Abstract
BackgroundChina has already achieved remarkable accomplishments in shrinking the malaria burden since the mid-20th Century. The country now plans to eliminate malaria by the year 2020. Looking at the dynamics of malaria outbreaks during the last decades might provide important information regarding the potential challenges of such an elimination strategy and might help to avoid mistakes of the past.MethodsA systematic review of the published literature (English and Chinese) was conducted to identify malaria outbreaks during the period 1990 until 2013 in China. The main causes of outbreaks as described in these papers were categorized according to whether they were related to population migration, environmental factors, vector and host related factors, and operational problems of the health services.ResultsThe review identified 36 malaria outbreaks over the 23-year study period, on which sufficient information was available. They mainly occurred in southern and central China involving 12 provinces/autonomous regions. More than half of all outbreaks (21/36, 58%) were attributed at least in part to population migration, with malaria importation to non- or low-endemic areas from high-endemic Chinese areas (13/15) or endemic countries (2/15) having been the most frequent reason (15/21, 71%). Other main causes were problems of the health services (15/36, 42%), in particular poor malaria case management (10/15, 67%), environmental factors (7/36, 19%), and vector and host related factors (5/36, 14%).ConclusionsBeside a number of other challenges, addressing population movement causing malaria appears to be of particular importance to the national malaria programme. Strengthening of surveillance for malaria and early radical treatment of cases should thus be considered among the most important tools for preventing malaria outbreaks and for the final goal of malaria elimination in China.
Highlights
China has already achieved remarkable accomplishments in shrinking the malaria burden since the mid-20th Century
Falciparum malaria was already restricted to only two provinces (Yunnan, Hainan) by 1998, and vivax malaria accounted for 95% of the indigenous malaria cases in 2012 [8,9]
English articles were searched from Medline, Web of Science, Embase, the Cochrane Central Register of Controlled Trials and Evidence for Policy and Practice Information and coordinating Centre (EPPI-Centre) by using the search terms ‘malaria’, ‘Plasmodium vivax’, ‘Plasmodium falciparum’, ‘outbreak’, ‘resurgence’, ‘re-emergence’ ‘relapse’ and ‘China’, ‘People’s Republic of China’
Summary
China has already achieved remarkable accomplishments in shrinking the malaria burden since the mid-20th Century. The country plans to eliminate malaria by the year 2020. Looking at the dynamics of malaria outbreaks during the last decades might provide important information regarding the potential challenges of such an elimination strategy and might help to avoid mistakes of the past. Despite two major outbreaks in the 1960s and 1970s, respectively, the country showed a steady decrease of its malaria burden [2]. Over the last two decades, China has further reduced the malaria burden, with a goal of elimination by 2020 [3,4]. Plasmodium falciparum and Plasmodium vivax are the two main malaria species in China. On the other side, imported falciparum malaria is increasingly seen in many provinces [8,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
