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Liu H, Zhou YW, Deng Y, Lin ZR, Zhang CL, Chen QY, Wei C, Duan KX, Zhou HN, Xu JW. Historical review of malaria control and elimination in the border areas of China: A case study of Yunnan Province. ADVANCES IN PARASITOLOGY 2022; 116:33-67. [PMID: 35752449 DOI: 10.1016/bs.apar.2021.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To understand how malaria could be eliminated in the original hyperendmic area for malaria along international borders in Yunnan Province, malaria situation and control were described on the basis of seven phases. At last the experiences and lessons of the program that reduced border malaria from hyperendmicity to malaria-free status were summarized. Malaria control and elimination area were particularly difficult in the Yunnan border. The achievement can be attributed to high political commitment, strategic and technical innovations based on the actual locality, effective collaboration and communication with neighbouring countries to carry out cross border interventions. Other border areas might perform their own pilot interventions based on their local context, including malaria burden, governing system, health service structure contextualized based on their socioeconomic development and ecology, and then a local decision could be made according to their own trial results.
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Affiliation(s)
- Hui Liu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Yao-Wu Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Yan Deng
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Zu-Rui Lin
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Cang-Lin Zhang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Qi-Yan Chen
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Chun Wei
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Kai-Xia Duan
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
| | - Hong-Ning Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China.
| | - Jian-Wei Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, Yunnan, PR China
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Baharia RK, Yadav CP, Sharma A. Four decades of epidemiological data reveal trajectories towards malaria elimination in Kheda district (Gujarat), western part of India. BMJ Glob Health 2021; 6:bmjgh-2021-005815. [PMID: 34880060 PMCID: PMC8655587 DOI: 10.1136/bmjgh-2021-005815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/03/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Malaria is a main public health problem in India and was so particularly in the state of Gujarat in the western part of the country. This study assesses the effects of various interventions on malaria cases using data from the last 33 years (1987-2019). METHODS Here we have analysed 33 years of malaria epidemiological data from a malaria clinic in Kheda district in Gujarat. The data were digitised yearly and monthly, age-wise and gender-wise, and descriptive analysis was performed to assess the effects of several interventions on malaria burden. RESULTS During 1987-2019, our clinic diagnosed 5466 Plasmodium vivax and 4732 P. falciparum malaria cases. Overall, there was a declining trend in malaria cases except for the years 1991, 1994, 2004 and 2005. The year 2004 especially witnessed an epidemic in Kheda as well as throughout Gujarat. Malaria infections were most common (40%) among the 21-40 years age group. Fever was the most common symptom in all age groups. INTERPRETATION Introduction of revised drug policy and improved surveillance technique (rapid diagnosis kits) have strengthened the diagnosis and treatment of malaria in the district. Use of pyrethroid in indoor residual insecticide spray has also strengthened vector control. Among the various interventions used, long-lasting insecticide nets and introduction of artemisinin-based combination therapy have played significant roles in controlling malaria cases. A more drastic decline in P. falciparum cases versus P. vivax is evident, but the latter persists in high proportions and therefore new tools for malaria control will be needed for elimination.
