Impact of COVID-19 pandemic on the management of imported malaria in China / 中国血吸虫病防治杂志

Objective To examine the impact of COVID-19 pandemic on the epidemic status of imported malaria and national malaria control program in China, so as to provide insights into post-elimination malaria surveillance. Methods All data pertaining to imported malaria cases were collected from Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 through December 31, 2021. The number of malaria cases, species of malaria parasites, country where malaria parasite were infected, diagnosis and treatment after returning to China, and response were compared before (from January 1, 2018 to January 22, 2020) and after the COVID-19 pandemic (from January 23, 2020 to December 31, 2021). Results A total of 2 054 imported malaria cases were reported in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 to December 31, 2021, and there were 1 722 cases and 332 cases reported before and after the COVID-19 pandemic, respectively. All cases were reported within one day after definitive diagnosis. The annual mean number of reported malaria cases reduced by 79.30% in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region after the COVID-19 pandemic (171 cases) than before the pandemic (826 cases), and the number of monthly reported malaria cases significantly reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region since February 2020. There was a significant difference in the constituent ratio of species of malaria parasites among the imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 146.70, P < 0.05), and P. falciparum malaria was predominant before the COVID-19 pandemic (72.30%), while P. ovale malaria (44.28%) was predominant after the COVID-19 pandemic, followed by P. falciparum malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic (χ2 = 13.83, P < 0.05), and the proportion of malaria cases that acquired Plasmodium infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; χ2 = 4.34, P < 0.05), while the proportion of malaria cases that acquired Plasmodium infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; χ2 = 9.88, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; χ2= 3.87, P < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; χ2 = 3.95, P < 0.05). Conclusions The number of imported malaria cases remarkably reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region of China during the COVID-19 pandemic, with a decreased proportion of completing case investigations within 3 days. The sensitivity of the malaria surveillance-response system requires to be improved to prevent the risk of secondary transmission of malaria due to the sharp increase in the number of imported malaria cases following the change of the COVID-19 containment policy.

Bibliometric analysis of status quo and hotspots of health policy research under the concept of One Health based on CiteSpace / 中华地方病学杂志

Objective:To learn about the status quo and hotspots in the field of health policy research under the concept of One Health.Methods:The Web of Science Core Collection (WoS) database and China National Knowledge Infrastructure (CNKI) database from 2001 to 2020 were searched for publications in the field of health policy research under the concept of One Health. A total of 3 515 publications in English and 42 in Chinese were included, CiteSpace 5.6.R3 software was used to analyze the number of publications, countries, institutions, authors, and keywords, and to draw visual maps.Results:The number of publications in WoS database was 52 in 2001 and 500 in 2020, with an overall upward trend in the number of publications; the first relevant publication in CNKI database was published in 2009, and the number of publications increased to 13 by 2020, but the total number was still low (42). Among the countries, the USA had the highest number of publications (1 385), total citations (48 780) and highly cited (≥10 citations) publications (671). Switzerland had the highest citations per publication (89.72). China ranked 5th in the number of publications (160) and 8th in total citations (4 643) and citations per publication (29.02), with fewer highly cited publications (82). The English author partnership had a large collaborative team led by Chris Degeling at the University of Sydney; the Chinese author partnership had a large research team led by Lu Jiahai at the School of Public Health, Sun Yat-sen University. In terms of country cooperation, French node had the largest centrality (0.30), the centrality of Chinese nodes was 0.01. Emerging infectious diseases, zoonose, and antibiotic resistance were high-frequency keywords in the English publications, while COVID-19, zoonose, antibiotic resistance, and food safety were high-frequency keywords in the Chinese publications.Conclusions:From 2001 to 2020, the overall trend of the number of publications in health policy research under the concept of One Health worldwide is on the rise. Emerging infectious diseases, zoonose, antibiotic resistance, and food safety are the current research hotspots in this field.

Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group.

The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness.

Establishment and application of monitoring and evaluation indicator framework for malaria elimination at province and county levels in China / 中国血吸虫病防治杂志

Objective To establish a monitoring and evaluation indicator framework in the context of malaria elimination in pilot areas in China,so as to further assess the malaria elimination work in the future. Methods Based on the consultancy, and according to the government documents such as Action Plan for Malaria Elimination in China (2010-2020),Technical Guidance for Malaria Elimination,Programme Evaluation on Malaria Elimination,the indicators were set up at both provincial and county levels and their application was conducted in Yunnan and Anhui provinces to assess the accountability,accessibility and applicability. Results An indicator framework was built up including four key components,which were input,process, output and impact indicators,in which 95 were provincial indicators and 98 were county indicators. The completion rate of the indicators of Yunnan and Anhui provinces were 94.7%(90/95)and 95.8%(91/95)respectively;and the completion rate of in?dicators of Tengchong and Feidong counties were 93.9%(92/98)and 92.9%(91/98)respectively. Conclusion The estab?lished indicator framework is reliable and applicable,which could effectively help to track the malaria elimination progress and identify gaps.