Malaria control along China-Myanmar Border during 2007-2013: an integrated impact evaluation.

BACKGROUND: Implementing effective interventions remain a lot of difficulties along all border regions. The emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great concern. China has effectively controlled cross-border transmission of malaria and artemisinin resistance of P. falciparum along the China-Myanmar border. METHODS: A combined quantitative and qualitative study was used to collect data, and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during 2007-2013. RESULTS: The parasite prevalence rate (PPR) in the five special regions of Myanmar was decreased from 13.6 % in March 2008 to 1.5 % in November 2013. Compared with the baseline (PPR in March 2008), the risk ratio was only 0.11 [95 % confidence interval (CI), 0.09-0. 14) in November 2013, which is equal to an 89 % reduction in the malaria burden. Annual parasite incidence (API) across 19 Chinese border counties was reduced from 19.6 per 10 000 person-years in 2006 to 0.9 per 10 000 person-years in 2013. Compared with the baseline (API in 2006), the API rate ratio was only 0.05(95 % CI, 0.04-0.05) in 2013, which equates to a reduction of the malaria burden by 95.0 %. Meanwhile, the health service system was strengthened and health inequity of marginalized populations reduced along the international border. CONCLUSION: The effective collaboration between China, Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified processes. The integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.

[Malaria epidemic trend and characteristics at monitoring sites in Yunnan province in 2008].

Malaria situation in 5 monitoring sites of Yunnan showed a decline trend from 2005 to 2008. The average malaria incidence in 2008 was 11.84/10,000 with a decrease of 66.1% in comparison to 2005. The seropositive rate with immuno-fluorescence assay (IFA) was 4.61% for pupils. 82% of the cases chose town or township hospitals as the first place of seeking diagnosis and treatment. 83.6% cases were diagnosed over 3 days of symptom appearing. The main clinical manifestation was fever every other day attack (occupied 72.7%). 98.4% of the cases were with light symptoms. The proportion of primary attacks and relapses among malaria patients were 95.3% and 4.7%, respectively. Plasmodium vivax was the main malaria parasite, occupying 81.2%. 97.2% of the local infected cases were found in the bordering areas of the country. The mosquito net utilization rate was 51.4%. Results showed that malaria has been effectively controlled in the monitoring sites of Yunnan.

[Serological detection of malaria for people entering China from 19 ports of entry covering 8 border prefectures of Yunnan].

OBJECTIVE: To evaluate malaria situation in areas of Yunnan Province bordering with Myanmar, Laos and Vietnam. METHODS: Blood samples on filter paper were collected from the entry people in March to December of 2007 involving 19 national and provincial ports of entry. Indirect fluorescent antibody test (IFAT) was carried out by using the blood samples collected before June 30 as the first half year and after July 1 as the second half year. Analysis was made on the relationship of IFAT positive rate and GMRT to malaria incidence in the province reported by the China information system for disease control and prevention. RESULTS: IFAT positive rate in the first half year (5.6%) was 20.9% higher than that of second half year (4.4%) (chi2=12.95%, P<0.05). There was a positive correlation between IFAT positive rate and the number of malaria cases reported in 2007 from the 8 bordering prefectures (r=0.8124, P<.05). The highest IFAT positive rate was found in Dehong (8.7%), Baoshan (7.1%), and Lingcang (65%). Among the 19 entry ports, the highest IFAT positive rate was found in 5 entry ports: Lvliang, Laying, Jiegao, Houqiao, and Qingshuihe, all in China-Myanmar border. The IFAT positive rate in the Chinese entry people increased with their days of staying outside the border. Among the entry people, the highest antibody positive rate was from those of Myanmar nationality (11.7%) followed by those from Yunnan (3.7%). CONCLUSION: To certain extent, higher malaria incidence outside the border impacts that of Yunnan Province.

[Malaria situation in Yunnan Province during 2001-2005].

OBJECTIVE: To analyze the trends of malaria incidence from 2001 to 2005 in Yunnan Province. METHOD: Malaria data in 2001-2005 were collected and statistically analyzed by using Microsoft excel 2003 and ArcView GIS 3.3 software. RESULTS: Among 63,562 malaria cases reported in the 5 years from 129 counties of 16 prefecture in the province, the average annual malaria incidence was 3.049/10,000 with an increase of 4.67% than the previous 5 years chi2 = 63.15, P < 0.05). There were 2 peaks of malaria incidence: May to August and October to November. Five prefectures with the highest malaria incidence were the prefecture bordering to the southern nations, and counties ranged first ten places of malaria incidence were all at the first line border areas besides Liang-He County which is in the second line border area. There were 23 counties with malaria incidence higher than 5 per ten thousand, occupying 80. 31% of all cases in the province but only 12.74% of the population. 87.30% of the cases and 79.36% of the death occurred in those under 45 years-old. Farmers, laborers and students were at the high-risk of malaria infection. Moving population accounted for 17.06% of the cases and 23.42% of the death in the province. CONCLUSION: Malaria is still an important part of public health in Yunnan Province, and people younger than 45 years-old, farmers, laborers and moving population are at the high risk for malaria infection.