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Affiliation(s)
- Rajendra Kumar Baharia
- Department of Parasite and Vector Control, ICMR-National Institute of Malaria Research, Nadiad, Gujarat, India
| | - Chander Prakash Yadav
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, India
| | - Amit Sharma
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, India
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Cun Y, Shi L, Kulski JK, Liu S, Yang J, Tao Y, Zhang X, Shi L, Yao Y. Haplotypic Associations and Differentiation of MHC Class II Polymorphic Alu Insertions at Five Loci With HLA-DRB1 Alleles in 12 Minority Ethnic Populations in China. Front Genet 2021; 12:636236. [PMID: 34305999 PMCID: PMC8292818 DOI: 10.3389/fgene.2021.636236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/08/2021] [Indexed: 01/11/2023] Open
Abstract
The analysis of polymorphic variations in the human major histocompatibility complex (MHC) class II genomic region on the short-arm of chromosome 6 is a scientific enquiry to better understand the diversity in population structure and the effects of evolutionary processes such as recombination, mutation, genetic drift, demographic history, and natural selection. In order to investigate associations between the polymorphisms of HLA-DRB1 gene and recent Alu insertions (POALINs) in the HLA class II region, we genotyped HLA-DRB1 and five Alu loci (AluDPB2, AluDQA2, AluDQA1, AluDRB1, AluORF10), and determined their allele frequencies and haplotypic associations in 12 minority ethnic populations in China. There were 42 different HLA-DRB1 alleles for ethnic Chinese ranging from 12 alleles in the Jinuo to 28 in the Yugur with only DRB1∗08:03, DRB1∗09:01, DRB1∗12:02, DRB1∗14:01, DRB1∗15:01, and DRB1∗15:02 present in all ethnic groups. The POALINs varied in frequency between 0.279 and 0.514 for AluDPB2, 0 and 0.127 for AluDQA2, 0.777 and 0.995 for AluDQA1, 0.1 and 0.455 for AluDRB1 and 0.084 and 0.368 for AluORF10. By comparing the data of the five-loci POALIN in 13 Chinese ethnic populations (including Han-Yunnan published data) against Japanese and Caucasian published data, marked differences were observed between the populations at the allelic or haplotypic levels. Five POALIN loci were in significant linkage disequilibrium with HLA-DRB1 in different populations and AluDQA1 had the highest percentage association with most of the HLA-DRB1 alleles, whereas the nearby AluDRB1 indel was strongly haplotypic for only DRB1∗01, DRB1∗10, DRB1∗15 and DRB1∗16. There were 30 five-locus POALIN haplotypes inferred in all populations with H5 (no Alu insertions except for AluDQA1) and H21 (only AluDPB2 and AluDQA1 insertions) as the two predominant haplotypes. Neighbor joining trees and principal component analyses of the Alu and HLA-DRB1 polymorphisms showed that genetic diversity of these genomic markers is associated strongly with the population characteristics of language family, migration and sociality. This comparative study of HLA-DRB1 alleles and multilocus, lineage POALIN frequencies of Chinese ethnic populations confirmed that POALINs whether investigated alone or together with the HLA class II alleles are informative genetic and evolutionary markers for the identification of allele and haplotype lineages and genetic variations within the same and/or different populations.
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Affiliation(s)
- Yina Cun
- Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Lei Shi
- Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jerzy K Kulski
- Faculty of Health and Medical Sciences, University of Western Australia Medical School, Crawley, WA, Australia
| | - Shuyuan Liu
- Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jia Yang
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Yufen Tao
- Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Xinwen Zhang
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Li Shi
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Yufeng Yao
- Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
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Feng X, Xia ZG, Feng J, Zhang L, Yan H, Tang L, Zhou XN, Zhou S. The contributions and achievements on malaria control and forthcoming elimination in China over the past 70 years by NIPD-CTDR. ADVANCES IN PARASITOLOGY 2020; 110:63-105. [PMID: 32563334 DOI: 10.1016/bs.apar.2020.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although the past decades have seen a remarkable decrease in malaria-caused mortality and morbidity, the infection remains a significant challenge to global health. In the battle against malaria, China has gained notable feat and achievement since the 1940s through the efforts of several generations. Notably, China has not recorded a single indigenous malaria case since August 2016. The National Institute of Parasitic Diseases of the Chinese Center for Disease Control and Prevention (NIPD), as the only specialized institution for parasitic disease at the national level, has played a significant role in the malaria control, prevention, and elimination in China in the different historical periods. In order to transfer Chinese experiences on malaria control and elimination to other Low and Middle Income Countries (LMICs) and to improve global health collaboration, we have summarized and reviewed the contributions and achievements by the NIPD over the past 70 years, covering the epidemic situation; field investigation and laboratory experimental research on both parasite and vector; research and development on diagnostics, drugs, and insecticides; surveillance and response; technical and international. Support and cooperation. In addition, we also focus in particular on malaria retransmission risk, strategies on management of imported malaria cases and mobile populations, surveillance and response capacity to be maintained in post-elimination stage, challenges on diagnosis, drug resistance, and insecticide resistance as future concerns.
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Affiliation(s)
- Xinyu Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Jun Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - He Yan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Linhua Tang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Shuisen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China.
