Achievements of the national malaria control and elimination program in the People’s Republic of China: the Atlas of Malaria Transmission in China

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.

Keywords

malaria / transmission / control / elimination / China / atlas

Jun Feng et al.

References

[1] Zhou ZJ. The malaria situation in the People’s Republic of China. Bull World Health Organ 1981; 59(6): 931–936

[2] TangLH. Chinese achievements in malaria control and research. Chin J Parasitol Parasit Dis (Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi) 1999; 17: 257–259 (in Chinese)

[3] 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(1): 315

[4] FengJZhouSS. From control to elimination: the historical retrospect of malaria control and prevention in China. Chin J Parasitol Parasit Dis (Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi) 2019; 37(5): 505–513 (in Chinese)

[5] Tang LH, Qian HL, Xu SH. Malaria and its control in the People’s Republic of China. Southeast Asian J Trop Med Public Health 1991; 22(4): 467–476

[6] Ministryof Health of China. National Malaria Elimination Action Plan (2010–2020). Beijing: Ministry of Health of China, 2010

[7] Chen JH, Fen J, Zhou XN. From 30 million to zero malaria cases in China: lessons learned for China−Africa collaboration in malaria elimination. Infect Dis Poverty 2021; 10(1): 51

[8] Feng J, Xiao H, Xia Z, Zhang L, Xiao N. Analysis of malaria epidemiological characteristics in the People’s Republic of China, 2004−2013. Am J Trop Med Hyg 2015; 93(2): 293–299

[9] Feng J, Xia ZG, Vong S, Yang WZ, Zhou SS, Xiao N. Preparedness for malaria resurgence in China: case study on imported cases in 2000−2012. Adv Parasitol 2014; 86: 231–265

[10] Feng J, Yan H, Feng XY, Zhang L, Li M, Xia ZG, Xiao N. Imported malaria in China, 2012. Emerg Infect Dis 2014; 20(10): 1778–1780

[11] Feng J, Tu H, Zhang L, Xia Z, Zhou S. Imported malaria cases—China, 2012−2018. China CDC Wkly 2020; 2(17): 277–284

[12] FengJZhangLTuHZhouSSXiaZG. From elimination to post-elimination: characteristics, challenges and re-transmission preventing strategy of imported malaria in China. China Trop Med (Zhongguo Re Dai Yi Xue) 2021(1); 21: 5–10 (in Chinese)

[13] NationalDevelopmentReformCommissionMinistryof Foreign AffairsMinistryof Commerce of the People’s Republic of China. Vision and Actions on Jointly Building Silk Road Economic Belt and 21st-Century Maritime Silk Road. Beijing: The State Council of the People’s Republic of China, 2015

[14] ZhouXNXiaZGSongYJFengJYinJHFengXYLiuXWYangYZhangLZhouHJ. The Atlas of Malaria Transmission in China. Shanghai: Sinomap Press, 2020

[15] Yang GJ, Tanner M, Utzinger J, Malone JB, Bergquist R, Chan EY, Gao Q, Zhou XN. Malaria surveillance-response strategies in different transmission zones of the People’s Republic of China: preparing for climate change. Malar J 2012; 11(1): 426

[16] Feng J, Liu J, Feng X, Zhang L, Xiao H, Xia Z. Towards malaria elimination: monitoring and evaluation of the “1-3-7” approach at the China−Myanmar border. Am J Trop Med Hyg 2016; 95(4): 806–810

[17] Chen T, Zhang S, Zhou SS, Wang X, Luo C, Zeng X, Guo X, Lin Z, Tu H, Sun X, Zhou H. Receptivity to malaria in the China−Myanmar border in Yingjiang County, Yunnan Province, China. Malar J 2017; 16(1): 478

[18] Tambo E, Ai L, Zhou X, Chen JH, Hu W, Bergquist R, Guo JG, Utzinger J, Tanner M, Zhou XN. Surveillance-response systems: the key to elimination of tropical diseases. Infect Dis Poverty 2014; 3(1): 17

[19] Liu Y, Hsiang MS, Zhou H, Wang W, Cao Y, Gosling RD, Cao J, Gao Q. Malaria in overseas labourers returning to China: an analysis of imported malaria in Jiangsu Province, 2001−2011. Malar J 2014; 13(1): 29

[20] Wong J. Achieving universal health coverage. Bull World Health Organ 2015; 93(9): 663–664

