Laboratory diagnosis for malaria in the elimination phase in China: efforts and challenges

Abstract

Malaria remains a global health challenge, although an increasing number of countries will enter pre-elimination and elimination stages. The prompt and precise diagnosis of symptomatic and asymptomatic carriers of Plasmodium parasites is the key aspect of malaria elimination. Since the launch of the China Malaria Elimination Action Plan in 2010, China has formulated clear goals for malaria diagnosis and has established a network of malaria diagnostic laboratories within medical and health institutions at all levels. Various external quality assessments were implemented, and a national malaria diagnosis reference laboratory network was established to strengthen the quality assurance in malaria diagnosis. Notably, no indigenous malaria cases have been reported since 2017, but the risk of re-establishment of malaria transmission cannot be ignored. This review summarizes the lessons about malaria diagnosis in the elimination phase, primarily including the establishments of laboratory networks and quality control in China, to better improve malaria diagnosis and maintain a malaria-free status. A reference is also provided for countries experiencing malaria elimination.

Keywords

malaria / laboratory diagnosis / quality control / malaria elimination / China

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Acknowledgements

This work was supported by the National Science and Technology Major Program of China (No. 2018ZX10101002-002), the Fifth Round of Three-Year Public Health Action Plan of Shanghai (No. GWV-10.1-XK13), and the Bill & Melinda Gates Foundation (No. INV-018913).

Compliance with ethics guidelines

Jianhai Yin, Mei Li, He Yan, Shuisen Zhou, and Zhigui Xia declare that they have no financial conflicts of interest. This manuscript is a review article and does not involve a research protocol requiring approval by a relevant institutional review board or ethics committee.

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