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Distribution of Killer-Cell Immunoglobulin-Like Receptor Genes and Combinations of Their Human Leucocyte Antigen Ligands in 11 Ethnic Populations in China. Cells 2019; 8:cells8070711. [PMID: 31336930 PMCID: PMC6678321 DOI: 10.3390/cells8070711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to analyze the distribution of killer-cell immunoglobulin-like receptor (KIR) genes and their human leucocyte antigen (HLA) ligand combinations in different original ethnic populations in China, and thus, to provide relevant genomic diversity data for the future study of viral infections, autoimmune diseases, and reproductive fitness. A total of 1119 unrelated individuals from 11 ethnic populations—including Hani, Jinuo, Lisu, Nu, Bulang, Wa, Dai, Maonan, Zhuang, Tu, and Yugu—from four original groups, were included. The presence/absence of the 16 KIR loci were detected, and the KIR gene’s phenotype, genotype, and haplotype A and B frequencies, as well as KIR ligand’s HLA allotype and KIR–HLA pairs for each population, were calculated. Principal component analysis and phylogenetic trees were constructed to compare the characteristics of the KIR and KIR–HLA pair distributions of these 11 populations. In total, 92 KIR genotypes were identified, including six new genotypes. The KIR and its HLA ligands had a distributed diversity in 11 ethnic populations in China, and each group had its specific KIR and KIR–HLA pair profile. The difference among the KIR–HLA pairs between northern and southern groups, but not among the four original groups, may reflect strong pressure from previous or ongoing infectious diseases, which have a significant impact on KIR and its HLA combination repertoires.
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Lu G, Liu Y, Beiersmann C, Feng Y, Cao J, Müller O. Challenges in and lessons learned during the implementation of the 1-3-7 malaria surveillance and response strategy in China: a qualitative study. Infect Dis Poverty 2016; 5:94. [PMID: 27716398 PMCID: PMC5050603 DOI: 10.1186/s40249-016-0188-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 08/24/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND China has made great progress in malaria control over the last century and now aims to eliminate malaria by 2020. In 2012, the country launched its 1-3-7 surveillance and response strategy for malaria elimination. The strategy involves to case reporting within 1 day, case investigation within 3 days, and focus investigation and public health actions within 7 days. The aim of this study was to evaluate the challenges in and lessons learned during the implementation of the 1-3-7 strategy in China so far. METHODS This qualitative study was conducted in two provinces in China: Gansu province (northwestern China) and Jiangsu province (southeastern China) in 2014. Key informant interviews (n = 6) and in-depth interviews (n = 36) about the implementation aspects of the 1-3-7 strategy were conducted with malaria experts, health staff, laboratory practitioners, and village doctors at the provincial, city, county, township, and village levels. RESULTS Broad themes related to the challenges in and lessons learned during the implementation of the 1-3-7 strategy were identified according to: case reporting within 1 day, case investigation within 3 days, focus investigation within 7 days, and the overall strategy. The major challenges outlined were related to respecting the timeline of surveillance procedures, the absence of or difficulties in following guidelines on conducting focus investigations, diagnostics, and the increasing number of returning migrant workers from malaria-endemic countries. Important lessons learned revolve around the importance of continuous capacity building, supervision and motivation, quality control, information technology support, applied research, governmental commitment, and intersectoral collaboration. CONCLUSIONS Surveillance is a key intervention in malaria elimination programs. The Chinese 1-3-7 strategy has already proven to be successful but still needs to be improved. In particular, dealing appropriately with imported malaria cases through the screening of migrant workers from malaria-endemic countries is essential for achieving and sustaining malaria elimination in China. China has perfect preconditions for successful malaria elimination provided political commitment and financial investment are guaranteed. The 1-3-7 strategy may also be considered as a model for other countries.
