Abstract
BackgroundChina 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.MethodsThere 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.ResultsThe 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.ConclusionDuring 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 county-level hospitals to higher-level hospitals for malaria treatment.
Highlights
China launched the National Malaria Elimination Programme (NMEP) in 2010 and set the goal that all health facilities should be able to diagnose malaria
There are few studies focus on the proportions of malaria patients seeking care in hospitals within county-level or prefecture-level areas. To address this knowledge gap, this study describes the distribution of malaria patients in different types of health facilities, and the proportions of patients seeking care in hospitals within county and prefectural administrative area in the context of the eradication phase of malaria
This study described the distribution of malaria patients in different types of health facilities, and the proportions of patients seeking care in hospitals within county and prefectural administrative areas during the implementation of National Malaria Elimination Programme
Summary
China launched the National Malaria Elimination Programme (NMEP) in 2010 and set the goal that all health facilities should be able to diagnose malaria. Malaria is one of the most prevalent mosquito-borne infectious diseases in the world, which can have a damaging impact on society and the economy [1,2,3]. According to the latest available data, an estimated 228 million malaria cases occurred worldwide, and 405,000 deaths associated with malaria were reported in 2018 [4, 5]. 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 (2006–2015) with the partnership of the Global Fund project [11, 12]. With the effective implementation of measures, such as multi-sectorial cooperation and communication strategy, the incidence of autochthonous malaria cases had declined sharply during the period 2006–2010 in China [13,14,15]
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