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Kandel S, Dahal G, Marasini RP, Paudel KP, Parajuli A, Thapa S, Aryal R, Jongcherdchootrakul K, Thitichai P. Malaria reporting timeliness analysis and factors associated with delayed notification, 2018-2022, Nepal. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003589. [PMID: 39186718 PMCID: PMC11346946 DOI: 10.1371/journal.pgph.0003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/31/2024] [Indexed: 08/28/2024]
Abstract
In order to monitor public health trends and identify disease outbreaks early, efficient and reliable notification and surveillance systems are essential. Nepal uses a 1-3-7 malaria surveillance approach. The Short Message System (SMS) -based system for timely notification has been established. However, knowledge gaps exist regarding the timeliness of notification, treatment initiation, and case-based investigations. Hence, this study identifies the timeliness of notification and factors associated with delayed notification. This study used a cross-sectional approach and used secondary malaria surveillance data from Nepal's national malaria elimination program for the period of 2018 to 2022. The study revealed that the majority (79.9%) of malaria cases were male, with a male-to-female ratio of 3.96:1. Occupation was found to be significantly associated with delayed notification. Repatriate workers had 0.60 times lower odds of experiencing delayed notification compared to the reference occupation. Similarly, individuals diagnosed in the Sudurpaschim and Lumbini provinces had significantly lower odds (0.48 and 0.38, respectively) of encountering delayed notification compared to the reference province. Furthermore, relying on a single laboratory tool for malaria diagnosis (either RDT or microscopy only) was significantly associated with delayed notification. Individuals diagnosed solely with RDT or microscopy had 2.04 and 1.79 times higher odds of experiencing delayed notification, respectively, compared to those diagnosed using both laboratory tools. This study provides insight into the timeliness of surveillance system approach by assessing delayed notification and the factors associated with it. No delays are identified in median notification, treatment time and in case investigation. Improvement in the timeliness of malaria reporting over the years was observed. Provinces with high burden of malaria and repatriate workers showed lower delayed notification and conversely, cases diagnosed with single laboratory tool showed delayed notification time.
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Affiliation(s)
- Shashi Kandel
- Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Gokarna Dahal
- Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Rudra Prasad Marasini
- Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
| | | | - Ashna Parajuli
- Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Susmita Thapa
- Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Rizu Aryal
- Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal
| | | | - Phanthanee Thitichai
- Department of Disease Control, Division of Epidemiology, Field Epidemiology Training Program, Ministry of Public Health, Nonthaburi, Thailand
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Sun D, Jiang H, Wang G, Hu X, Wang S, Chen Y. Factors Contributing to the Pre-Elimination of Malaria from Hainan Island, China, 1986-2009. Am J Trop Med Hyg 2023; 109:1063-1071. [PMID: 37918006 PMCID: PMC10622475 DOI: 10.4269/ajtmh.23-0303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/17/2023] [Indexed: 11/04/2023] Open
Abstract
Malaria was endemic in Hainan Island, China, for a lengthy period before its elimination. Here, we aim to gain a better understanding of malaria elimination by assessing and quantifying the relative effects of longitudinal changes in specific antimalarial interventions, socioeconomic development approaches, and malaria vectors on malaria prevalence in Hainan during the 1986-2009 pre-elimination period. Annual data were collected on the incidence of malaria, the number of residents protected by drugs (RPD), the number of residents protected by vector control, the presence of Anopheles minimus and Anopheles dirus, the annual per capita income of rural residents, major cash crop (rubber plantation) areas, the literacy rate of adult rural residents, and the rate of reinforced concrete house construction in rural areas. Backward stepwise multiple linear regression models were developed to identify the factors associated with the annual malaria incidence (AMI). The AMI declined from 20.3 to 0.8 per 10,000 population from 1986 to 2009; this decrease was significantly associated with an increase in the number of RPD and improved literacy rate among rural adults. The results of this study implied that the sustained distribution of antimalarial drugs and increase in education levels in risk areas significantly impacted the reduction and elimination of malaria infection in Hainan. We suggest that these findings could be applicable to malaria-endemic areas in Southeast Asia with similar natural and socioeconomic environments to Hainan and where malaria incidence has decreased to a low level.
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Affiliation(s)
- Dingwei Sun
- Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Hongwei Jiang
- Graduate School of Humanities, Osaka University, Toyonaka City, Japan
- Research Institute for Humanity and Nature, Kyoto, Japan
| | - Guangze Wang
- Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Ximin Hu
- Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Shanqing Wang
- Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Yan Chen
- Hainan Provincial Center for Disease Control and Prevention, Haikou, China
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3
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Zaw AS, Win ESS, Yan SW, Thein KS, Verma V, McLean ARD, Kyaw TT, White NJ, Smithuis FM. Successful elimination of falciparum malaria following the introduction of community-based health workers in Eastern Myanmar: A retrospective analysis. PLoS Med 2023; 20:e1004318. [PMID: 38033155 PMCID: PMC10721164 DOI: 10.1371/journal.pmed.1004318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/14/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Myanmar has a large majority of all malaria in the Greater Mekong Subregion. In the past decade, substantial progress was made in malaria control. The residual burden of malaria is in remote areas where currently recommended malaria elimination approaches are generally not feasible. In such hard-to-reach communities in Mon state, East Myanmar, Medical Action Myanmar introduced community health workers (CHWs) to deliver early diagnosis and treatment for malaria. We conducted a retrospective analysis to assess the impact of this intervention. METHODS AND FINDINGS This retrospective analysis involved data collected routinely from a CHW programme in Mon state conducted between 2011 and 2018. A network of 172 CHWs serving a population of 236,340 was deployed. These CHWs carried out 260,201 malaria rapid diagnostic tests (RDTs) to investigate patients with acute febrile illness. The median blood examination rate was 1.33%; interquartile range (IQR) (0.38 to 3.48%); 95% CI [1.28%, 1.36%] per month. The changes in malaria incidence and prevalence in patients presenting with fever were assessed using negative binomial regression mixed effects models fitted to the observed data. The incidence of Plasmodium falciparum malaria (including mixed infections) declined by 70%; 95% CI [65%, 75%]; p < 0.001 for each year of CHW operation. The incidence of P. vivax malaria declined by 56%; 95% CI [50%, 62%]; p < 0.001 per year. Malaria RDT positivity rates for P. falciparum and P. vivax declined by 69%; 95% CI [62%, 75%]; p < 0.001 and 53%; 95% CI [47%, 59%]; p < 0.001 per year, respectively. Between 2017 and 2018, only 1 imported P. falciparum case was detected in 54,961 RDTs. The main limitations of the study are use of retrospective data with possible unidentified confounders and uncharacterised population movement. CONCLUSIONS The introduction of CHWs providing community-based malaria diagnosis and treatment and basic health care services in remote communities in Mon state was associated with a substantial reduction in malaria. Within 6 years, P. falciparum was eliminated and the incidence of P. vivax fell markedly.
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Affiliation(s)
- Aye Sandar Zaw
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | | | | | | | | | - Alistair R. D. McLean
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Thar Tun Kyaw
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Nicholas J. White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Frank M. Smithuis
- Medical Action Myanmar, Yangon, Myanmar
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Yi B, Zhang L, Yin J, Zhou S, Xia Z. 1-3-7 surveillance and response approach in malaria elimination: China's practice and global adaptions. Malar J 2023; 22:152. [PMID: 37161379 PMCID: PMC10169118 DOI: 10.1186/s12936-023-04580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/28/2023] [Indexed: 05/11/2023] Open
Abstract
There has been a significant reduction in malaria morbidity and mortality worldwide from 2000 to 2019. However, the incidence and mortality increased again in 2020 due to the disruption to services during the COVID-19 pandemic. Surveillance to reduce the burden of malaria, eliminate the disease and prevent its retransmission is, therefore, crucial. The 1-3-7 approach proposed by China has played an important role in eliminating malaria, which has been internationally popularized and adopted in some countries to help eliminate malaria. This review summarizes the experience and lessons of 1-3-7 approach in China and its application in other malaria-endemic countries, so as to provide references for its role in eliminating malaria and preventing retransmission. This approach needs to be tailored and adapted according to the region condition, considering the completion, timeliness and limitation of case-based reactive surveillance and response. It is very important to popularize malaria knowledge, train staff, improve the capacity of health centres and monitor high-risk groups to improve the performance in eliminating settings. After all, remaining vigilance in detecting malaria cases and optimizing surveillance and response systems are critical to achieving and sustaining malaria elimination.
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Affiliation(s)
- Boyu Yi
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Jianhai Yin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Shuisen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Zhigui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China.
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Prempree P, Bisanzio D, Sudathip P, Kanjanasuwan J, Powell I, Gopinath D, Suttiwong C, Pinyajeerapat N, Poortinga A, Sintasath D, Shah JA. Environmental Factors Linked to Reporting of Active Malaria Foci in Thailand. Trop Med Infect Dis 2023; 8:tropicalmed8030179. [PMID: 36977180 PMCID: PMC10051531 DOI: 10.3390/tropicalmed8030179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/22/2023] Open
Abstract
Thailand has made substantial progress towards malaria elimination, with 46 of the country’s 77 provinces declared malaria-free as part of the subnational verification program. Nonetheless, these areas remain vulnerable to the reintroduction of malaria parasites and the reestablishment of indigenous transmission. As such, prevention of reestablishment (POR) planning is of increasing concern to ensure timely response to increasing cases. A thorough understanding of both the risk of parasite importation and receptivity for transmission is essential for successful POR planning. Routine geolocated case- and foci-level epidemiological and case-level demographic data were extracted from Thailand’s national malaria information system for all active foci from October 2012 to September 2020. A spatial analysis examined environmental and climate factors associated with the remaining active foci. A logistic regression model collated surveillance data with remote sensing data to investigate associations with the probability of having reported an indigenous case within the previous year. Active foci are highly concentrated along international borders, particularly Thailand’s western border with Myanmar. Although there is heterogeneity in the habitats surrounding active foci, land covered by tropical forest and plantation was significantly higher for active foci than other foci. The regression results showed that tropical forest, plantations, forest disturbance, distance from international borders, historical foci classification, percentage of males, and percentage of short-term residents were associated with the high probability of reporting indigenous cases. These results confirm that Thailand’s emphasis on border areas and forest-going populations is well placed. The results suggest that environmental factors alone are not driving malaria transmission in Thailand; rather, other factors, including demographics and behaviors that intersect with exophagic vectors, may also be contributors. However, these factors are syndemic, so human activities in areas covered by tropical forests and plantations may result in malaria importation and, potentially, local transmission, in foci that had previously been cleared. These factors should be addressed in POR planning.
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Affiliation(s)
- Preecha Prempree
- Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand;
| | - Donal Bisanzio
- Inform Asia—USAID’s Health Research Program, RTI International, Bangkok 10330, Thailand; (D.B.); (I.P.)
| | - Prayuth Sudathip
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (P.S.); (J.K.); (C.S.)
| | - Jerdsuda Kanjanasuwan
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (P.S.); (J.K.); (C.S.)
| | - Isabel Powell
- Inform Asia—USAID’s Health Research Program, RTI International, Bangkok 10330, Thailand; (D.B.); (I.P.)
| | | | - Chalita Suttiwong
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (P.S.); (J.K.); (C.S.)
| | - Niparueradee Pinyajeerapat
- U.S. President’s Malaria Initiative, United States Agency for International Development (USAID), Regional Development Mission for Asia, Bangkok 10330, Thailand; (N.P.); (D.S.)
| | - Ate Poortinga
- The SERVIR-Mekong Project, Asian Disaster Preparedness Center, Bangkok 10400, Thailand;
| | - David Sintasath
- U.S. President’s Malaria Initiative, United States Agency for International Development (USAID), Regional Development Mission for Asia, Bangkok 10330, Thailand; (N.P.); (D.S.)
| | - Jui A. Shah
- Inform Asia—USAID’s Health Research Program, RTI International, Bangkok 10330, Thailand; (D.B.); (I.P.)
- Correspondence: ; Tel.: +66-(0)98-275-8210
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6
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Sun XD, Zhao YL, Lin ZR, Zhao Y, Zhou YW, Li SG, Guo XR, Tian P, Duan KX, Ding CL, Chen QY, Sui Y, Lu SN, Cotter C, Wang DQ, Zheng Z. Implementing a novel capture and ligation probe-PCR method in mass screen and treatment to support malaria elimination efforts in the China-Myanmar border region. Malar J 2023; 22:21. [PMID: 36658578 PMCID: PMC9854064 DOI: 10.1186/s12936-023-04449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Mass screening and treatment (MSAT) for malaria elimination lacks an ideal diagnostic tool to allow sensitive and affordable test of the target population in the field. This study evaluated whether Capture and Ligation Probe-PCR (CLIP-PCR) could be used in a field MSAT in Laiza City, Myanmar. METHODS On day 0, two dried blood spots were collected from each participant. On day 1, all samples were screened for Plasmodium in a 20 m2 laboratory with workbench, a biosafety cabinet, a refrigerator, a benchtop shaking incubator and a qPCR machine, by four technicians using CLIP-PCR with sample pooling, at a health clinic of the Chinese bordering town of Nabang. On day 2, all positives were followed up and treated. RESULTS Of 15,038 persons (65% of the total population) screened, 204 (1.36%) were CLIP-PCR positives. Among them, 188, 14, and 2 were infected with Plasmodium vivax, Plasmodium falciparum, and P. vivax/P. falciparum mix, respectively. The testing capacity was 538 persons/day, with a cost of US$0.92 /person. The proportion of submicroscopic infection was 64.7%. All positive individuals received treatment within 72 h after blood collection. CONCLUSION Using CLIP-PCR in MSAT in low transmission settings can support the malaria elimination efforts in the China-Myanmar border region.
