BackgroundInsecticide resistance in malaria vectors is a growing concern in many countries and requires immediate attention because of the limited chemical arsenal available for vector control. There is lack of systematic and standard monitoring data of malaria vector resistance in the endemic areas, which is essential for the ambitious goal of malaria elimination programme of China.MethodsIn 2010, eight provinces from different malaria endemic region were selected for study areas. Bioassays were performed on F1 progeny of Anopheles sinensis reared from wild-caught females using the standard WHO susceptibility test with diagnostic concentrations of 0.25% deltamethrin and 4% DDT.ResultsFor An. sinensis, the results indicated that exposure to 0.25% deltamethrin of F1 families with mortalities ranging from 5.96% to 64.54% and less than 80% mortality to DDT at the diagnostic concentration of 4% across the study areas.ConclusionsAnopheles sinensis was completely resistant to both deltamethrin and DDT, and resistance to pyrethroid has risen strikingly compared to that recorded during 1990s. The results highlight the importance of longitudinal insecticide resistance monitoring and the urgent need for a better understanding of the status of insecticide resistance in this region.
BackgroundEpidemiological data in the border area of the northern Myanmar near China are either of little accuracy or sparse of information, due to the poor public health system in these areas, and malaria cases may be severely underestimated. This study aimed to investigate malaria prevalence and health facilities for malaria services, and to provide the baseline information for malaria control in these areas.MethodsA cluster, randomized, cross-sectional survey was conducted in four special regions of northern Myanmar, near China: 5,585 people were selected for a malaria prevalence survey and 1,618 households were selected for a mosquito net-owning survey. Meanwhile, a total of 97 health facilities were surveyed on their malaria services. The data were analysed and descriptive statistics were used.ResultsA total of 761 people were found positive through microscopy test, including 290 people for Plasmodium falciparum, 460 for Plasmodium vivax, two for Plasmodium malariae, and nine for mixed infection. The average prevalence of malaria infection was 13.6% (95% CI: 12.7-14.6%). There were significant differences of prevalence of malaria infection among the different regions (P < 0.01); 38.1% (95% CI: 28.3-48.0%) of health facilities had malaria microscope examination service, and 35.1% (95% CI: 25.4-44.7%) of these had malaria treatment services, 23.7% (95% CI: 15.1-32.3%) had malaria outreach services. 28.3% (95% CI: 26.1-30.6%) of households owned one or more long-lasting insecticidal bed nets (LLINs).ConclusionThe prevalence of malaria infection was high in the four special regions of northern Myanmar, near China. Malaria services in health facilities in these areas were weak. ITNs/LLINs owning rate was also low. The cross-border cooperation mechanism should be further strengthened to share the epidemical data about malaria, support technical assistance, and conduct joint malaria control or elimination activities.
BackgroundFor many countries where malaria is endemic, the burden of malaria is high in border regions. In ethnic minority areas along the Myanmar-China border, residents have poor access to medical care for diagnosis and treatment, and there have been many malaria outbreaks in such areas. Since 2007, with the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), a malaria control project was introduced to reduce the malaria burden in several ethnic minority regions.MethodsA malaria control network was established during the period from 2007 to 2014. Multiple malaria interventions, including diagnosis, treatment, distribution of LLINs and health education, were conducted to improve the accessibility and quality of malaria control services for local residents. Annual cross-sectional surveys were conducted to evaluate intervention coverage and indicators of malaria transmission.ResultsIn ethnic minority regions where a malaria control network was established, both the annual malaria incidence (19.1 per thousand per year, in 2009; 8.7, in 2014) and malaria prevalence (13.6 % in 2008; 0.43 % in 2014) decreased dramatically during the past 5–6 years. A total of 851 393 febrile patients were detected, 202 598 malaria cases (including confirmed cases and suspected cases) were treated, and 759 574 LLINs were delivered to populations at risk. Of households in 2012, 73.9 % had at least one ITNs/LLINs (vs. 28.3 %, in 2008), and 50.7 % of children less than 5 years and 50.3 % of pregnant women slept under LLINs the night prior to their visit. Additionally, malaria knowledge was improved in 68.4 % of residents.ConclusionThere has been great success in improving malaria control in these regions from 2007 to 2014. Malaria burdens have decreased, especially in KOK and WA. The continued maintenance of sustainable malaria control networks in these regions may be a long-term process, due to regional conflicts and the lack of funds, technology, and health workers. Furthermore, information and scientific support from the international community should be offered to these ethnic minority regions to uphold recent achievements.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0191-0) contains supplementary material, which is available to authorized users.
Introduction: This study aimed to investigate the baseline level of malaria awareness in residents in 20 malaria-endemic provinces from October 2010 to January 2011 at the beginning of the implementation of the China National Malaria Elimination Programme (NMEP). Methodology: A structured questionnaire about basic malaria knowledge was administrated to residents in rural areas from 20 provinces, municipalities, and autonomous regions. Results: A total of 182,085 residents no younger than 15 years of age took part in the cross-sectional investigation; 3,232 were excluded because of incomplete survey responses. Of the respondents, 56.86% were aware of malaria, 18.03% responded correctly to all five questions, and 5.57% answered all the questions incorrectly. Malaria awareness among different age groups was statistically significant (p < 0.001), males had a better understanding of malaria than did females (p < 0.001), and Type I counties had a better understanding than did Type II counties (p < 0.001). Conclusions: The level of malaria awareness was low among residents at the beginning of the NMEP, especially about malaria pathogenicity and preventive methods. Health education campaigns should be developed and implemented to increase the public perceptions about malaria prevention and treatment, and to promote malaria elimination in China.
ObjectiveTo ascertain the trends and burden of malaria in China and the costs of interventions for 2011–2015.MethodsWe analysed the spatiotemporal and demographic features of locally transmitted and imported malaria cases using disaggregated surveillance data on malaria from 2011 to 2015, covering the range of dominant malaria vectors in China. The total and mean costs for malaria elimination were calculated by funding sources, interventions and population at risk.FindingsA total of 17 745 malaria cases, including 123 deaths (0.7%), were reported in mainland China, with 15 840 (89%) being imported cases, mainly from Africa and south-east Asia. Almost all counties of China (2855/2858) had achieved their elimination goals by 2015, and locally transmitted cases dropped from 1469 cases in 2011 to 43 cases in 2015, mainly occurring in the regions bordering Myanmar where Anopheles minimus and An. dirus are the dominant vector species. A total of United States dollars (US$) 134.6 million was spent in efforts to eliminate malaria during 2011–2015, with US$ 57.2 million (43%) from the Global Fund to Fight AIDS, Tuberculosis and Malaria and US$ 77.3 million (57%) from the Chinese central government. The mean annual investment (US$ 27 million) per person at risk (574 million) was US$ 0.05 (standard deviation: 0.03).ConclusionThe locally transmitted malaria burden in China has decreased. The key challenge is to address the remaining local transmission, as well as to reduce imported cases from Africa and south-east Asia. Continued efforts and appropriate levels of investment are needed in the 2016–2020 period to achieve elimination.
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