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Affiliation(s)
- Guangyu Lu
- Department of Preventive Medicine, Medical College of Yangzhou University, Yangzhou University, 225001 Yangzhou, China
- Institute of Public Health, Medical School, The Ruprecht-Karls-Universität Heidelberg, INF 324, 69120 Heidelberg, Germany
| | - Yaobao Liu
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Claudia Beiersmann
- Institute of Public Health, Medical School, The Ruprecht-Karls-Universität Heidelberg, INF 324, 69120 Heidelberg, Germany
| | - Yu Feng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jun Cao
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
- Public Health Research Center, Jiangnan University, Wuxi, China
| | - Olaf Müller
- Institute of Public Health, Medical School, The Ruprecht-Karls-Universität Heidelberg, INF 324, 69120 Heidelberg, Germany
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Hu T, Liu YB, Zhang SS, Xia ZG, Zhou SS, Yan J, Cao J, Feng ZC. Shrinking the malaria map in China: measuring the progress of the National Malaria Elimination Programme. Infect Dis Poverty 2016; 5:52. [PMID: 27197517 PMCID: PMC4873993 DOI: 10.1186/s40249-016-0146-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 05/13/2016] [Indexed: 11/17/2022] Open
Abstract
Background Remarkable progress has been made towards the elimination of malaria in China since the National Malaria Elimination Programme (NMEP) was launched in 2010. The incidence of locally-acquired malaria cases has declined rapidly and endemic areas have also dramatically shrunk. In total, 3 078 malaria cases were reported in 2014, but only 56 cases were indigenous. In order to further promote the elimination programme, we reviewed the progress of and experiences associated with malaria elimination in China, and identified the challenges and priorities for the next stage of the programme. Methods Data were collected from the web-based China Information System for Disease Control and Prevention, and the China Annual Report of Malaria Elimination. The progress towards the elimination of malaria from 2010 to 2014 was measured. Results During the implementation of the NMEP from 2010 to 2014, local malaria incidence has declined continuously, only remaining in the Yunnan Province and Tibet Autonomous Region in 2014. By the end of 2015, 75.6 % (1 636/2 163) of the malaria-endemic counties passed the sub-national elimination assessment. The main challenges are cases of border malaria and imported malaria from other countries. Sustainable support and investment from the government, the establishment of an effective surveillance and response system, and risk assessments for the potential reintroduction of malaria are priorities for the next stage of the elimination programme. Conclusions The NMEP in China has been successfully implemented thus far and the malaria map has shrunk dramatically. The priorities for malaria elimination are interventions to block transmission at border areas, management of imported malaria cases, preventing malaria reintroduction, capacity building, and sustainability of malaria surveillance and response. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0146-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tao Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.,Bureau of Disease Prevention and Control, National Health and Family Planning Commission of the People's Republic of China, Beijing, People's Republic of China
| | - Yao-Bao Liu
- Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, People's Republic of China
| | - Shao-Sen Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Jun Yan
- Bureau of Disease Prevention and Control, National Health and Family Planning Commission of the People's Republic of China, Beijing, People's Republic of China
| | - Jun Cao
- Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, People's Republic of China.,Public Health Research Center, Jiangnan University, Wuxi, People's Republic of China
| | - Zhan-Chun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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Affiliation(s)
- Colin Binns
- Curtin University, Perth, Western Australia, Australia
| | - Wah-Yun Low
- University of Malaya, Kuala Lumpur, Malaysia
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Feng J, Xia ZG, Vong S, Yang WZ, Zhou SS, Xiao N. Preparedness for malaria resurgence in China: case study on imported cases in 2000-2012. ADVANCES IN PARASITOLOGY 2015; 86:231-65. [PMID: 25476887 DOI: 10.1016/b978-0-12-800869-0.00009-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Malaria is the most important parasitic protozoan infection that has caused serious threats to human health globally. China has had success in reducing the morbidity and mortality of malaria to the lowest level through sustained and large-scale interventions. Although the total number of malaria cases declined gradually, the burden of the imported malaria cases mainly from Southeast Asian and African countries has increased substantially since 2000, posing a severe threat to public health in China. This review explores and analyses the epidemiological characteristics of the imported malaria based on data from 2000 to 2012, in order to provide theoretical bases and insights into effective prevention, avoid the resurgence of malaria in malaria-susceptible areas and develop appropriate strategies to protect people's health in China. This review also intends to offer the useful information of innovative approaches and tools that are required for malaria elimination in various settings.