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Affiliation(s)
- Xiao-dong Sun
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Ya-ling Zhao
- grid.506261.60000 0001 0706 7839Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
| | - Zu-rui Lin
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Ye Zhao
- grid.506261.60000 0001 0706 7839Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
| | - Yao-wu Zhou
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Shi-gang Li
- Yingjiang Centre for Disease Control and Prevention, Yingjiang, 679300 China
| | - Xiang-rui Guo
- Yingjiang Centre for Disease Control and Prevention, Yingjiang, 679300 China
| | - Peng Tian
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Kai-xia Duan
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Chun-li Ding
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Qi-yan Chen
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Yuan Sui
- grid.4367.60000 0001 2355 7002Brown School, Washington University, St. Louis, MO USA
| | - Shen-ning Lu
- grid.508378.1WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Science and Technology, Ministry of Health, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, 200025 China
| | - Chris Cotter
- grid.266102.10000 0001 2297 6811Malaria Elimination Initiative, Institute for Global Health Sciences, University of California, San Francisco, CA USA ,grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Duo-quan Wang
- grid.4367.60000 0001 2355 7002Brown School, Washington University, St. Louis, MO USA
| | - Zhi Zheng
- grid.506261.60000 0001 0706 7839Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
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Feng J, Zhang L, Xia Z, Zhou S, Xiao N, Zhou XN. Achievements of the national malaria control and elimination program in the People's Republic of China: the Atlas of Malaria Transmission in China. Front Med 2022; 17:85-92. [PMID: 36469233 PMCID: PMC9734496 DOI: 10.1007/s11684-021-0917-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022]
Abstract
In 2017, China achieved the target of zero indigenous malaria case for the first time, and has been certified as malaria free by World Health Organization in 2021. To further summarize the historical achievements and technical experiences of the elimination program, a project on the Roadmap Analysis and Verification for Malaria Elimination in China was carried out. Results of the project were compiled and published as the Atlas of Malaria Transmission in China (The Atlas). The Atlas using modern digital information technologies, has been supported by various data from 24 malaria endemic provinces of China since 1950, to assess the changes in malaria epidemic patterns from 1950 to 2019 at national and provincial levels. The Atlas is designed as two volumes, including a total of 1850 thematic maps and more than 130 charts, consisting of introductory maps, thematic maps of malaria epidemic and control at national and provincial levels. It objectively and directly shows the epidemic history, evolution process, and great achievements of the national malaria control and elimination program in China. The Atlas has important reference value for summing up historical experience in the national malaria elimination program of China, and malaria control and elimination in other endemic countries in the world.
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Affiliation(s)
- Jun Feng
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Li Zhang
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Zhigui Xia
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Shuisen Zhou
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Ning Xiao
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Xiao-Nong Zhou
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
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8
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Wesolowski A, Ippolito MM, Gebhardt ME, Ferriss E, Schue JL, Kobayashi T, Chaponda M, Kabuya JB, Muleba M, Mburu M, Matoba J, Musonda M, Katowa B, Lubinda M, Hamapumbu H, Simubali L, Mudenda T, Shields TM, Hackman A, Shiff C, Coetzee M, Koekemoer LL, Munyati S, Gwanzura L, Mutambu S, Stevenson JC, Thuma PE, Norris DE, Bailey JA, Juliano JJ, Chongwe G, Mulenga M, Simulundu E, Mharakurwa S, Agre P, Moss WJ. Policy Implications of the Southern and Central Africa International Center of Excellence for Malaria Research: Ten Years of Malaria Control Impact Assessments in Hypo-, Meso-, and Holoendemic Transmission Zones in Zambia and Zimbabwe. Am J Trop Med Hyg 2022; 107:68-74. [PMID: 36228913 PMCID: PMC9662215 DOI: 10.4269/ajtmh.21-1288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/28/2022] [Indexed: 11/07/2022] Open
Abstract
The International Centers of Excellence for Malaria Research (ICEMR) were established by the National Institute of Allergy and Infectious Diseases more than a decade ago to provide multidisciplinary research support to malaria control programs worldwide, operating in endemic areas and contributing technology, expertise, and ultimately policy guidance for malaria control and elimination. The Southern and Central Africa ICEMR has conducted research across three main sites in Zambia and Zimbabwe that differ in ecology, entomology, transmission intensity, and control strategies. Scientific findings led to new policies and action by the national malaria control programs and their partners in the selection of methods, materials, timing, and locations of case management and vector control. Malaria risk maps and predictive models of case detection furnished by the ICEMR informed malaria elimination programming in southern Zambia, and time series analyses of entomological and parasitological data motivated several major changes to indoor residual spray campaigns in northern Zambia. Along the Zimbabwe-Mozambique border, temporal and geospatial data are currently informing investigations into a recent resurgence of malaria. Other ICEMR findings pertaining to parasite and mosquito genetics, human behavior, and clinical epidemiology have similarly yielded immediate and long-term policy implications at each of the sites, often with generalizable conclusions. The ICEMR programs thereby provide rigorous scientific investigations and analyses to national control and elimination programs, without which the impediments to malaria control and their potential solutions would remain understudied.
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Affiliation(s)
- Amy Wesolowski
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Matthew M. Ippolito
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary E. Gebhardt
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ellen Ferriss
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jessica L. Schue
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tamaki Kobayashi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | | | | | | | | | | | | | | | | | | | | | - Andre Hackman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Clive Shiff
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Maureen Coetzee
- Wits Research Institute for Malaria, Faculty of Health Sciences, University of the Witwatersrand and National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Lizette L. Koekemoer
- Wits Research Institute for Malaria, Faculty of Health Sciences, University of the Witwatersrand and National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Shungu Munyati
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Lovemore Gwanzura
- Biomedical Research and Training Institute, Harare, Zimbabwe
- University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | | | - Jennifer C. Stevenson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Macha Research Trust, Choma, Zambia
| | - Philip E. Thuma
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Macha Research Trust, Choma, Zambia
| | - Douglas E. Norris
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Jonathan J. Juliano
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Modest Mulenga
- Directorate of Research and Postgraduate Studies, Lusaka Apex Medical University, Lusaka, Zambia
| | | | - Sungano Mharakurwa
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Africa University, Mutare, Zimbabwe
| | - Peter Agre
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - William J. Moss
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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9
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Sudathip P, Naowarat S, Kitchakarn S, Gopinath D, Bisanzio D, Pinyajeerapat N, Sintasath D, Shah JA. Assessing Thailand's 1-3-7 surveillance strategy in accelerating malaria elimination. Malar J 2022; 21:222. [PMID: 35850687 PMCID: PMC9294779 DOI: 10.1186/s12936-022-04229-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/21/2022] [Indexed: 12/19/2022] Open
Abstract
Background Thailand’s strong malaria elimination programme relies on effective implementation of its 1-3-7 surveillance strategy, which was endorsed and implemented nationwide in 2016. For each confirmed malaria patient, the Ministry of Public Health’s Division of Vector Borne Diseases (DVBD) ensures completion of case notification within 1 day, case investigation within 3 days, and foci investigation within 7 days. To date, there has not been a comprehensive assessment of the performance and achievements of the 1-3-7 surveillance strategy although such results could help Thailand’s future malaria elimination strategic planning. Methods This study examined adherence to the 1-3-7 protocols, tracked progress against set targets, and examined geographic variations in implementation of the 1-3-7 strategy in the programme’s initial 5 years. An auto-regressive integrated moving average (ARIMA) time series analysis with seasonal decomposition assessed the plausible implementation effect of the 1-3-7 strategy on malaria incidence in the programme’s initial 5 years. The quantitative analysis included all confirmed malaria cases from public health and non-governmental community facilities from October 2014 to September 2021 (fiscal year [FY] 2015 to FY 2021) (n = 77,405). The spatial analysis included active foci with known geocoordinates that reported more than five cases from FY 2018 to FY 2021. Results From FY 2017 to FY 2021, on-time case notification improved from 24.4% to 89.3%, case investigations from 58.0% to 96.5%, and foci investigations from 37.9% to 87.2%. Adherence to timeliness protocols did not show statistically significant variation by area risk classification. However, adherence to 1-3-7 protocols showed a marked spatial heterogeneity among active foci, and the ARIMA model showed a statistically significant acceleration in the reduction of malaria incidence. The 1-3-7 strategy national indicators and targets in Thailand have shown progressive success, and most targets were achieved for FY 2021. Conclusion The results of Thailand’s 1-3-7 surveillance strategy are associated with a decreased incidence in the period following the adoption of the strategy although there is notable geographic variation. The DVBD will continue to implement and adapt the 1-3-7 strategy to accelerate progress toward malaria elimination. This assessment may be useful for domestic strategic planning and to other countries considering more intensive case and foci investigation and response strategies.
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Affiliation(s)
- Prayuth Sudathip
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Sathapana Naowarat
- Inform Asia: USAID's Health Research Program, RTI International, Bangkok, Thailand
| | - Suravadee Kitchakarn
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Donal Bisanzio
- Inform Asia: USAID's Health Research Program, RTI International, Bangkok, Thailand
| | - Niparueradee Pinyajeerapat
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Regional Development Mission for Asia, Bangkok, Thailand
| | - David Sintasath
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Regional Development Mission for Asia, Bangkok, Thailand
| | - Jui A Shah
- Inform Asia: USAID's Health Research Program, RTI International, Bangkok, Thailand.
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10
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Lu S, Huang L, Duan L, Xu Q, Ma X, Ding W, Wang D, Lv S, Xiao N. Role of international network on surveillance and response system leading to malaria elimination: China's engagement in global health. Infect Dis Poverty 2022; 11:64. [PMID: 35659108 PMCID: PMC9166191 DOI: 10.1186/s40249-022-00991-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/20/2022] [Indexed: 12/02/2022] Open
Abstract
China has accumulated multiple practices and experiences in building and enhancing malaria surveillance and response system. As China’s engagement into global health has gathered stronger momentum than ever, China together with the Swiss Tropical and Public Health Institute and WHO has organised five sessions of the International Forum on Surveillance-Response System Leading to Tropical Diseases Elimination during 2012–2020, in which malaria elimination has always been one of the hottest topics. In this study, the roles of international network on the surveillance and response system were explored to achieve a global malaria-free goal. China’s approach to malaria elimination has demonstrated significance of global collaboration on taking joint prevention and control, and building a worldwide institutional-based network.
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Affiliation(s)
- Shenning Lu
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
| | - Lulu Huang
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
| | - Lei Duan
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China.,State Key Laboratory of Genetic Engineering, Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering, Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Infectious Diseases, School of Life Science, Huashan Hospital, Fudan University, Shanghai, 200433, China
| | - Qiuli Xu
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China.,Pudong New Area Center for Disease Control and Prevention and Pudong Institute of Preventive Medicine, Fudan University, Pudong New Area, Shanghai, 200136, China
| | - Xuejiao Ma
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
| | - Wei Ding
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
| | - Duoquan Wang
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China.,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shan Lv
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China.,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ning Xiao
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China. .,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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11
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Smithuis FM, White NJ. Spend wisely to eliminate malaria. THE LANCET. INFECTIOUS DISEASES 2022; 22:e171-e175. [PMID: 34953537 DOI: 10.1016/s1473-3099(21)00256-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 05/25/2023]
Abstract
The countries of the Greater Mekong subregion-Myanmar, Thailand, Laos, Cambodia, and Vietnam-have set a target of eliminating all Plasmodium falciparum malaria by 2025. Generous funding has been provided, principally by The Global Fund to Fight AIDS, Tuberculosis, and Malaria, to achieve this objective and thereby prevent the spread of artemisinin-resistant Plasmodium falciparum to India and Africa. As the remaining time to reach agreed targets is limited and future external funding is uncertain, it is important to be realistic about the future and spend what remaining funding is left, wisely. New, labour intensive, vertical approaches to malaria elimination (such as the 1-3-7 approach) should not be promoted as these are unproven, likely to be ineffective, costly, and unlikely to be sustainable in the most remote areas where malaria prevalence is highest. Instead, the focus should be on reducing the malaria burden more rapidly in the remaining localised high transmission foci with proven effective interventions, including mass drug administration. Well supported community-based health workers are the key operatives in controlling malaria, but their remit should be broadened to sustain the uptake of their services as malaria declines. This strategy is a sustainable evolution, which will improve rural health care while ensuring progress towards malaria elimination.
