Monitoring and evaluation of intervals from onset of fever to diagnosis before “1-3-7” approach in malaria elimination: a retrospective study in Shanxi Province, China from 2013 to 2018

Abstract

Background China’s 1-3-7 approach was extensively implemented to monitor the timeframe of case reporting, case investigation and foci response in the malaria elimination. However, activities before diagnosis and reporting (before ‘1’) would counteract the efficiency of 1-3-7 approach but few data have evaluated this issue. This study aims to evaluate the timelines between onset of fever and diagnosis at healthcare facilities in Shanxi Province. Methods Routine data were extracted from IDIRMS and NMISM database from 2013 to 2018. Time intervals between onset of fever and healthcare-seeking and between healthcare-seeking and diagnosis were calculated. Each of the documented malaria cases was geo-coded and paired to the county-level layers of polygon. Results A total of 90 cases were reported in 2013–2018 in Shanxi Province, and 73% of cases reported at provincial health facilities. All malaria cases were imported from Africa (90%) and Southeast Asia (10%) especially around the Chinese Spring Festival (n = 46, 51%). The median days between fever and healthcare-seeking and between healthcare-seeking and diagnosis of malaria were 3 and 2, respectively. Conclusions The current “1-3-7” approach is well executed in Shanxi Province, but delays intervals observed in case finding before 1-3-7 approach occurred in all levels of facilities in Shanxi Province, which imply that more efforts are highlighted for timely case finding. Health education should be provided for improving awareness of healthcare-seeking, and various technical training aiming at the physicians should be carried out to improve diagnosis of malaria.

Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagnostic tools during 2011–2018

“…Therefore, prevention and treatment against P. falciparum should be highly considered in Wuhan. Over the years (from 2014 to 2018), the Plasmodium species leading to imported malaria were becoming diversified, just as in other provinces of China, including Shandong [ 59 ], Zhejiang [ 62 ], Shanxi [ 63 ] and Chongqing municipality [ 64 ]. In this period, the imported non-falciparum cases and P. vivax / P. ovale cases showed no significantly increasing trend by year, but more attention should be focused on this increasing Plasmodium species diversity.…”

“…Even so, two time slots should be paid more attention for the prevention of imported malaria. One is the Chinese Spring Festival, which leads to the most frequent migration between provinces in China and brings many overseas Chinese home [ 5 , 63 , 64 , 71 ]. Another is the anopheles active phase [ 5 , 64 , 70 – 72 ].…”

Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagnostic tools during 2011–2018

“…Therefore, prevention and treatment against P. falciparum should be highly considered in Wuhan. Over the years (from 2014 to 2018), the Plasmodium species leading to imported malaria were becoming diversi ed, just as in other provinces of China, including Shandong [59], Zhejiang [62], Shanxi [63] and Chongqing municipality [64]. In this period, the imported non-P.f.…”

“…Even so, we have to emphasize that two time slots should be paid more attention for the prevention of imported malaria. One is the Chinese Spring Festival, which leads to the most frequent migration between provinces in China and brings many overseas Chinese home [5,63,64,71]. Another is the anopheles active phase [5,64,[70][71][72].…”

Seven decades towards malaria elimination in Yunnan, China

“…Routine vector control was used in strata I and II where foci were not cleared. Also, the '1-3-7′ approach was introduced as the combined standard operating procedure for surveillance and response, specifying case reporting within 1 day after diagnosis, case investigation within 3 days, and focus investigation and action within 7 days [43][44][45][46][47][48]. Depending on the type of focus, the response could include reactive case detection, with recent fever as an indicator for testing a blood sample, focal MDA, vector control (IRS or ITNs) and health education [21].…”