Malaria control along China-Myanmar Border during 2007–2013: an integrated impact evaluation

Abstract

BackgroundImplementing effective interventions remain a lot of difficulties along all border regions. The emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great concern. China has effectively controlled cross-border transmission of malaria and artemisinin resistance of P. falciparum along the China-Myanmar border.MethodsA combined quantitative and qualitative study was used to collect data, and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during 2007–2013.ResultsThe parasite prevalence rate (PPR) in the five special regions of Myanmar was decreased from 13.6 % in March 2008 to 1.5 % in November 2013. Compared with the baseline (PPR in March 2008), the risk ratio was only 0.11 [95 % confidence interval (CI), 0.09–0. 14) in November 2013, which is equal to an 89 % reduction in the malaria burden. Annual parasite incidence (API) across 19 Chinese border counties was reduced from 19.6 per 10 000 person-years in 2006 to 0.9 per 10 000 person-years in 2013. Compared with the baseline (API in 2006), the API rate ratio was only 0.05(95 % CI, 0.04–0.05) in 2013, which equates to a reduction of the malaria burden by 95.0 %. Meanwhile, the health service system was strengthened and health inequity of marginalized populations reduced along the international border.ConclusionThe effective collaboration between China, Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified processes. The integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0171-4) contains supplementary material, which is available to authorized users.

Treatment seeking behavior and associated factors of suspected dengue fever among Shan people in eastern Shan special region IV, Myanmar: a cross-sectional study

“…In the ESSR4, only the hospital of ESSR4 can perform laboratory-based diagnosis and treatment. DF is becoming a new threat to public health after the China Global Fund to fight AIDS, Tuberculosis and Malaria project has successfully reduced the malaria burden along the China-Myanmar border [9]. However, funding is still not enough to control DF.…”

“…Improved treatment for dengue fever (DF) has decreased the case fatality rate by approximately half with each decade since 1980 [6]. Dengue has replaced malaria to become another threat to public health along the China-Myanmar border [7,8] as malaria has been successfully controlled [9]. More prompt and proper interventions are needed now because of the unavailability of anti-dengue drugs and low efficacy of current dengue vaccines [10,11].…”

Epidemiology of Imported Infectious Diseases, China, 2005–2016

“…The reason for the large number of imported cases is that Yunnan Province has long international borders with Myanmar, Laos, Vietnam, and other countries of the Greater Mekong Subregion that show a high incidence of malaria (16). The persons who cross these borders to enter or leave China increase opportunities for infectious diseases to be imported from adjacent countries (3,14,18,19), especially from Myanmar (12,13,20). P. falciparum malaria was imported mainly from Ghana and P. vivax malaria mainly from Asia, which was consistent with Zhou's findings (5).…”

Ending Malaria Transmission in the Asia Pacific Malaria Elimination Network (APMEN) Countries: Challenges and the Way Forward

“…Then, cross-border initiatives should be initiated through sharing of programme data including insecticide resistance, blood testing at the border areas, and treatment of symptomatic cases [177,[202][203][204][205][206][207][208]. Such successful cross-border case studies in the region have led to significant reduction in malaria burden in the study areas [209].…”