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Affiliation(s)
- Frank M Smithuis
- Medical Action Myanmar, Yangon, Myanmar; Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
| | - Nicholas J White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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12
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Tegegne E, Alemu Gelaye K, Dessie A, Shimelash A, Asmare B, Deml YA, Lamore Y, Temesgen T, Demissie B, Teym A. Spatio-Temporal Variation of Malaria Incidence and Risk Factors in West Gojjam Zone, Northwest Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221095702. [PMID: 35558819 PMCID: PMC9087229 DOI: 10.1177/11786302221095702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/25/2022] [Indexed: 06/15/2023]
Abstract
Introduction Malaria is a life-threatening acute febrile illness which is affecting the lives of millions globally. Its distribution is characterized by spatial, temporal, and spatiotemporal heterogeneity. Detection of the space-time distribution and mapping high-risk areas is useful to target hot spots for effective intervention. Methods Time series cross sectional study was conducted using weekly malaria surveillance data obtained from Amhara Public Health Institute. Poisson model was fitted to determine the purely spatial, temporal, and space-time clusters using SaTScan™ 9.6 software. Spearman correlation, bivariate, and multivariable negative binomial regressions were used to analyze the relation of the climatic factors to count of malaria incidence. Result Jabitenan, Quarit, Sekela, Bure, and Wonberma were high rate spatial cluster of malaria incidence hierarchically. Spatiotemporal clusters were detected. A temporal scan statistic identified 1 risk period from 1 July 2013 to 30 June 2015. The adjusted incidence rate ratio showed that monthly average temperature and monthly average rainfall were independent predictors for malaria incidence at all lag-months. Monthly average relative humidity was significant at 2 months lag. Conclusion Malaria incidence had spatial, temporal, spatiotemporal variability in West Gojjam zone. Mean monthly temperature and rainfall were directly and negatively associated to count of malaria incidence respectively. Considering these space-time variations and risk factors (temperature and rainfall) would be useful for the prevention and control and ultimately achieve elimination.
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Affiliation(s)
- Eniyew Tegegne
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Kassahun Alemu Gelaye
- Institutes of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Awrajaw Dessie
- Institutes of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Shimelash
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Biachew Asmare
- Department of Human Nutrition, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yikeber Argachew Deml
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Ethiopia
| | - Yonas Lamore
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tegegne Temesgen
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Biruk Demissie
- Department of Environmental Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abraham Teym
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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13
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Obadia T, Nekkab N, Robinson LJ, Drakeley C, Mueller I, White MT. Developing sero-diagnostic tests to facilitate Plasmodium vivax Serological Test-and-Treat approaches: modeling the balance between public health impact and overtreatment. BMC Med 2022; 20:98. [PMID: 35300700 PMCID: PMC8932240 DOI: 10.1186/s12916-022-02285-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/07/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Eliminating Plasmodium vivax will require targeting the hidden liver-stage reservoir of hypnozoites. This necessitates new interventions balancing the benefit of reducing vivax transmission against the risk of over-treating some individuals with drugs which may induce haemolysis. By measuring antibodies to a panel of vivax antigens, a strategy of serological-testing-and-treatment (PvSeroTAT) can identify individuals with recent blood-stage infections who are likely to carry hypnozoites and target them for radical cure. This provides a potential solution to selectively treat the vivax reservoir with 8-aminoquinolines. METHODS PvSeroTAT can identify likely hypnozoite carriers with ~80% sensitivity and specificity. Diagnostic test sensitivities and specificities ranging 50-100% were incorporated into a mathematical model of vivax transmission to explore how they affect the risks and benefits of different PvSeroTAT strategies involving hypnozoiticidal regimens. Risk was measured as the rate of overtreatment and benefit as reduction of community-level vivax transmission. RESULTS Across a wide range of combinations of diagnostic sensitivity and specificity, PvSeroTAT was substantially more effective than bloodstage mass screen and treat strategies and only marginally less effective than mass drug administration. The key test characteristic determining of the benefit of PvSeroTAT strategies is diagnostic sensitivity, with higher values leading to more hypnozoite carriers effectively treated and greater reductions in vivax transmission. The key determinant of risk is diagnostic specificity: higher specificity ensures that a lower proportion of uninfected individuals are unnecessarily treated with primaquine. These relationships are maintained in both moderate and low transmission settings (qPCR prevalence 10% and 2%). Increased treatment efficacy and adherence can partially compensate for lower test performance. Multiple rounds of PvSeroTAT with a lower performing test may lead to similar or higher reductions in vivax transmission than fewer rounds with a higher performing test, albeit with higher rate of overtreatment. CONCLUSIONS At current performance, PvSeroTAT is predicted to be a safe and efficacious option for targeting the hypnozoite reservoir towards vivax elimination. P. vivax sero-diagnostic tests should aim for both high performance and ease of use in the field. The target product profiles informing such development should thus reflect the trade-offs between impact, overtreatment, and ease of programmatic implementation.
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Affiliation(s)
- Thomas Obadia
- G5 Épidémiologie et Analyse des Maladies Infectieuses, Département de Santé Globale, Institut Pasteur, F-75015, Paris, France.
- Unité Malaria: Parasites et Hôtes, Département Parasites et Insectes vecteurs, Institut Pasteur, F-75015, Paris, France.
- Hub de Bioinformatique et Biostatistique, Département de Biologie Computationnelle, Institut Pasteur, F-75015, Paris, France.
| | - Narimane Nekkab
- G5 Épidémiologie et Analyse des Maladies Infectieuses, Département de Santé Globale, Institut Pasteur, F-75015, Paris, France
- Unité Malaria: Parasites et Hôtes, Département Parasites et Insectes vecteurs, Institut Pasteur, F-75015, Paris, France
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Leanne J Robinson
- Population Health & Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Australia
- Burnet Institute, Melbourne, Victoria, Australia
| | - Chris Drakeley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, UK
| | - Ivo Mueller
- Unité Malaria: Parasites et Hôtes, Département Parasites et Insectes vecteurs, Institut Pasteur, F-75015, Paris, France
- Population Health & Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Australia
| | - Michael T White
- G5 Épidémiologie et Analyse des Maladies Infectieuses, Département de Santé Globale, Institut Pasteur, F-75015, Paris, France
- Unité Malaria: Parasites et Hôtes, Département Parasites et Insectes vecteurs, Institut Pasteur, F-75015, Paris, France
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14
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Tu H, Feng J, Yu C, Lin K, Peiyu W, Shaomi X, Lingyun L, Jian L. Asymptomatic malaria infection at the China-Vietnam border: Knowledge and implications for the cross-border migrant population during the COVID-19 pandemic. Travel Med Infect Dis 2022; 47:102307. [PMID: 35276354 PMCID: PMC8902057 DOI: 10.1016/j.tmaid.2022.102307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/02/2022] [Accepted: 03/05/2022] [Indexed: 11/28/2022]
Abstract
Background Eliminating malaria along the China-Vietnam border remains one of the greatest challenges in China, especially during the coronavirus disease 2019 (COVID-19) pandemic, which has disrupted the continuity of malaria control and elimination programs. Understanding the factors associated with asymptomatic malaria infection will inform control interventions aimed at elimination of the disease among migrants from Vietnam working in China, who constitute an at-risk population. Methods From March 2018 to September 2019, 108 migrants from Vietnam working in Ningming County, Guangxi, were enrolled in this study. Each person was interviewed using a structured questionnaire. Blood samples were collected and sent for PCR detection and sequencing. The obtained sequences were analyzed using the BLAST program and DNAMAN software. Results The proportion of participants with malaria knowledge was low, with 19.4% (21/108) reporting knowledge about transmission, 23.2% (25/108) reporting knowledge about clinical symptoms, 7.4% (8/108) reporting awareness of the risk of death and 14.8% (16/108) reporting awareness of prevention methods. No significant difference in the malaria knowledge rate was found among occupational groups, except in the migrant worker group, whose knowledge rate was higher than those in the other occupational groups (χ2 = 32.452, p < 0.001). Although most of the participants (80.6%, 87/108) owned mosquito nets, only approximately half of the participants (49.1%, 53/108) reported using bed nets. The parasitological analysis revealed that 5.6% (6/108) of all the participants were positive for malaria, including 5 participants with Plasmodium falciparum and 1 participant with Plasmodium vivax malaria. There were no statistically significant differences in the positivity rates among the different age, sex, family-size, nationality, occupational, and behavior groups. The positivity rates in individuals who did not use mosquito nets, did not use mosquito coils, and did not install mosquito nets were 4.8% (1/21), 6.8% (3/44), and 3.6% (2/55), respectively. Conclusion Health education focused on high-risk populations, such as migrant workers and forest goers, should be strengthened. Verbal communication and information transmission via the internet, radio, and mobile phone platforms may be required during the COVID-19 pandemic. Further risk assessments and proactive case detection should also be performed in Ningming County and other border counties in Guangxi to detect active and asymptomatic infections in a timely manner and prevent re-establishment of the disease in these communities.
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Affiliation(s)
- Hong Tu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, PR China
| | - Jun Feng
- Shanghai Municipal Center for Diseases Control and Prevention, Shanghai, PR China.
| | - Chenghang Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, PR China
| | - Kangming Lin
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi, PR China
| | - Wang Peiyu
- Ningming County Center for Diseases Control and Prevention, Ningming, Guangxi, PR China
| | - Xiang Shaomi
- Ningming County Center for Diseases Control and Prevention, Ningming, Guangxi, PR China
| | - Luo Lingyun
- Ningming County Center for Diseases Control and Prevention, Ningming, Guangxi, PR China
| | - Li Jian
- Ningming County Center for Diseases Control and Prevention, Ningming, Guangxi, PR China
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15
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Shi TQ, Shen HM, Chen SB, Kassegne K, Cui YB, Xu B, Chen JH, Zheng B, Wang Y. Genetic Diversity and Natural Selection of Plasmodium vivax Duffy Binding Protein-II From China-Myanmar Border of Yunnan Province, China. Front Microbiol 2021; 12:758061. [PMID: 34912313 PMCID: PMC8667024 DOI: 10.3389/fmicb.2021.758061] [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: 08/13/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
Malaria incidence has declined dramatically over the past decade and China was certified malaria-free in 2021. However, the presence of malaria in border areas and the importation of cases of malaria parasites are major challenges for the consolidation of the achievements made by China. Plasmodium vivax Duffy binding protein (PvDBP) performs a significant role in erythrocyte invasion, and is considered a promising P. vivax vaccine. However, the highly polymorphic region of PvDBP (PvDBP-II) impedes the development of blood-stage vaccine against P. vivax. In this study, we investigated the genetic diversity and natural selection of PvDBP-II among 124 P. vivax isolates collected from the China-Myanmar border (CMB) in Yunnan Province, China, during 2009–2011. To compare genetic diversity, natural selection, and population structure with CMB isolates, 85 pvdbp-II sequences of eastern Myanmar isolates were obtained from GenBank. In addition, global sequences of pvdbp-II were retrieved from GenBank to establish genetic differentiation relationships and networks with the CMB isolates. In total, 22 single nucleotide polymorphisms reflected in 20 non-synonymous and two synonymous mutations were identified. The overall nucleotide diversity of PvDBP-II from the 124 CMB isolates was 0.0059 with 21 haplotypes identified (Hd = 0.91). The high ratio of non-synonymous to synonymous mutations suggests that PvDBP-II had evolved under positive selection. Population structure analysis of the CMB and eastern Myanmar isolates were optimally grouped into five sub-populations (K = 5). Polymorphisms of PvDBP-II display that CMB isolates were genetically diverse. Mutation, recombination, and positive selection promote polymorphism of PvDBP-II of P. vivax population. Although low-level genetic differentiation in eastern Myanmar was identified along with the more effective malaria control measures, the complexity of population structure in malaria parasites has maintained. In conclusion, findings from this study advance knowledge of the understanding of the dynamic of P. vivax population, which will contribute to guiding the rational design of a PvDBP-II based vaccine.