[21] Wang D, Chaki P, Mlacha Y, Gavana T, Michael MG, Khatibu R, Feng J, Zhou ZB, Lin KM, Xia S, Yan H, Ishengoma D, Rumisha S, Mkude S, Mandike R, Chacky F, Dismasi C, Abdulla S, Masanja H, Xiao N, Zhou XN. Application of community-based and integrated strategy to reduce malaria disease burden in southern Tanzania: the study protocol of China−UK−Tanzania pilot project on malaria control. Infect Dis Poverty 2019; 8(1): 4

[22] Mlacha YP, Wang D, Chaki PP, Gavana T, Zhou Z, Michael MG, Khatib R, Chila G, Msuya HM, Chaki E, Makungu C, Lin K, Tambo E, Rumisha SF, Mkude S, Mahende MK, Chacky F, Vounatsou P, Tanner M, Masanja H, Aregawi M, Hertzmark E, Xiao N, Abdulla S, Zhou XN. Effectiveness of the innovative 1,7-malaria reactive community-based testing and response (1, 7-mRCTR) approach on malaria burden reduction in Southeastern Tanzania. Malar J 2020; 19(1): 292

[23] Zhou XN. China declared malaria-free: a milestone in the world malaria eradication and Chinese public health. Infect Dis Poverty 2021; 10(1): 98

[24] FengJZhangLZhangSSXiaZGZhouSS. The progress of national malaria elimination and epidemiological characteristics of malaria in China in 2017. Chin J Parasitol Parasit Dis (Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi) 2018; 36(3): 201−209 (in Chinese)

[25] Galappaththy GN, Fernando SD, Abeyasinghe RR. Imported malaria: a possible threat to the elimination of malaria from Sri Lanka?. Trop Med Int Health 2013; 18(6): 761–768

[26] Feng X, Levens J, Zhou XN. Protecting the gains of malaria elimination in China. Infect Dis Poverty 2020; 9(1): 43

[27] LinCYChenZWangSQLuoPZWuDLZhengAJWeiJJ. Investigation of a rare local epidemic of Plasmodium malariae infection in Sanya City, Hainan Province. China Trop Med (Zhongguo Re Dai Yi Xue) 2016; 16(5): 481–484 (in Chinese)

[28] SunYWYuDMChenJLiXWangBWangZJMaoLLYaoWQ. Two individual incidences of vivax malaria in Dandong municipality of Liaoning Province. Chin J Publ Heal (Zhongguo Gong Gong Wei Sheng) 2017; 33(2): 314–316 (in Chinese)

[29] FengJZhangLZhangSSXiaZGZhouSS. Epidemiological characteristics of malaria and the progress towards its elimination in China in 2018. Chin J Parasitol Parasit Dis (Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi) 2019; 37(3): 241–247 (in Chinese)

[30] Liu H, Zhou Y, Deng Y, Lin Z, Zhang C, Chen Q, Wei C, Duan K, Tian P, Zhou H, Xu J. Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003–2020: a case study. Infect Dis Poverty 2022; 11(1): 51

[31] Yang HL, Baloch Z, Xu JW, Sun XD, Lin ZR, Zhou YW, Zhao XT, Lv Q, Xu SY, Ding CL, Chen QY, Tian P, Dung KX, Xia XS, Zhou HN. Malaria: elimination tale from Yunnan Province of China and new challenges for reintroduction. Infect Dis Poverty 2021; 10(1): 101

[32] 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(1): 158

[33] Wang D, Lv S, Ding W, Lu S, Zhang H, Kassegne K, Xia S, Duan L, Ma X, Huang L, Gosling R, Levens J, Abdulla S, Mudenda M, Okpeku M, Matengu KK, Serge P Diagbouga, Xiao N, Zhou XN. Could China’s journey of malaria elimination extend to Africa?. Infect Dis Poverty 2022; 11(1): 55

[34] Qian MB, Li SZ, Zhou XN. After malaria: which parasitic disease will China eliminate next?. Nature 2021; 596(7871): 189

Acknowledgements

The work was supported by the key techniques in collaborative prevention and control of major infectious diseases in the Belt and Road (No. 2018ZX10101002-004). We thank all the staffs from the provincial CDCs in China and Chinese Center for Disease Control and Prevention who provided invaluable support in the study.

Compliance with ethics guidelines

Jun Feng, Li Zhang, Zhigui Xia, Shuisen Zhou, Ning Xiao, and Xiao-Nong Zhou declare that they have no competing interests. The data in the study were obtained from paper-source and web-source, therefore the ethics and participatory consent was not needed, and this study was approved by the National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention.

RIGHTS & PERMISSIONS

2022 Higher Education Press