…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with malaria infection along China–Myanmar border: a case–control study

Deng

Wang

et al. 2022

Malar J

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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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“…This system was evaluated nine years after its implementation in order to improve the quality of the malaria surveillance system [ 5 ]. The WHO recognizes the importance of having a computer platform for real-time reporting [ 6 ]. This serves as an example that after a time of implementation of a system, it is important to carry out evaluations that denote areas of opportunity to improve the information systems.…”

Section: Introductionmentioning

confidence: 99%

Web Geographic Information System: A Support Tool for the Study, Evaluation, and Monitoring of Foci of Malaria Transmission in Mexico

Santos-Luna

Román-Pérez

Reyes-Cabrera³

et al. 2023

IJERPH

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Malaria is currently an endemic disease in Mexico. The country joined the WHO’s E-25 initiative for the elimination of Plasmodium vivax to achieve elimination and certification within the established period. Having a Web-based information system was, therefore, deemed necessary to assist in the detection, investigation, and elimination of transmission in the foci, as well as for the timely treatment of malaria-positive cases. The “Information System for the Elimination of Malaria in Mexico” was designed, developed, and implemented with a geographic vision, which includes a Web tool to georeference homes and aquatic systems, a dashboard and an indicator evaluation card for monitoring activities, notification of probable cases, and vector control among other indicators. The implementation of the system was gradual in the seven states that are currently in the malaria elimination phase; subsequently, the system was implemented in non-transmission states. In 2020, the system implementation stage began; first, the basic data of more than 96,000 homes throughout the country were georeferenced, and then the primary data capture tools of 17 formats, 32 reports, and 2 geographic viewers were enabled for information queries. A total of 56 active foci have been identified in 406 localities as well as 71 residual foci in 320 localities. Recently, the Foci Manager was developed, which is a specific tool for the study, evaluation, and monitoring of active foci through a GIS, a dashboard, and a systematized evaluation certificate. Georeferencing tools decreased the cost of spatial data collection.

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Achieving malaria elimination in China

Cited by 23 publications

References 7 publications

Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

Risk factors associated with malaria infection along China–Myanmar border: a case–control study

Web Geographic Information System: A Support Tool for the Study, Evaluation, and Monitoring of Foci of Malaria Transmission in Mexico

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