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Affiliation(s)
- Tian-Qi Shi
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Hai-Mo Shen
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Shen-Bo Chen
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Kokouvi Kassegne
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan-Bing Cui
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Bin Xu
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Jun-Hu Chen
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China.,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zheng
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,National Health Commission of the People's Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China.,World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China.,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Wang
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Institute of Parasitic Diseases, Hangzhou, China
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16
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Lin ZR, Li SG, Sun XD, Guo XR, Zheng Z, Yang J, Pian HR, Tian P, Chen QY, Sun XY, Ding CL, Duan KX, Chen HW, Bee DY, Zhou HN. Effectiveness of joint 3 + 1 malaria strategy along China-Myanmar cross border areas. BMC Infect Dis 2021; 21:1246. [PMID: 34906092 PMCID: PMC8670156 DOI: 10.1186/s12879-021-06920-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 11/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cross-border malaria in Laiza City of Myanmar seriously affected Yingjiang County of China and compromised reaching the goal of malaria elimination by 2020. Since 2017, a pilot project on 3 + 1 strategy of joint cross-border malaria prevention and control was carried out for building a malaria buffer in these border areas. Here, 3 were the three preventive lines in China where different focalized approaches of malaria elimination were applied and + 1 was a defined border area in Myanmar where the integrated measures of malaria control were adopted. METHODS A 5-year retrospective analysis (2015 to 2019) was conducted that included case detection, parasite prevalence and vector surveillance. Descriptive statistics was used and the incidence or rates were compared. The annual parasite incidence and the parasite prevalence rate in + 1 area of Myanmar, the annual importation rate in Yingjiang County of China and the density of An. minimus were statistically significant indictors to assess the effectiveness of the 3 + 1 strategy. RESULTS In + 1 area of Myanmar from 2015 to 2019, the averaged annual parasite incidence was (59.11 ± 40.73)/1000 and Plasmodium vivax accounted for 96.27% of the total confirmed cases. After the pilot project, the annual parasite incidence dropped 89% from 104.77/1000 in 2016 to 12.18/1000 in 2019, the microscopic parasite prevalence rate dropped 100% from 0.34% in 2017 to zero in 2019 and the averaged density of An. Minimus per trap-night dropped 93% from 1.92 in June to 0.13 in September. The submicroscopic parasite prevalence rate increased from 1.15% in 2017 to 1.66% in 2019 without significant difference between the two surveys (P = 0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The averaged annual importation rate from 2015 to 2019 was (0.47 ± 0.15)/1000. After the pilot project, the annual importation rate dropped from 0.59/1000 in 2016 to 0.28/1000 in 2019 with an overall reduction of 53% in the whole county. The reduction was 67% (57.63/1000 to 18.01/1000) in the first preventive line, 52% (0.20/1000 to 0.10/1000) in the second preventive line and 36% (0.32/1000 to 0.22/1000) in the third preventive line. The averaged density of An. Minimus per trap-night in the first preventive line dropped 94% from 2.55 in June to 0.14 in September, without significant difference from that of + 1 area of Myanmar (Z value = - 1.18, P value = 0.24). CONCLUSION The pilot project on 3 + 1 strategy has been significantly effective in the study areas and a buffer zone of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China.
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Affiliation(s)
- Zu-Rui Lin
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China
| | - Shi-Gang Li
- Yangjiang Centre for Disease Control and Prevention, Yangjiang, 679300, China
| | - Xiao-Dong Sun
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China.
| | - Xiang-Rui Guo
- Yangjiang Centre for Disease Control and Prevention, Yangjiang, 679300, China
| | - Zhi Zheng
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100730, China.
| | - Jie Yang
- Dehong Centre for Disease Control and Prevention, Mangshi, 678400, China
| | - Hong-Ru Pian
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100730, China
| | - Peng Tian
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China
| | - Qi-Yan Chen
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China
| | | | - Chun-Li Ding
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China
| | - Kai-Xia Duan
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China
| | - Hong-Wei Chen
- Nangbang Township Central Hospital, Yingjiang, 679300, China
| | - Dakhidam Yaw Bee
- Malaria Project Office, Health Department of Kachin Special Region II, Laiza City, Myanmar
| | - Hong-Ning Zhou
- Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Pu'er, 665000, China.
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Huang F, Zhang L, Tu H, Cui YW, Zhou SS, Xia ZG, Zhou HN. Epidemiologic Analysis of Efforts to Achieve and Sustain Malaria Elimination along the China-Myanmar Border. Emerg Infect Dis 2021; 27:2869-2873. [PMID: 34670652 PMCID: PMC8544968 DOI: 10.3201/eid2711.204428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Malaria cases have dramatically declined in China along the Myanmar border, attributed mainly to adoption of the 1-3-7 surveillance and response approach. No indigenous cases have been reported in China since 2017. Counties in the middle and southern part of the border area have a higher risk for malaria importation and reestablishment after elimination.
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A retrospective analysis of malaria epidemiological characteristics in Yingjiang County on the China-Myanmar border. Sci Rep 2021; 11:14129. [PMID: 34239003 PMCID: PMC8266812 DOI: 10.1038/s41598-021-93734-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/15/2021] [Indexed: 11/08/2022] Open
Abstract
Yingjiang County, which is on the China–Myanmar border, is the main focus for malaria elimination in China. The epidemiological characteristics of malaria in Yingjiang County were analysed in a retrospective analysis. A total of 895 malaria cases were reported in Yingjiang County between 2013 and 2019. The majority of cases occurred in males (70.7%) and individuals aged 19–59 years (77.3%). Plasmodium vivax was the predominant species (96.6%). The number of indigenous cases decreased gradually and since 2017, no indigenous cases have been reported. Malaria cases were mainly distributed in the southern and southwestern areas of the county; 55.6% of the indigenous cases were reported in Nabang Township, which also had the highest risk of imported malaria. The “1–3–7” approach has been implemented effectively, with 100% of cases reported within 24 h, 88.9% cases investigated and confirmed within 3 days and 98.5% of foci responded to within 7 days. Although malaria elimination has been achieved in Yingjiang County, sustaining elimination and preventing the re-establishment of malaria require the continued strengthening of case detection, surveillance and response systems targeting the migrant population in border areas.
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Schapira A, Kondrashin A. Prevention of re-establishment of malaria. Malar J 2021; 20:243. [PMID: 34059072 PMCID: PMC8165810 DOI: 10.1186/s12936-021-03781-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/24/2021] [Indexed: 02/01/2023] Open
Abstract
The current consensus on prevention of re-establishment of malaria is based on the following principles: (1) Fundamental role of general health services; (2) Surveillance; (3) Vector control; (4) Border actions; (5) Intersectoral collaboration. These principles are critically reviewed, and it is pointed out that alertness of the general health services to suspected malaria (vigilance) needs to be maintained everywhere, while health education is rational only if targeting high-risk sub-populations. It is argued that prevention of re-establishment of malaria transmission should be integrated with prevention of malaria mortality in cases of imported malaria, and that this requires collaboration with entities dealing with travellers’ health and the availability of chemoprophylaxis and other measures for travellers to malaria endemic countries.
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Affiliation(s)
- Allan Schapira
- Bicol University College of Medicine, Legazpi City, Philippines.
| | - Anatoly Kondrashin
- Martsinovski Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, Sechenov University, 119 435, Moscow, Russia
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Lertpiriyasuwat C, Sudathip P, Kitchakarn S, Areechokchai D, Naowarat S, Shah JA, Sintasath D, Pinyajeerapat N, Young F, Thimasarn K, Gopinath D, Prempree P. Implementation and success factors from Thailand's 1-3-7 surveillance strategy for malaria elimination. Malar J 2021; 20:201. [PMID: 33906648 PMCID: PMC8076878 DOI: 10.1186/s12936-021-03740-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
Thailand’s National Malaria Elimination Strategy 2017–2026 introduced the 1-3-7 strategy as a robust surveillance and response approach for elimination that would prioritize timely, evidence-based action. Under this strategy, cases are reported within 1 day, cases are investigated within 3 days, and foci are investigated and responded to within 7 days, building on Thailand’s long history of conducting case investigation since the 1980s. However, the hallmark of the 1-3-7 strategy is timeliness, with strict deadlines for reporting and response to accelerate elimination. This paper outlines Thailand’s experience adapting and implementing the 1-3-7 strategy, including success factors such as a cross-sectoral Steering Committee, participation in a collaborative regional partnership, and flexible local budgets. The programme continues to evolve to ensure prompt and high-quality case management, capacity maintenance, and adequate supply of lifesaving commodities based on surveillance data. Results from implementation suggest the 1-3-7 strategy has contributed to Thailand’s decline in malaria burden; this experience may be useful for other countries aiming to eliminate malaria.
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Affiliation(s)
- Cheewanan Lertpiriyasuwat
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Prayuth Sudathip
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Suravadee Kitchakarn
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Darin Areechokchai
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Sathapana Naowarat
- Inform Asia: USAID's Health Research Program, RTI International, Bangkok, Thailand
| | - Jui A Shah
- Inform Asia: USAID's Health Research Program, RTI International, Bangkok, Thailand.
| | - David Sintasath
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Regional Development Mission for Asia, Bangkok, Thailand
| | - Niparueradee Pinyajeerapat
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Regional Development Mission for Asia, Bangkok, Thailand
| | - Felicity Young
- Inform Asia: USAID's Health Research Program, RTI International, Bangkok, Thailand
| | | | | | - Preecha Prempree
- Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
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21
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Li XH, Zhou HN, Xu JW, Lin ZR, Sun XD, Li JY, Lin XX, Xie Y, Alonso P, Yang HL. Seven decades towards malaria elimination in Yunnan, China. Malar J 2021; 20:147. [PMID: 33711990 PMCID: PMC7953382 DOI: 10.1186/s12936-021-03672-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Yunnan Province was considered the most difficult place in China for malaria elimination because of its complex malaria epidemiology, heterogeneous ecological features, relatively modest economic development, and long, porous border with three malaria endemic countries: Lao People's Democratic Republic, Myanmar, and Viet Nam. METHODS Academic publications and grey literature relevant to malaria elimination in Yunnan covering the period from 1950 until 2020 inclusive were considered. The following academic indexes were searched: China Science Periodical Database, China National Knowledge Infrastructure Database, and MEDLINE. Grey literature sources were mainly available from the National Institute of Parasitic Diseases (NIPD), the Chinese Center for Diseases Control and Prevention, and the Yunnan Institute of Parasitic Diseases (YIPD). RESULTS A malaria elimination campaign in the 1950-1960s, based mainly on mass administration of antimalarial drugs and large-scale vector control, reduced morbidity and mortality from malaria and interrupted transmission in some areas, although elimination was not achieved. Similar strategies were used to contain outbreaks and a resurgence of disease during the 1970s, when malaria services were discontinued. From the 1980s, malaria incidence declined, despite the challenges of large numbers of mobile and migrant populations and an unstable primary health care system in rural areas following economic transformation. Launch of the national malaria elimination programme in 2010 led to adoption of the '1-3-7' surveillance and response strategy specifying timely detection of and response for every case, supported by the establishment of a real-time web-based disease surveillance system and a new primary health care system in rural areas. Border malaria was addressed in Yunnan by strengthening the surveillance system down to the lowest level, cross-border collaboration with neighbouring countries and non-governmental organizations, and the involvement of other sectors. CONCLUSIONS Seven decades of work to eliminate malaria in Yunnan have shown the importance of political commitment, technically sound strategies with high quality implementation, a robust surveillance and response system at all levels, community participation and effective management of border malaria. The experiences and lessons learned from elimination remain important for prevention re-establishment of malaria transmission in the Province.
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Affiliation(s)
- Xiao-Hong Li
- Global Malaria Programme, World Health Organization, Geneva, Switzerland.
| | - Hong-Ning Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Jian-Wei Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Zu-Rui Lin
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Xiao-Dong Sun
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Jia-Yin Li
- Yunnan Representative Office, Health Poverty Action (UK), Kunming, China
| | - Xian-Xian Lin
- Yunnan Representative Office, Health Poverty Action (UK), Kunming, China
| | - Yan Xie
- School of Public Health, Peking University, Beijing, China
| | - Pedro Alonso
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Heng-Lin Yang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
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22
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A foci cohort analysis to monitor successful and persistent foci under Thailand's Malaria Elimination Strategy. Malar J 2021; 20:118. [PMID: 33639951 PMCID: PMC7910787 DOI: 10.1186/s12936-021-03648-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/04/2022] Open
Abstract
Background Thailand’s success in reducing malaria burden is built on the efficient “1-3-7” strategy applied to the surveillance system. The strategy is based on rapid case notification within 1 day, case investigation within 3 days, and targeted foci response to reduce the spread of Plasmodium spp. within 7 days. Autochthonous transmission is still occurring in the country, threatening the goal of reaching malaria-free status by 2024. This study aimed to assess the effectiveness of the 1-3-7 strategy and identify factors associated with presence of active foci. Methods Data from the national malaria information system were extracted from fiscal years 2013 to 2019; after data cleaning, the final dataset included 81,012 foci. A Cox’s proportional hazards model was built to investigate factors linked with the probability of becoming an active focus from 2015 to 2019 among foci that changed status from non-active to active focus during the study period. We performed a model selection technique based on the Akaike Information Criteria (AIC). Results The number of yearly active foci decreased from 2227 to 2013 to 700 in 2019 (68.5 %), and the number of autochthonous cases declined from 17,553 to 3,787 (78.4 %). The best Cox’s hazard model showed that foci in which vector control interventions were required were 18 % more likely to become an active focus. Increasing compliance with the 1-3-7 strategy had a protective effect, with a 22 % risk reduction among foci with over 80 % adherence to 1-3-7 timeliness protocols. Other factors associated with likelihood to become or remain an active focus include previous classification as an active focus, presence of Plasmodium falciparum infections, level of forest disturbance, and location in border provinces. Conclusions These results identified factors that favored regression of non-active foci to active foci during the study period. The model and relative risk map align with the national malaria program’s district stratification and shows strong spatial heterogeneity, with high probability to record active foci in border provinces. The results of the study may be useful for honing Thailand’s program to eliminate malaria and for other countries aiming to accelerate malaria elimination.