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Affiliation(s)
- Jun Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Shanghai, People's Republic of China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Shanghai, People's Republic of China
| | - Sirenda Vong
- World Health Organization, China Representative Office, Beijing, People's Republic of China
| | - Wei-Zhong Yang
- Chinese Preventive Medicine Association, Beijing, People's Republic of China; Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Shanghai, People's Republic of China
| | - Ning Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Shanghai, People's Republic of China
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Feng XY, Xia ZG, Vong S, Yang WZ, Zhou SS. Surveillance and response to drive the national malaria elimination program. ADVANCES IN PARASITOLOGY 2015; 86:81-108. [PMID: 25476882 DOI: 10.1016/b978-0-12-800869-0.00004-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The national action plan for malaria elimination in China (2010-2020) was issued by the Chinese Ministry of Health along with other 13 ministries and commissions in 2010. The ultimate goal of the national action plan was to eliminate local transmission of malaria by the end of 2020. Surveillance and response are the most important components driving the whole process of the national malaria elimination programme (NMEP), under the technical guidance used in NMEP. This chapter introduces the evolution of the surveillance from the control to the elimination stages and the current structure of national surveillance system in China. When the NMEP launched, both routine surveillance and sentinel surveillance played critical role in monitoring the process of NMEP. In addition, the current response strategy of NMEP was also reviewed, including the generally developed "1-3-7 Strategy". More effective and sensitive risk assessment tools were introduced, which cannot only predict the trends of malaria, but also are important for the design and adjustment of the surveillance and response systems in the malaria elimination stage. Therefore, this review presents the landscape of malaria surveillance and response in China as well as their contribution to the NMEP, with a focus on activities for early detection of malaria cases, timely control of malaria foci and epidemics, and risk prediction. Furthermore, challenges and recommendations for accelerating NMEP through surveillance are put forward.
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Affiliation(s)
- Xin-Yu Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Sirenda Vong
- World Health Organization, China Representative Office, Beijing, People's Republic of China
| | - Wei-Zhong Yang
- Chinese Preventive Medicine Association, Beijing, People's Republic of China; Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
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Zhou XN, Xia ZG, Wang RB, Qian YJ, Zhou SS, Utzinger J, Tanner M, Kramer R, Yang WZ. Feasibility and roadmap analysis for malaria elimination in China. ADVANCES IN PARASITOLOGY 2015; 86:21-46. [PMID: 25476880 DOI: 10.1016/b978-0-12-800869-0.00002-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To understand the current status of the malaria control programme at the county level in accordance with the criteria of the World Health Organisation, the gaps and feasibility of malaria elimination at the county and national levels were analysed based on three kinds of indicators: transmission capacity, capacity of the professional team, and the intensity of intervention. Finally, a roadmap for national malaria elimination in the People's Republic of China is proposed based on the results of a feasibility assessment at the national level.
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Affiliation(s)
- Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Ru-Bo Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Ying-Jun Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, MOH; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Randall Kramer
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Wei-Zhong Yang
- Chinese Preventive Medicine Association, Beijing, People's Republic of China; Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
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Yin JH, Yan H, Huang F, Li M, Xiao HH, Zhou SS, Xia ZG. Establishing a China malaria diagnosis reference laboratory network for malaria elimination. Malar J 2015; 14:40. [PMID: 25628071 PMCID: PMC4320439 DOI: 10.1186/s12936-015-0556-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/09/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In China, the prevalence of malaria has reduced dramatically due to the elimination programme. The continued success of the programme will depend upon the accurate diagnosis of the disease in the laboratory. The basic requirements for this are a reliable malaria diagnosis laboratory network and quality management system to support case verification and source tracking. METHODS The baseline information of provincial malaria laboratories in the China malaria diagnosis reference laboratory network was collected and analysed, and a quality-assurance activity was carried out to assess their accuracies in malaria diagnosis by microscopy using WHO standards and PCR. RESULTS By the end of 2013, nineteen of 24 provincial laboratories have been included in the network. In the study, a total of 168 staff were registered and there was no bias in their age, gender, education level, and position. Generally Plasmodium species were identified with great accuracy by microscopy and PCR. However, Plasmodium ovale was likely to be misdiagnosed as Plasmodium vivax by microscopy. CONCLUSIONS China has established a laboratory network for primary malaria diagnosis which will cover a larger area. Currently, Plasmodium species can be identified fairly accurately by microscopy and PCR. However, laboratory staff need additional trainings on accurate identification of P. ovale microscopically and good performance of PCR operations.
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Affiliation(s)
- Jian-hai Yin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - He Yan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - Mei Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - Hui-hui Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - Shui-sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - Zhi-gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, Shanghai, People's Republic of China.
