Chinese action towards global malaria eradication – Authors' reply

et al. 2020

Preprint

Background: China launched the National Malaria Elimination Program (NMEP) in 2010 that set the goal that all health facilities had the ability to diagnose malaria along with the hospitals at all levels had the ability to treat malaria by 2015. To provide a reference for the control of imported malaria, we conducted a study on the distribution of malaria patients seeking care in different types of health facilities. Methods: The data used for the analysis was obtained through the Infectious Diseases Information Reporting Management System (IDIRMS) and stratified multistage sampling. Descriptive statistical analysis was used to investigate the distribution of malaria patients in different types of health facilities, and the Chi-square test was used to compare the proportions of patients seeking care outside their current residence region between different types of hospitals. Point maps were drawn to visualize the spatial distribution of hospitals reporting malaria cases, and flow maps were created to show spatial flow of malaria patients by using the ArcGIS software. Results: The proportions of malaria patients who sought care in hospitals, township hospitals, and Centers for Disease Control and Prevention (CDCs) were 81.7%, 14.7% and 3.6%, respectively. For those who sought care in hospitals, the percentages who sought care in provincial, prefecture-level and county-level hospitals were 17.4%, 60.5% and 22.1%, correspondingly; the proportions of malaria patients who sought care in tertiary hospitals, secondary hospitals, and primary hospitals were 59.8%, 39.9% and 0.3%, respectively. Moreover, the proportions of patients seeking care in hospitals within county and prefectural administrative area were 18.2%, 63.4%, respectively. Conclusion: During the implementation of NMEP, malaria patients tended to seek care in tertiary hospitals and prefecture-level hospitals, and more than half of patients could be treated in hospitals in prefecture-level areas. In the current phase, it is necessary to establish referral system from grassroots medical institutions to hospitals designated for malaria treatment. Keywords: Geographic variation; Care-seeking behavior; Geospatial distribution; Medical treatment preference

Section: Subject Areasmentioning

confidence: 99%

Distribution of malaria patients seeking care in different types of health facilities during the implementation of National Malaria Elimination Program

Gang

et al. 2020

Preprint

“…After the Chinese government put a great deal of efforts into the control of malaria epidemics, the morbidity and mortality rates of malaria had reached their lowest level historically in the late twentieth century [7]. However, after 2000, a malaria resurgence occurred in China, and peaked in 2006 with approximately 64,178 malaria cases reported [8][9][10]. China immediately launched the National Malaria Control Programme (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) with the partnership of the Global Fund project [11,12].…”

Section: Introductionmentioning

confidence: 99%

Distribution of malaria patients seeking care in different types of health facilities during the implementation of National Malaria Elimination Programme

Feng

et al. 2020

Malar J

Background: China launched the National Malaria Elimination Programme (NMEP) in 2010 and set the goal that all health facilities should be able to diagnose malaria. Additionally, hospitals at all levels could treat malaria by 2015. To provide a reference for the control of imported malaria, a study was conducted on the distribution of malaria patients seeking care in different types of health facilities. Methods: There were two data sources. One was obtained through the Infectious Diseases Information Reporting Management System (IDIRMS), which only contained the name of health facilities and the number of cases. The other was obtained through multistage stratified cluster sampling. Descriptive statistical analysis was used to investigate the distribution of malaria patients attending different types of health facilities (hospitals, township hospitals, and Centers for Disease Control and Prevention), hospital tiers (county-level, prefecture-level, and provincial-level), and hospital levels (primary, secondary, and tertiary). Chi-square test was also used to compare the proportions of patients seeking care outside their current residence region between different types of hospitals. Point maps were drawn to visualize the spatial distribution of hospitals reporting malaria cases, and flow maps were created to show the spatial flow of malaria patients by using the ArcGIS software. Results: The proportions of malaria patients who sought care in hospitals, township hospitals, and Centers for Disease Control and Prevention were 81.7%, 14.7%, and 3.6%, respectively. For those who sought care in hospitals, the percentages of patients who sought care in provincial-level, prefecture-level and county-level hospitals were 17.4%, 60.5% and 22.1%, correspondingly; the proportions of patients who sought care in tertiary hospitals, secondary hospitals, and primary hospitals were 59.8%, 39.9%, and 0.3%, respectively. Moreover, the proportions of patients seeking care in hospitals within county and prefectural administrative areas were 18.2%, 63.4%, respectively. Conclusion: During the implementation of NMEP, malaria patients tended to seek care in tertiary hospitals and prefecture-level hospitals, and more than half of patients could be treated in hospitals in prefecture-level areas. In

“…Century. However, after 2000, a resurgence of malaria occurred in China, and peaked in 2006 with approximately 64,178 malaria cases reported [7][8][9]. China immediately launched the National Malaria Control Program (NMCP) (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) with the partnership of the Global Fund project [10,11].…”

Section: Introductionmentioning

confidence: 99%

Spatial analysis of care-seeking behavior among malaria patients in China’s Malaria Eradication Program: A Geographic Information System Analysis

et al. 2019

Preprint

Background: China launched a new round of National Malaria Eradication Program (NMEP) in 2010 that sets the goal to eliminate malaria by 2020, while it has been challenged by the large-scale frequent population migration. To assess the influence of geographic mobility of population on the epidemiology of malaria, we conducted a comprehensive study about the care-seeking behavior among malaria patients. Methods: The malaria cases were identified within a national database from the National Health Commission of the People’s Republic of China. All health institutions and facilities reported malaria patient records during the period from January 2014 to December 2016. Overall 1633 malaria patients were selected in six provinces located in eastern, central and western China that saw most severe malaria epidemic using stratified sampling. Descriptive statistical analysis was used to investigate the distribution of malaria patients in various medical institutions, and the chi-square test was used to compare the cross-regional visit rates of different types of hospitals. Colored maps were drawn to visualize the spatial distribution of hospitals and spatial flow of malaria patients by using the ArcGIS software. Results: The proportions of malaria patients who sought medical care in general hospitals, township hospitals, and professional public health institutions were 81.7%, 14.7% and 3.6%, respectively. For those who visited hospitals, the percentages who chose provincial, prefecture-level and county-level hospitals for malaria treatment were 17.4%, 60.5% and 22.1%, correspondingly; the proportions of malaria patients who sought medical care in tertiary hospitals, secondary hospitals, and primary hospitals were 59.8%, 39.9% and 0.3%, respectively. Moreover, the proportions of inter-provincial, inter-city and inter-county patients were 3.9%, 82.4% and 80.2%, respectively. In addition, we also found that the percentage of malaria patients who sought treatment in designated hospitals was high. Conclusion: With the implementation of National Malaria Control Program (NMCP), malaria patients tended to seek medical care in designate tertiary hospitals, and slightly more than half of patients could be treated in health institutions and facilities in prefectural area. In the post-stage of malaria elimination, it is necessary to establish prompt response grassroots hospitals to refer malaria patients to designated malaria treatment hospitals.