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Huang F, Jacob CG, Takala-Harrison S, Adams M, Yang HL, Liu H, Xia ZG, Zhou SS, Tang LH, Plowe CV. Genomic Epidemiology of Antimalarial Drug Resistance in Plasmodium falciparum in Southern China. Front Cell Infect Microbiol 2021; 10:610985. [PMID: 33489939 PMCID: PMC7820777 DOI: 10.3389/fcimb.2020.610985] [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: 09/28/2020] [Accepted: 11/20/2020] [Indexed: 12/05/2022] Open
Abstract
Emerging artemisinin resistance in Southeast Asia poses a significant risk to malaria control and eradication goals, including China’s plan to eliminate malaria nationwide by 2020. Plasmodium falciparum was endemic in China, especially in Southern China. Parasites from this region have shown decreased susceptibility to artemisinin and delayed parasite clearance after artemisinin treatment. Understanding the genetic basis of artemisinin resistance and identifying specific genetic loci associated with this phenotype is crucial for surveillance and containment of resistance. In this study, parasites were collected from clinical patients from Yunnan province and Hainan island. The parasites were genotyped using a P. falciparum-specific single nucleotide polymorphism (SNP) microarray. The SNP profiles examined included a total of 27 validated and candidate molecular markers of drug resistance. The structure of the parasite population was evaluated by principal component analysis by using the EIGENSOFT program, and ADMIXTURE was used to calculate maximum likelihood estimates for the substructure analysis. Parasites showed a high prevalence of resistance haplotypes of pfdhfr and pfdhps and moderate prevalence of pfcrt. There was no mutation identified on pfmdr1. Candidate SNPs on chromosomes 10, 13, and 14 that were associated with delayed parasite clearance showed a low prevalence of mutants. Parasites from Southern China were clustered and separated from those from Southeast Asia. Parasites from Yunnan province were substructured from parasites from Hainan island. This study provides evidence for a genomic population with drug resistance in Southern China and also illustrates the utility of SNP microarrays for large-scale parasite molecular epidemiology.
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Affiliation(s)
- Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | | | - Shannon Takala-Harrison
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Matthew Adams
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Heng-Lin Yang
- Malaria Department, Yunnan Institute of Parasitic Diseases, Puer, China
| | - Hui Liu
- Malaria Department, Yunnan Institute of Parasitic Diseases, Puer, China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Lin-Hua Tang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
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24
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Song X, Shi Q, Zhang C, Kong X, Lv Y, Wang H, Liu H, Liu L, Guo X, Kou J, Huang X, Wang H, Cheng P, Gong M. Analysis of Epidemiological Changes and Prevention Effects for Malaria in Weifang, Shandong Province, China from 1957 to 2017. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1857-1867. [PMID: 33346239 PMCID: PMC7719643 DOI: 10.18502/ijph.v49i10.4687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background We aimed to conduct a retrospective analysis of the epidemiological changes and prevention effects for malaria in Weifang, Shandong Peninsula, China from 1957 to 2017. Methods The malaria data from a web-based reporting system were analyzed to explore malaria epidemiological characteristics and prevention effects in Weifang. Results Overall, 1, 704, 890 malaria cases were reported in Weifang from 1957 to 2017, of which two major malaria epidemics occurred in 1961 (827.28/10, 000) and 1971 (366.14/10, 000). Prior to 1997, all malaria patients (1, 704, 829) were infected with Plasmodium vivax (P. vivax). After 2007, the cases of Plasmodium falciparum (P. falciparum) showed an upward trend (76.8%). The reported cases after the 21st century were mainly imported cases, and the last indigenous case was a patient that infected with P. vivax in 2006. Overall, 36 imported cases were reported from 2010 to 2017, of which 88.9% were acquired in Africa. Except for one 32-year-old woman, the rest were male (97.2%), in which laborers and farmers represented the vast majority (66.6%). From 1987 to 2017, there were 1, 224, 474 cases of fever with blood tests, and the average blood test rate was 4.9%. From 1957 to 2017, a total of 1, 704, 890 malaria patients were treated, 96 cases were treated during resting phase from 1987 to 2017. Conclusion Weifang should continue to strengthen the management of the migrant population, making blood tests for fever patients and patient treatment as important means of malaria control and monitoring.
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Affiliation(s)
- Xiao Song
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China.,School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Zhangqiu 250200, Shandong, China
| | - Qiqi Shi
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Chongxing Zhang
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Xiangli Kong
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Yeyuan Lv
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Haifang Wang
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Hongmei Liu
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Lijuan Liu
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Xiuxia Guo
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Jingxuan Kou
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Xiaodan Huang
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Huaiwei Wang
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Peng Cheng
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
| | - Maoqing Gong
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining 272033, Shandong, China
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Huang F, Zhang L, Xue JB, Zhou HN, Thi A, Zhang J, Zhou SS, Xia ZG, Zhou XN. From control to elimination: a spatial-temporal analysis of malaria along the China-Myanmar border. Infect Dis Poverty 2020; 9:158. [PMID: 33213516 PMCID: PMC7676414 DOI: 10.1186/s40249-020-00777-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/06/2020] [Indexed: 01/27/2023] Open
Abstract
Background Malaria cases have declined significantly along the China-Myanmar border in the past 10 years and this region is going through a process from control to elimination. The aim of this study is to investigate the epidemiology of malaria along the border, will identify challenges in the progress from control to elimination. Methods National reported malaria cases from China and Myanmar, along with the data of 18 Chinese border counties and 23 townships in Myanmar were obtained from a web-based diseases information reporting system in China and the national malaria control program of Myanmar, respectively. Epidemiological data was analyzed, including the number of reported cases, annual parasite index and proportion of vivax infection. Spatial mapping of the annual parasite index (API) at county or township level in 2014 and 2018 was performed by ArcGIS. The relationship of malaria endemicity on both sides of the border was evaluated by regression analysis. Results The number of reported malaria cases and API declined in the border counties or townships. In 2014, 392 malaria cases were reported from 18 Chinese border counties, including 8.4% indigenous cases and 91.6% imported cases, while the highest API (0.11) was occurred in Yingjiang County. There have been no indigenous cases reported since 2017, but 164 imported cases were reported in 2018 and 97.6% were imported from Myanmar. The average API in 2014 in 23 Myanmar townships was significantly greater than that of 18 Chinese counties (P < 0.01). However, the API decreased significantly in Myanmar side from 2014 to 2018 (P < 0.01). The number of townships with an API between 0 and 1 increased to 15 in 2018, compared to only five in 2014, while still four townships had API > 10. Plasmodium vivax was the predominant species along the border. The number of reported malaria cases and the proportion of vivax infection in the 18 Chinese counties were strongly correlated with those of the 23 Myanmar townships (P < 0.05). Conclusions Malaria elimination is approaching along the China-Myanmar border. However, in order to achieve the malaria elimination in this region and prevent the re-establishment of malaria in China after elimination, continued political, financial and scientific commitment is required.
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Affiliation(s)
- Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Jing-Bo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Hong-Ning Zhou
- Yunnan Institute of Parasitic Diseases, Puer, 665000, China
| | - Aung Thi
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, 15011, Myanmar
| | - Jun Zhang
- Health Poverty Action East Asia Programme Office, Kunming, 650000, China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.
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Perera R, Caldera A, Wickremasinghe AR. Reactive Case Detection (RACD) and foci investigation strategies in malaria control and elimination: a review. Malar J 2020; 19:401. [PMID: 33172462 PMCID: PMC7653886 DOI: 10.1186/s12936-020-03478-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background Reactive case detection (RACD) and foci investigation are key strategies in malaria elimination and prevention of its re-establishment. They are a key part of surveillance that has been recommended by the World Health Organization (WHO) to be considered as a core intervention and as one of the three pillars of the Global Technical Strategy for Malaria 2016–2030. Methods A search using the key words “Reactive Case Detection”, “RACD”, “RCD” and “Malaria” was carried out in PubMed, Scopus, Taylor and Francis online databases for studies published until 31st July 2019. The inclusion criteria for selection of articles for review included (1) how RACD is implemented in each country; (2) challenges faced in RACD implementation; (3) suggestions on how the effectiveness of RACD process can be improved. Results 411 titles were identified, 41 full text articles were screened and 29 were found eligible for inclusion in the review. Published literature on RACD, and case and foci investigations has mostly assessed the process of the activity. Most studies have documented that the yield of positives in RACD has been highest in the index case’s household and the immediate neighbourhood of the index case. Microscopy and RDTs are the common tests used in RACD. The guidelines for case and foci investigation, and RACD and PACD, are not universally adopted and are country-specific. Some of the limitations and challenges identified include lack of proper guidelines, logistic issues and problems with public compliance. Conclusions Although there is no documented evidence that RACD is useful in malaria elimination settings, most authors have opined that RACD is necessary for malaria elimination. Lack of knowledge in the target populations, a target radius and how to carry out the RACD process is a major challenge in the decision-making process.
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Affiliation(s)
- Ruwanthi Perera
- Department of Public Health, Faculty of Medicine, University of Kelaniya, P. O. Box 6, Thalagolla Road, Ragama, 11010, Sri Lanka
| | - Amandhi Caldera
- Department of Public Health, Faculty of Medicine, University of Kelaniya, P. O. Box 6, Thalagolla Road, Ragama, 11010, Sri Lanka
| | - A Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, P. O. Box 6, Thalagolla Road, Ragama, 11010, Sri Lanka.
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Anand A, Favero R, Dentinger C, Ralaivaomisa A, Ramamonjisoa S, Rabozakandraina O, Razafimandimby E, Razafindrakoto J, Wolf K, Steinhardt L, Gomez P, Rabary M, Andriamananjara MN, Mioramalala SA, Rakotovao JP. Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018. Malar J 2020; 19:351. [PMID: 33004061 PMCID: PMC7528237 DOI: 10.1186/s12936-020-03417-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/15/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Madagascar's Malaria National Strategic Plan 2018-2022 calls for progressive malaria elimination beginning in low-incidence districts (< 1 case/1000 population). Optimizing access to prompt diagnosis and quality treatment and improving outbreak detection and response will be critical to success. A malaria elimination readiness assessment (MERA) was performed in health facilities (HFs) of selected districts targeted for malaria elimination. METHODS A mixed methods survey was performed in September 2018 in five districts of Madagascar. Randomly selected HFs were assessed for availability of malaria commodities and frequency of training and supervision conducted. Health providers (HPs) and community health volunteers (CHVs) were interviewed, and outpatient consultations at HFs were observed. To evaluate elimination readiness, a composite score ranging from 0 to 100 was designed from all study tools and addressed four domains: (1) resource availability, (2) case management (CM), (3) data management and use, and (4) training, supervision, and technical assistance; scores were calculated for each HF catchment area and district based on survey responses. Stakeholder interviews on malaria elimination planning were conducted at national, regional and district levels. RESULTS A quarter of the 35 HFs surveyed had no rapid diagnostic tests (RDTs). Of 129 patients with reported or recorded fever among 300 consultations observed, HPs tested 56 (43%) for malaria. Three-quarters of the 35 HF managers reviewed data for trends. Only 68% of 41 HPs reported receiving malaria-specific training. Of 34 CHVs surveyed, 24% reported that treating fever was no longer among their responsibilities. Among treating CHVs, 13 (50%) reported having RDTs, and 11 (42%) had anti-malarials available. The average district elimination readiness score was 52 out of 100, ranging from 48 to 57 across districts. Stakeholders identified several challenges to commodity management, malaria CM, and epidemic response related to lack of training and funding disruptions. CONCLUSION This evaluation highlighted gaps in malaria CM and elimination readiness in Madagascar to address during elimination planning. Strategies are needed that include training, commodity provision, supervision, and support for CHVs. The MERA can be repeated to assess progress in filling identified gaps and is a feasible tool that could be used to assess elimination targets in other countries.
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Affiliation(s)
- Anjoli Anand
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA.
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Rachel Favero
- Maternal Child Survival Program, Washington, DC, USA
| | - Catherine Dentinger
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- US President's Malaria Initiative, US Centers for Disease Control and Prevention, Antananarivo, Madagascar
| | | | | | | | | | - Jocelyn Razafindrakoto
- US President's Malaria Initiative, US Centers for Disease Control and Prevention, Antananarivo, Madagascar
| | | | - Laura Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Zhao X, Thanapongtharm W, Lawawirojwong S, Wei C, Tang Y, Zhou Y, Sun X, Cui L, Sattabongkot J, Kaewkungwal J. Malaria Risk Map Using Spatial Multi-Criteria Decision Analysis along Yunnan Border During the Pre-elimination Period. Am J Trop Med Hyg 2020; 103:793-809. [PMID: 32602435 PMCID: PMC7410425 DOI: 10.4269/ajtmh.19-0854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
In moving toward malaria elimination, finer scale malaria risk maps are required to identify hotspots for implementing surveillance–response activities, allocating resources, and preparing health facilities based on the needs and necessities at each specific area. This study aimed to demonstrate the use of multi-criteria decision analysis (MCDA) in conjunction with geographic information systems (GISs) to create a spatial model and risk maps by integrating satellite remote-sensing and malaria surveillance data from 18 counties of Yunnan Province along the China–Myanmar border. The MCDA composite and annual models and risk maps were created from the consensus among the experts who have been working and know situations in the study areas. The experts identified and provided relative factor weights for nine socioeconomic and disease ecology factors as a weighted linear combination model of the following: ([Forest coverage × 0.041] + [Cropland × 0.086] + [Water body × 0.175] + [Elevation × 0.297] + [Human population density × 0.043] + [Imported case × 0.258] + [Distance to road × 0.030] + [Distance to health facility × 0.033] + [Urbanization × 0.036]). The expert-based model had a good prediction capacity with a high area under curve. The study has demonstrated the novel integrated use of spatial MCDA which combines multiple environmental factors in estimating disease risk by using decision rules derived from existing knowledge or hypothesized understanding of the risk factors via diverse quantitative and qualitative criteria using both data-driven and qualitative indicators from the experts. The model and fine MCDA risk map developed in this study could assist in focusing the elimination efforts in the specifically identified locations with high risks.