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
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Dhimal M, Ahrens B, Kuch U. Malaria control in Nepal 1963-2012: challenges on the path towards elimination. Malar J 2014; 13:241. [PMID: 24957851 PMCID: PMC4078365 DOI: 10.1186/1475-2875-13-241] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria is still a priority public health problem of Nepal where about 84% of the population are at risk. The aim of this paper is to highlight the past and present malaria situation in this country and its challenges for long-term malaria elimination strategies. METHODS Malariometric indicator data of Nepal recorded through routine surveillance of health facilities for the years between 1963 and 2012 were compiled. Trends and differences in malaria indicator data were analysed. RESULTS The trend of confirmed malaria cases in Nepal between 1963 and 2012 shows fluctuation, with a peak in 1985 when the number exceeded 42,321, representing the highest malaria case-load ever recorded in Nepal. This was followed by a steep declining trend of malaria with some major outbreaks. Nepal has made significant progress in controlling malaria transmission over the past decade: total confirmed malaria cases declined by 84% (12,750 in 2002 vs 2,092 in 2012), and there was only one reported death in 2012. Based on the evaluation of the National Malaria Control Programme in 2010, Nepal recently adopted a long-term malaria elimination strategy for the years 2011-2026 with the ambitious vision of a malaria-free Nepal by 2026. However, there has been an increasing trend of Plasmodium falciparum and imported malaria proportions in the last decade. Furthermore, the analysis of malariometric indicators of 31 malaria-risk districts between 2004 and 2012 shows a statistically significant reduction in the incidence of confirmed malaria and of Plasmodium vivax, but not in the incidence of P. falciparum and clinically suspected malaria. CONCLUSIONS Based on the achievements the country has made over the last decade, Nepal is preparing to move towards malaria elimination by 2026. However, considerable challenges lie ahead. These include especially, the need to improve access to diagnostic facilities to confirm clinically suspected cases and their treatment, the development of resistance in parasites and vectors, climate change, and increasing numbers of imported cases from a porous border with India. Therefore, caution is needed before the country embarks towards malaria elimination.
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Affiliation(s)
- Meghnath Dhimal
- Nepal Health Research Council (NHRC), Ministry of Health and Population Complex, Ramshah Path, Kathmandu, Nepal.
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Yin J, Xia Z, Yan H, Huang Y, Lu L, Geng Y, Xiao N, Xu J, He P, Zhou S. Verification of clinically diagnosed cases during malaria elimination programme in Guizhou Province of China. Malar J 2013; 12:130. [PMID: 23587165 PMCID: PMC3637121 DOI: 10.1186/1475-2875-12-130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 04/12/2013] [Indexed: 11/10/2022] Open
Abstract
Background China is implementing a National Malaria Elimination Programme. A high proportion of clinically diagnosed malaria cases is reported in some provinces of China. In order to understand the exact situation and make clear the nature of these patients, it is of much importance to make case verifications, particularly from the pathogenic perspective. Methods Guizhou Province was targeted because of its high proportion of clinically diagnosed malaria cases. After random selection of around 10% of malaria cases from 1 May 2011 to 30 April 2012, reported through the national web-based case reporting system from this province, field verifications were made on 14–17 May 2012 as follows. Firstly, the reported information of each case was rechecked with the onsite case registrations and investigation forms, and an in-depth interview was conducted with each patient. Secondly, the patient’s blood smears kept by local CDC were cross-checked microscopically by a national experienced microscopist. Thirdly, two kinds of polymerase chain reaction (PCRs). including Tag-primer nested/multiplex PCR (UT-PCR) based on cytochrome oxidase gene (cox I) and nested PCR based on 18s rRNA gene were performed simultaneously using local CDC kept filter paper of dry blood samples to identify the Plasmodium spp. Results Twelve out of 152 malaria cases were selected, including nine clinically diagnosed malaria cases, two confirmed falciparum malaria cases and one confirmed vivax malaria case. The original case documents on the site were completely in conformity with their reported data, and all the patients recalled their malaria symptoms and being cured only after consuming the corresponding anti-malarial drugs. Moreover, the re-examination results of microscopy and PCR were exactly in agreement with the original tests. Discussion No inconsistent results were found against the reported case information in the present study and the reasons for clinically diagnosed patients remains unclear. Uniform and standardized sample collection and processing should be trained among clinicians, more sensitive and specific techniques should be explored to used in malaria diagnosis. A further study is needed in order to be more observationally focussed rather than retrospective.
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Affiliation(s)
- Jianhai Yin
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention-NIPD, China CDC, Shanghai 200025, China
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