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Affiliation(s)
- Xiaotao Zhao
- Yunnan Institute of Parasitic Diseases, Pu'er, P. R. China.,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Weerapong Thanapongtharm
- Department of Livestock Development, Veterinary Epidemiological Center, Bureau of Disease Control and Veterinary Services, Bangkok, Thailand
| | - Siam Lawawirojwong
- Geo-Informatics and Space Technology Development Agency, Bangkok, Thailand
| | - Chun Wei
- Yunnan Institute of Parasitic Diseases, Pu'er, P. R. China
| | - Yerong Tang
- Yunnan Institute of Parasitic Diseases, Pu'er, P. R. China
| | - Yaowu Zhou
- Yunnan Institute of Parasitic Diseases, Pu'er, P. R. China
| | - Xiaodong Sun
- Yunnan Institute of Parasitic Diseases, Pu'er, P. R. China
| | - Liwang Cui
- Division of Infectious Diseases and Internal Medicine, Department of Internal Medicine, University of South Florida, Tampa, Florida
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jaranit Kaewkungwal
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Construction and application of surveillance and response systems for parasitic diseases in China, led by NIPD-CTDR. ADVANCES IN PARASITOLOGY 2020; 110:349-371. [PMID: 32563331 PMCID: PMC7220163 DOI: 10.1016/bs.apar.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Parasitic diseases have been widely epidemic in China with a long history. Great endeavours made in past 70 years led to significant decrease in morbidity and mortablity caused by several major parasitic diseases, while challenges existed to eliminate parasitic diseases. Surveillance-response system has play a crucial role in identifying public health problems, ascertaining the distribution and epidemic dynamics, discovering outbreaks and epidemic anomalies, evaluating the effects of on-site intervention activities and identifying risk factors. In this article, we reviewed the progress of the surveillance system for parasitic diseases, analysed the role of NIPD in the construction and application of surveillance-response system of parasitic diseases through elaborating the surveillance activities and typical surveillance-response events led by NIPD. Suggestion and comments for improve the surveillance-response system were put forward for further control or elimination of parasitic diseases.
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Xia S, Zheng JX, Wang XY, Xue JB, Hu JH, Zhang XQ, Zhou XN, Li SZ. Epidemiological big data and analytical tools applied in the control programmes on parasitic diseases in China: NIPD's sustained contributions in 70 years. ADVANCES IN PARASITOLOGY 2020; 110:319-347. [PMID: 32563330 DOI: 10.1016/bs.apar.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The analysis of epidemiological data has played an important role for the academic research carried out by the National Institute of Parasitic Diseases, China CDC, since its foundation in 1950s. Those researches, e.g., the temporal-spatial patterns of disease transmission and the identification of risk factors, have contributed significantly to the national parasitic disease control and elimination programmes in China. With the development and application of epidemiological data analysis in the last decade, all research results improve our understanding of parasitic diseases epidemiology and related health issues through the application platform of epidemiological big data and analytical tools. In particular, implementation research on analytical predictions on disease outbreak or epidemic risks have provided references to the scientific guidance on effective preventions and interventions in the parasitic disease elimination in China, such as fliariasis, malaria and schistosomiasis. This review has reflected the function of data accumulation and application of temporospatial tools in parasitic diseases control, and the ways of the NIPD's sustained contributions to the disease control programmes in China.
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Affiliation(s)
- Shang 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
| | - Jin-Xin Zheng
- 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
| | - Xin-Yi Wang
- 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
| | - Jing-Bo Xue
- 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
| | - Jian-Hong Hu
- 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
| | - Xue-Qiang 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, 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; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China; National Health Commission of China, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China.
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Potential for a web-based management information system to improve malaria control: An exploratory study in the Lahat District, South Sumatra Province, Indonesia. PLoS One 2020; 15:e0229838. [PMID: 32516344 PMCID: PMC7282623 DOI: 10.1371/journal.pone.0229838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/14/2020] [Indexed: 11/19/2022] Open
Abstract
Background A web-based malaria reporting information system (MRIS) has the potential to improve malaria reporting and management. The aim of this study was to evaluate the existing manual paper-based MRIS and to provide a way to overcome the obstacles by developing a web-based MRIS in Indonesia. Methods An exploratory study was conducted in 2012 in Lahat District, South Sumatra Province of Indonesia. We evaluated the current reporting system and identified the potential benefits of using a web-based MRIS by in-depth interviews on selected key informants. Feasibility study was then conducted to develop a prototype system. A web-based MRIS was developed, integrated and synchronized, with suitability ranging from Primary Healthcare Centres (PHCs) to the Lahat District Health Office. Results The paper-based reporting system was sub-optimal due to a lack of transportation, communication, and human capacity. We developed a web-based MRIS to replace the current one. Although the web-based system has the potential to improve the malaria reporting information system, there were some barriers to its implementation, including lack of skilled operators, computer availability and lack of internet access. Recommended ways to overcome the obstacles are by training operators, making the application in an offline mode and able to be operated by mobile phone text messaging for malaria reporting. Conclusion The web-based MRIS has the potential to be implemented as an enhanced malaria reporting information system and investment in the system to support timely management responses is essential for malaria elimination. The developed application can be cloned to other areas that have similar characteristics and MRIS with a built-in web base to aid its application in the 5G future.
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32
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Zhao X, Thanapongtharm W, Lawawirojwong S, Wei C, Tang Y, Zhou Y, Sun X, Sattabongkot J, Kaewkungwal J. Spatiotemporal Trends of Malaria in Relation to Economic Development and Cross-Border Movement along the China-Myanmar Border in Yunnan Province. THE KOREAN JOURNAL OF PARASITOLOGY 2020; 58:267-278. [PMID: 32615740 PMCID: PMC7338897 DOI: 10.3347/kjp.2020.58.3.267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/02/2020] [Accepted: 04/06/2020] [Indexed: 12/01/2022]
Abstract
The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.
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Affiliation(s)
- Xiaotao Zhao
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China
| | - Weerapong Thanapongtharm
- Veterinary Epidemiological Center, Bureau of Disease Control and Veterinary Services, Department of Livestock Development, Bangkok, Thailand
| | - Siam Lawawirojwong
- Geo-Informatics and Space Technology Development Agency, Bangkok, Thailand
| | - Chun Wei
- Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China
| | - Yerong Tang
- Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China
| | - Yaowu Zhou
- Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China
| | - Xiaodong Sun
- Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China
| | - Jestumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jaranit Kaewkungwal
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Zhang Q, Liu Y, Hu Y, Zhao Y, Yang C, Qian D, Zhou R, Li S, Guan Z, Lu D, Zhang H, Guo W. The "1-3-7" Approach to Malaria Surveillance and Response - Henan Province, China, 2012-2018. China CDC Wkly 2020; 2:289-292. [PMID: 34594641 PMCID: PMC8422168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 04/21/2020] [Indexed: 12/04/2022] Open
Abstract
What is already known about this topic? The "1-3-7" approach to malaria surveillance and response was a key measure for malaria elimination in China and was first introduced into the World Health Organization (WHO) as an international guideline for malaria surveillance and response in 2018. What is added by this report? The "1-3-7" approach was well implemented in Henan Province from 2012-2018. Over this study period, a total of 1,294 malaria cases were detected and reported, and all cases were diagnosed and reported within 1 day with 99.23% (1,284/1,294) of cases were investigated within 3 days. In addition, 93.7% (1,212/1,294) of foci were investigated and vector control was implemented within 7 days at all residual non-active foci to prevent further spread. What are the implications for public health practice? The "1-3-7" controlling pattern would be an effective and approachable method for implementation especially in malaria-eliminating countries and regions, but the interval from symptom onset to diagnosis cannot be ignored. Thus, the roles and responsibilities that all actors involved in the health sector must be specified too.
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Affiliation(s)
- Qunqun Zhang
- Henan Center for Disease Prevention and Control, Zhengzhou, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ying Liu
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Yabo Hu
- Henan Center for Disease Prevention and Control, Zhengzhou, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuling Zhao
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Chengyun Yang
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Dan Qian
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Ruimin Zhou
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Suhua Li
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Zhou Guan
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Deling Lu
- Henan Center for Disease Prevention and Control, Zhengzhou, China
| | - Hongwei Zhang
- Henan Center for Disease Prevention and Control, Zhengzhou, China,College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wanshen Guo
- Henan Center for Disease Prevention and Control, Zhengzhou, China,Wanshen Guo,
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Feng J, Tu H, Zhang L, Xia Z, Zhou S. Imported Malaria Cases - China, 2012-2018. China CDC Wkly 2020; 2:277-283. [PMID: 34594639 PMCID: PMC8422169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/20/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jun Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Hong Tu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Zhigui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Shuisen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China,Shuisen Zhou,
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Kheang ST, Sovannaroth S, Barat LM, Dysoley L, Kapella BK, Po L, Nguon S, Gimnig J, Slot R, Samphornarann T, Meng SK, Dissanayake G, AlMossawi HJ, Longacre C, Kak N. Malaria elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia. BMC Public Health 2020; 20:544. [PMID: 32321475 PMCID: PMC7178947 DOI: 10.1186/s12889-020-08634-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background Cambodia has targeted malaria elimination within its territory by 2025 and is developing a model elimination package of strategies and interventions designed to achieve this goal. Methods Cambodia adopted a simplified 1-3-7 surveillance model in the Sampov Loun operational health district in western Cambodia beginning in July 2015. The 1-3-7 approach targets reporting of confirmed cases within one day, investigation of specific cases within three days, and targeted control measures to prevent further transmission within seven days. In Sampov Loun, response measures included reactive case detection (testing of co-travelers, household contacts and family members, and surrounding households with suspected malaria cases), and provision of health education, and insecticide-treated nets. Day 28 follow up microscopy was conducted for all confirmed P. falciparum and P. falciparum-mixed-species malaria cases to assess treatment efficacy. Results The number of confirmed malaria cases in the district fell from 519 in 2015 to 181 in 2017, and the annual parasite incidence (API) in the district fell from 3.21 per 1000 population to 1.06 per 1000 population. The last locally transmitted case of malaria in Sampov Loun was identified in March 2016. In response to the 408 index cases identified, 1377 contacts were screened, resulting in the identification of 14 positive cases. All positive cases occurred among index case co-travelers. Conclusion The experience of the 1-3-7 approach in Sampov Loun indicates that the basic essential malaria elimination package can be feasibly implemented at the operational district level to achieve the goal of malaria elimination in Cambodia and has provided essential information that has led to the refinement of this package.
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Affiliation(s)
| | | | - Lawrence M Barat
- President's Malaria Initiative/United States Agency for International Development, Washington, DC, USA
| | - Lek Dysoley
- National Malaria Control Program, Phnom Penh, Cambodia
| | - Bryan K Kapella
- President's Malaria Initiative/Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ly Po
- National Malaria Control Program, Phnom Penh, Cambodia
| | | | - John Gimnig
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rida Slot
- President's Malaria Initiative/United States Agency for International Development, Phnom Penh, Cambodia
| | | | | | - Gunawardena Dissanayake
- President's Malaria Initiative/United States Agency for International Development, Phnom Penh, Cambodia
| | | | | | - Neeraj Kak
- University Research Co., LLC, Chevy Chase, MD, USA.
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Cao Y, Cotter C, Wang W, Liu Y, Zhou H, Zhu G, Cao J. Malaria Elimination in China: Improving County-Level Malaria Personnel Knowledge of the 1-3-7 Strategy through Tabletop Exercises. Am J Trop Med Hyg 2020; 102:804-810. [PMID: 32100680 PMCID: PMC7124899 DOI: 10.4269/ajtmh.19-0560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/09/2020] [Indexed: 11/07/2022] Open
Abstract
As China moves to the prevention of reestablishment of malaria, maintaining skills for malaria in county personnel on the "1-3-7" surveillance and response strategy is critical. China's "1-3-7" strategy defines targets used to guide and monitor malaria case reporting, investigation, and response, respectively: reporting of malaria cases within 1 day, their confirmation and investigation within 3 days, and the appropriate public health response to prevent further transmission within 7 days. Assessing the knowledge of local CDC malaria personnel on the "1-3-7" surveillance and response strategy is urgently needed. In June 2016, two different training modules (classroom-style teaching and tabletop exercises) were conducted for 125 CDC staff in Jiangsu Province, China, to determine the effectiveness of the two training modules on CDC staff knowledge and learning of the "1-3-7" strategy. The classroom-style training module just imparted the malaria knowledge to participants through teaching. Tabletop exercises were carried out through discussion-based scenarios using questions and answers on the "1-3-7" strategy. Questionnaires assessing knowledge improvement were designed and administered to personnel responsible for malaria surveillance and response activities, including at baseline and end line. Overall, knowledge of the "1-3-7" strategy for malaria elimination was 63.2% correct at baseline, 70.6% after implementing a classroom-style teaching module (χ2 = 11.20, P = 0.001), and 84.6% after the tabletop exercise module (χ2 = 48.82, P < 0.001). The knowledge of each component of the "1-3-7" strategy improved significantly after the tabletop exercise module. The total proportion of respondents with a high score (greater than or equal to 75%) was 82.7% in the classroom-style module and 95.2% in the tabletop exercise module. The proportion of respondents with a high score significantly increased after tabletop exercises in the stratified demographic groups of men who work at the county CDC level, have a bachelor's degree, hold a professional title as professor or assistant, are aged 31-50 years, and have attained 11-20 years of service with the CDC compared with the classroom-style module. Acceptability of the classroom-style module (78.2%) compared with tabletop exercises (94.4%) by the CDC malaria personnel increased significantly (χ2 = 11.96, P = 0.004). Feedback from participants on the modules suggest the tabletop exercises were an effective training method, which could maintain and improve the knowledge and capacity for malaria surveillance and response in basic CDC level personnel in China.
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Affiliation(s)
- Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, People’s Republic of China
| | - Chris Cotter
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, California
| | - Weiming Wang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, People’s Republic of China
| | - Yaobao Liu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, People’s Republic of China
| | - Huayun Zhou
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, People’s Republic of China
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, People’s Republic of China
| | - Jun Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, People’s Republic of China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China
- Public Health Research Center, Jiangnan University, Wuxi, People’s Republic of China
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Aung PP, Thein ZW, Hein ZNM, Aung KT, Mon NO, Linn NYY, Thi A, Wai KT, Maung TM. Challenges in early phase of implementing the 1-3-7 surveillance and response approach in malaria elimination setting: A field study from Myanmar. Infect Dis Poverty 2020; 9:18. [PMID: 32036792 PMCID: PMC7008564 DOI: 10.1186/s40249-020-0632-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/21/2020] [Indexed: 11/25/2022] Open
Abstract
Background The National Plan for Malaria Elimination (NPME) in Myanmar (2016–2030) aims to eliminate indigenous Plasmodium falciparum malaria in six states/regions of low endemicity by 2020 and countrywide by 2030. To achieve this goal, in 2016 the National Malaria Control Program (NMCP) implemented the “1-3-7” surveillance and response strategy. This study aims to identify the barriers to successful implementation of the NPME which emerged during the early phase of the “1-3-7” approach deployment. Methods A mixed-methods study was conducted with basic health staff (BHS) and Vector Born Disease Control Program (VBDC) staff between 2017 and 2018 in six townships of six states/regions targeted for sub-national elimination by 2020. A self-administered questionnaire, designed to assess the knowledge required to implement the “1-3-7” approach, was completed by 544 respondents. Bivariate analysis was performed for quantitative findings and thematic analysis was conducted for qualitative findings using Atals.ti software. Results Although 83% of participants reported performing the key activities in the “1-3-7” surveillance and response approach, less than half could report performing those activities within 3 days and 7 days (40 and 43%, respectively). Low proportion of BHS correctly identified six categories of malaria cases and three types of foci (22 and 26%, respectively). In contrast, nearly 80% of respondents correctly named three types of case detection methods. Most cited challenges included ‘low community knowledge on health’ (43%), ‘inadequate supplies’ (22%), and ‘transportation difficulty’ (21%). Qualitative data identified poor knowledge of key surveillance activities, delays in reporting, and differences in reporting systems as the primary challenges. The dominant perceived barrier to success was inability to control the influx of migrant workers into target jurisdictions especially in hard-to-reach areas. Interviews with township medical officers and the NMCP team leaders further highlighted the necessity of refresher training for every step in the “1-3-7” surveillance and response approach. Conclusions The performance of the “1-3-7” surveillance and response approach in Myanmar delivers promising results. However, numerous challenges are likely to slow down malaria elimination progress in accordance with the NPME. Multi-stakeholder engagement and health system readiness is critical for malaria elimination at the sub-national level.
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Affiliation(s)
- Poe Poe Aung
- Duke Global Health Institute Myanmar Program, Yangon, Myanmar.
| | - Zaw Win Thein
- Duke Global Health Institute Myanmar Program, Yangon, Myanmar
| | - Zar Ni Min Hein
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Kyaw Thet Aung
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Nwe Oo Mon
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Nay Yi Yi Linn
- National Malaria Control Program, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aung Thi
- National Malaria Control Program, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Khin Thet Wai
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Thae Maung Maung
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
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Wang T, Zhou SS, Feng J, Oo MM, Chen J, Yan CF, Zhang Y, Tie P. 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. Malar J 2019; 18:235. [PMID: 31299985 PMCID: PMC6626373 DOI: 10.1186/s12936-019-2865-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/03/2019] [Indexed: 11/10/2022] Open
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.
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Affiliation(s)
- Ting Wang
- Shanxi Center for Disease Control and Prevention, Taiyuan, 030012, China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Jun Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Myo Minn Oo
- Center for Operational Research, International Union Against Tuberculosis and Lung Disease, Mandalay, 05021, Myanmar
| | - Jing Chen
- Shanxi Center for Disease Control and Prevention, Taiyuan, 030012, China
| | - Chang-Fu Yan
- Shanxi Center for Disease Control and Prevention, Taiyuan, 030012, China
| | - Yi Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Ping Tie
- Shanxi Center for Disease Control and Prevention, Taiyuan, 030012, China.
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Feng J, Kong X, Xu D, Yan H, Zhou H, Tu H, Lin K. Investigation and Evaluation of Genetic Diversity of Plasmodium falciparum Kelch 13 Polymorphisms Imported From Southeast Asia and Africa in Southern China. Front Public Health 2019; 7:95. [PMID: 31069209 PMCID: PMC6491575 DOI: 10.3389/fpubh.2019.00095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/04/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: In this study, we aimed to analyse the genetic diversity Kelch 13 (K13) propeller allele of the Plasmodium falciparum isolates mainly imported from Southeast Asia and Africa in southern China, including the provinces of Yunnan and Guangxi. Methods: At enrolment, we collected blood samples from patients with confirmed cases of malaria infection between January 2012 and December 2017, for analysis. Individual patient information was obtained via a malaria surveillance system. The malaria infections and P. falciparum K13 mutations were diagnosed by using a nested polymerase chain reaction (PCR) method. Results: The K13 mutations were identified in 283 P. falciparum isolates from 18 counties in Yunnan and 22 counties in Guangxi. Of Forty-six isolates (46/283, 16.3%) that harbored K13 mutant alleles were detected: 26.8% in Yunnan (33/123) and 8.1% in Guangxi (13/160). A total of 18 different K13 mutations were detected. Only the F446I mutation was detected in Yunnan isolates, and F446I was more frequent (20/46, 43.5%) than other alleles. Further, the temporal distribution of the F446I mutation ratio from 2012 to 2015 exhibited no significant difference in Yunnan Province (2012, 2/13, 15.4%; 2013, 7/40, 17.5%; 2014, 7/33, 21.2%; 2015, 4/37, 10.8%, p = 0.121). A578S allele was the main K13 mutation (5/283, 1.8%) from Africa. The K13 mutants were present in 33.3% of indigenous isolates, 27.4% of isolates from Southeast Asia, and 7.9% of isolates from Africa. The analysis of 10 neutral microsatellite loci of 60 isolates showed that at the TAA109 locus, the expected heterozygosity of F446I (He = 0.112 ± 0.007) was much lower than that of wild type and other mutation types in Myanmar isolates. With respect to geographic distribution, TAA109 also exhibited a significant difference between isolates from Southeast Asia (He = 0.139 ± 0.012) and those from Africa (He = 0.603 ± 0.044). Conclusions: The present findings on the geographic diversity of K13 mutant alleles in P. falciparum may provide a basis for routine molecular surveillance and risk assessment, to monitor artemisinin resistance (ART) in China. Our results will be helpful for enriching the artemisinin resistance database in China during the elimination and post-elimination phases.
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Affiliation(s)
- Jun Feng
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.,World Health Organization Collaborating Centre for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Xiangli Kong
- Shandong Institute of Parasitic Diseases, Shandong Academy of Medical Sciences, Jining, China
| | - Dongmei Xu
- Department of Food and Pharmaceutical Engineering, Shijiazhuang University of Applied Technology, Shijiazhuang, China
| | - He Yan
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.,World Health Organization Collaborating Centre for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Hongning Zhou
- Yunnan Institute of Parasitic Diseases, Pu'er, China
| | - Hong Tu
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.,World Health Organization Collaborating Centre for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Shanghai, China
| | - Kangming Lin
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Institute of Parasitic Diseases, Nanning, China
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Feng J, Zhang L, Huang F, Yin JH, Tu H, Xia ZG, Zhou SS, Xiao N, Zhou XN. Ready for malaria elimination: zero indigenous case reported in the People's Republic of China. Malar J 2018; 17:315. [PMID: 30157876 PMCID: PMC6116478 DOI: 10.1186/s12936-018-2444-9] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/04/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Malaria was once one of the most serious public health problems in China. However, the disease burden has sharply declined and epidemic areas have shrunk after the implementation of an integrated malaria control and elimination strategy, especially since 2000. In this review, the lessons were distilled from the Chinese national malaria elimination programme and further efforts to mitigate the challenges of malaria resurgence are being discussed. METHODS A retrospective evaluation was performed to assess the changes in malaria epidemic patterns from 1950 to 2017 at national level. The malaria data before 2004 were collected from paper-based annual reports. After 2004, each of the different cases from the Infectious Diseases Information Reporting Management System (IDIRMS) was closely examined and scrutinized. An additional documenting system, the National Information Management System for Malaria, established in 2012 to document the interventions of three parasitic diseases, was also examined to complete the missing data from IDIRMS. RESULTS From 1950 to 2017, the occurrence of indigenous malaria has been steeply reduced, and malaria-epidemic regions have substantially shrunk, especially after the launch of the national malaria elimination programme. There were approximately 30 million malaria cases annually before 1949 with a mortality rate of 1%. A total of 5999 indigenous cases were documented from 2010 to 2016, with a drastic reduction of 99% over the 6 years (2010, n = 4262; 2016, n = 3). There were indigenous cases reported in 303 counties from 18 provinces in 2010, but only 3 indigenous cases were reported in 2 provinces nationwide in 2016. While in 2017, for the first time, zero indigenous case was reported in China, and only 7 of imported cases were in individuals who died of Plasmodium falciparum infection. CONCLUSION Malaria elimination in China is a country-led and country-owned endeavour. The country-own efforts were a clear national elimination strategy, supported by two systems, namely a case-based surveillance and response system and reference laboratory system. The country-led efforts were regional and inter-sectoral collaboration as well as sustained monitoring and evaluation. However, there are still some challenges, such as the maintenance of non-transmission status, the implementation of a qualified verification and assessment system, and the management of imported cases in border areas, through regional cooperation. The findings from this review can probably help improving malaria surveillance systems in China, but also in other elimination countries.
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Affiliation(s)
- Jun Feng
- 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, Ministry of Health, 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, 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
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, 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, Shanghai, People's Republic of China
| | - Fang Huang
- 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, Ministry of Health, 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, Shanghai, People's Republic of China
| | - Jian-Hai Yin
- 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, Ministry of Health, 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, Shanghai, People's Republic of China
| | - Hong Tu
- 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, Ministry of Health, 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, 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, Ministry of Health, 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, 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, Ministry of Health, 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, Shanghai, People's Republic of China
| | - Ning Xiao
- 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, Ministry of Health, 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, 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.
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, 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, Shanghai, People's Republic of China.
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Kyaw AMM, Kathirvel S, Das M, Thapa B, Linn NYY, Maung TM, Lin Z, Thi A. "Alert-Audit-Act": assessment of surveillance and response strategy for malaria elimination in three low-endemic settings of Myanmar in 2016. Trop Med Health 2018; 46:11. [PMID: 29686526 PMCID: PMC5898078 DOI: 10.1186/s41182-018-0092-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/21/2018] [Indexed: 11/21/2022] Open
Abstract
Background Myanmar, a malaria endemic country of Southeast Asia, adopted surveillance and response strategy similar to “1-3-7” Chinese strategy to achieve sub-national elimination in six low-endemic region/states of the country. Among these, Yangon, Bago-East, and Mon region/states have implemented this malaria surveillance and response strategy with modification in 2016. The current study was conducted to assess the case notification, investigation, classification, and response strategy (NICR) in these three states. Methods This was a retrospective cohort study using routine program data of all patients with malaria diagnosed and reported under the National Malaria Control Programme in 2016 from the above three states. As per the program, all malaria cases need to be notified within 1 day and investigated within 3 days of diagnosis and response to control (active case detection and control) should be taken for all indigenous malaria cases within 7 days of diagnosis. Results A total of 959 malaria cases were diagnosed from the study area in 2016. Of these, the case NICR details were available only for 312 (32.5%) malaria cases. Of 312 cases, the case notification, investigation, and classification were carried out within 3 days of malaria diagnosis in 95.5% cases (298/312). Of 208 indigenous malaria cases (66.7%, 208/312), response to control was taken in 96.6% (201/208) within 7 days of diagnosis. Conclusion The timeline at each stage of the strategy namely case notification, investigation, classification, and response to control was followed, and response action was taken in nearly all indigenous malaria cases for the available case information. Strengthening of health information and monitoring system is needed to avoid missing information. Future research on feasibility of mobile/tablet-based surveillance system and providing response to all cases including imported malaria can be further studied.
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Affiliation(s)
- Aye Mon Mon Kyaw
- National Malaria Control Programme/Vector Borne Disease Control, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Soundappan Kathirvel
- International Union Against Tuberculosis and Lung Disease, Southeast Asia, New Delhi, India.,3Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mrinalini Das
- Médecins Sans Frontières (MSF) OCB, New Delhi, India
| | - Badri Thapa
- World Health Organization Country Office for Myanmar, Yangon, Myanmar
| | - Nay Yi Yi Linn
- National Malaria Control Programme/Vector Borne Disease Control, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thae Maung Maung
- Department of Medical Research, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Zaw Lin
- National Malaria Control Programme/Vector Borne Disease Control, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aung Thi
- National Malaria Control Programme/Vector Borne Disease Control, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
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Feng J, Tu H, Zhang L, Zhang S, Jiang S, Xia Z, Zhou S. Mapping transmission foci to eliminate malaria in the People's Republic of China, 2010-2015: a retrospective analysis. BMC Infect Dis 2018; 18:115. [PMID: 29514598 PMCID: PMC5840925 DOI: 10.1186/s12879-018-3018-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 02/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has initiated the National Malaria Elimination Action Plan, which aims to eliminate malaria by 2020. However, the transmission of malaria occurs sporadically or in distinct foci, which greatly hampers progress toward elimination in China and other countries. The object of this study was to foci categorization and evaluates whether the response met the requirements issued by the nation or WHO. METHODS Residual transmissions were investigated and located with fine spatial resolution mapping from parasitological confirmed malaria cases by use of routine national surveillance data. The "1-3-7" timeframes were monitored for each focus between 2012 and 2015. Each focus was identified, and the application of appropriate measures was evaluated. RESULTS A total of 5996 indigenous cases were recorded between 2010 and 2015; during this period, the number of cases declined by 99.1% (2010, n = 4262; 2015, n = 39). Most indigenous cases (92.5%) were reported in Anhui (n = 2326), Yunnan (n = 1373), Henan (n = 930), Hubei (n = 459), and Guizhou (n = 458). The temporal distribution showed that the indigenous malaria cases were clustered during the period of May to August. A total of 320 foci were carefully investigated and analyzed: 24 were active foci; 72, residual non-active foci; and 224 cleared-up foci. For the foci response evaluation, all the active foci were investigated within 7 days, while 80.2% of the residual non-active foci were responded within 7 days. In addition, reactive case detection (RACD) was carried out with 92.9% of the active foci and vector investigation carried out with 75%. For residual non-active foci, RACD was carried out with 83.2% and vector investigation with 78.2% of the foci. CONCLUSIONS This study used nationwide data to categorize foci in China and evaluate the response of these areas during the control and elimination phases. Our approach stratifies future control responses by identifying those locations where the elimination of endemic transmission is needed, such as in the counties at the China-Myanmar border and in Tibet. In addition, this study will help local CDC staff to reassess their needs and responses against different types of foci during the elimination and post-elimination phases.
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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, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Hong Tu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Shaosen Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Shan Jiang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Zhigui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Shuisen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, 200025 People’s Republic of China
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Zhang X, Yao L, Sun J, Pan J, Chen H, Zhang L, Ruan W. Malaria in Southeastern China from 2012 to 2016: Analysis of Imported Cases. Am J Trop Med Hyg 2018; 98:1107-1112. [PMID: 29488463 PMCID: PMC5928818 DOI: 10.4269/ajtmh.17-0476] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
To study the epidemiological distribution and the incident trends of imported malaria from 2012 to 2016 in Zhejiang Province, southeastern China, we collected data on malaria from the Information System for Parasitic Disease Control and Prevention. A total of 1,003 malaria cases were reported during 2012–2016, and all of these cases were imported. Plasmodium falciparum was the predominant species (76.3%) in Zhejiang Province. The percentage of Plasmodium vivax decreased from 33.6% to 8.1%, whereas the percentage of Plasmodium ovale and Plasmodium malariae increased. Most cases were male (89.8%), mostly in the age group of 21–50 years (82.6%). Businessmen (33.0%), workers (21.0%), farmers (18.8%), and overseas laborers (11.7%) were at high risk. The origin of the largest number of imported cases was Africa (89.5%), followed by Asia (10.0%) and Oceania (0.5%). The time interval from illness onset to confirmation was found to be significantly associated with the complications of patients. Out of 3,461 febrile individuals tested during reactive case detection, 10 malaria-positive individuals were identified. Effective surveillance and response system should be strengthened to prevent the reintroduction of malaria.
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Affiliation(s)
- Xuan Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Linong Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Jinren Pan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Hualiang Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Lingling Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Wei Ruan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
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Lin K, Wei H, Jiang W, Li J, Zhang W, Wei S, Yang Y, Huang Y, Feng X, Tu H, Feng J. Malaria in the Guangxi Zhuang Autonomous Region in China: A Twelve-Year Surveillance Data Study. Am J Trop Med Hyg 2017; 97:1163-1169. [PMID: 28820683 PMCID: PMC5637578 DOI: 10.4269/ajtmh.16-0260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/08/2017] [Indexed: 01/02/2023] Open
Abstract
The incidence of an indigenous malaria, defined as malaria acquired by a local mosquito transmission, declined from 2004 to 2015 in the Guangxi Zhuang Autonomous Region. However, imported malaria, defined as malaria acquired from other endemic regions outside of China, has been increasing in the region, as in the rest of the country, particularly the disease caused by Plasmodium falciparum. A retrospective study was conducted to explore malaria-endemic characteristics in Guangxi during the 2004-2015 timeframe; a total of 2,726 confirmed malaria cases were reported, and the majority (90.3%) were due to P. falciparum (N = 1,697 [62.2%]) and Plasmodium vivax (N = 765 [28.1%]). Thirty-four indigenous cases (1.2%) were observed, with no cases of transmission recorded since 2012. Imported P. vivax and Plasmodium ovale infections increased since 2013. The interval between returning to China and the onset of illness was longer for P. vivax and P. ovale infections than for P. falciparum and Plasmodium malariae infections. The difference interval among the species is likely because of the relapse of P. vivax and P. ovale caused by the activation of the latent hypnozoites. Therefore, health clinics should raise awareness and carry out epidemiological studies and follow-up surveys on migrant workers to avoid misdiagnosis and mistreatment. The evaluation of radical treatment should be carried out using a genotyping technology based on glucose-6-phosphate dehydrogenase deficiency levels, and some new drugs active against the hypnozoites should be developed to mitigate malaria in the region.
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Affiliation(s)
- Kangming Lin
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Haiyan Wei
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Weikang Jiang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China
- WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
- National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Jun Li
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Weiwei Zhang
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Shujiao Wei
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Yichao Yang
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Yaming Huang
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Xiangyang Feng
- Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China
| | - Hong Tu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China
- WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
- National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Jun Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China
- WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
- National Center for International Research on Tropical Diseases, Shanghai 200025, China
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Cotter C, Sudathip P, Herdiana H, Cao Y, Liu Y, Luo A, Ranasinghe N, Bennett A, Cao J, Gosling RD. Piloting a programme tool to evaluate malaria case investigation and reactive case detection activities: results from 3 settings in the Asia Pacific. Malar J 2017; 16:347. [PMID: 28830519 PMCID: PMC5568298 DOI: 10.1186/s12936-017-1991-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Case investigation and reactive case detection (RACD) activities are widely-used in low transmission settings to determine the suspected origin of infection and identify and treat malaria infections nearby to the index patient household. Case investigation and RACD activities are time and resource intensive, include methodologies that vary across eliminating settings, and have no standardized metrics or tools available to monitor and evaluate them. METHODS In response to this gap, a simple programme tool was developed for monitoring and evaluating (M&E) RACD activities and piloted by national malaria programmes. During the development phase, four modules of the RACD M&E tool were created to assess and evaluate key case investigation and RACD activities and costs. A pilot phase was then carried out by programme implementers between 2013 and 2015, during which malaria surveillance teams in three different settings (China, Indonesia, Thailand) piloted the tool over a period of 3 months each. This study describes summary results of the pilots and feasibility and impact of the tool on programmes. RESULTS All three study areas implemented the RACD M&E tool modules, and pilot users reported the tool and evaluation process were helpful to identify gaps in RACD programme activities. In the 45 health facilities evaluated, 71.8% (97/135; min 35.3-max 100.0%) of the proper notification and reporting forms and 20.0% (27/135; min 0.0-max 100.0%) of standard operating procedures (SOPs) were available to support malaria elimination activities. The tool highlighted gaps in reporting key data indicators on the completeness for malaria case reporting (98.8%; min 93.3-max 100.0%), case investigations (65.6%; min 61.8-max 78.4%) and RACD activities (70.0%; min 64.7-max 100.0%). Evaluation of the SOPs showed that knowledge and practices of malaria personnel varied within and between study areas. Average monthly costs for conducting case investigation and RACD activities showed variation between study areas (min USD $844.80-max USD $2038.00) for the malaria personnel, commodities, services and other costs required to carry out the activities. CONCLUSION The RACD M&E tool was implemented in the three pilot areas, identifying key gaps that led to impacts on programme decision making. Study findings support the need for routine M&E of malaria case reporting, case investigation and RACD activities. Scale-up of the RACD M&E tool in malaria-eliminating settings will contribute to improved programme performance to the high level that is required to reach elimination.
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Affiliation(s)
- Chris Cotter
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF), 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA. .,Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden.
| | - Prayuth Sudathip
- Department of Disease Control, Bureau of Vector Borne Diseases, Ministry of Public Health, Nonthaburi, Thailand
| | - Herdiana Herdiana
- Paritrana Asia Foundation, Jakarta, Indonesia.,United Nations Children's Fund (UNICEF), Aceh Field Office, Banda Aceh, Indonesia
| | - Yuanyuan 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, Jiangsu, People's Republic of China
| | - 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, Jiangsu, People's Republic of China
| | - Alex Luo
- Global Health Sciences, University of California, San Francisco (UCSF), San Francisco, USA
| | | | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF), 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA.,Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco (UCSF), San Francisco, USA
| | - 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, Jiangsu, People's Republic of China
| | - Roly D Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF), 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA.,Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco (UCSF), San Francisco, USA
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Abstract
Complications arising from malaria are a concern for public health authorities worldwide, since the annual caseload in humans usually exceeds millions. Of more than 160 species of Plasmodium, only 4 infect humans, with the most severe cases ascribed to Plasmodium falciparum and the most prevalent to Plasmodium vivax. Over the past 70 years, since World War II, when the first antimalarial drugs were widely used, many efforts have been made to combat this disease, including vectorial control, new drug discoveries and genetic and molecular approaches. Molecular approaches, such as glycobiology, may lead to new therapeutic targets (both in the host and the parasites), since all interactions are mediated by carbohydrates or glycan moieties decorating both cellular surfaces from parasite and host cells. In this review, we address the carbohydrate-mediated glycobiology that directly affects Plasmodium survival or host resistance.
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Affiliation(s)
- Pollyanna S Gomes
- Departamento de Imunologia, Instituto de Microbiologia, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
| | - Daniel F Feijó
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz)Salvador, Brazil
| | - Alexandre Morrot
- Departamento de Imunologia, Instituto de Microbiologia, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil.,Instituto Oswaldo CruzFiocruz, Rio de Janeiro, Brazil
| | - Celio G Freire-de-Lima
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
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Wang D, Cotter C, Sun X, Bennett A, Gosling RD, Xiao N. Adapting the local response for malaria elimination through evaluation of the 1-3-7 system performance in the China-Myanmar border region. Malar J 2017; 16:54. [PMID: 28137293 PMCID: PMC5282924 DOI: 10.1186/s12936-017-1707-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background Assessing the essential components of ‘1-3-7’ strategy along the China–Myanmar border is critical to identify gaps and challenges to support evidence-based decision making. Methods A mixed-method retrospective study including quantitative and qualitative analysis of the 1-3-7 system components was conducted. Sampled counties were chosen based on malaria incidence from 1 January 2012 to 31 December 2014. Results All 260 confirmed malaria cases from sampled counties were reported within 1 day and had completed case investigations. 70.0% of all Reactive Case Detection (RACD) events were conducted and 90.1% of those were within 7 days. Only ten additional individuals were found malaria positive out of 3662 individuals tested (0.3%) by rapid diagnostic test during RACD events. Conclusions Key gaps were identified in case investigation and RACD activities in Yunnan Province border counties. This evidence supports improving the RACD (or “7”) response strategy in this setting. Given the challenges in this border region, it will be critical to adapt the RACD response to promote the malaria elimination along the China border. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1707-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Duoquan Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Pathology, World Health Organization Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Chris Cotter
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Xiaodong Sun
- Yunnan Institute of Parasitic Diseases, Puer, 665000, People's Republic of China
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Roly D Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Ning Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Pathology, World Health Organization Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China.
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