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Malaria in China 2011-2015: an observational study

Malaria in China 2011-2015: an observational study
Malaria in China 2011-2015: an observational study
Objective To ascertain the trends and burden of malaria in China and the costs of intervention for 2011-2015 while experiencing transitions between funders during a national plan launched to interrupt malaria transmission in most counties by 2015 and ultimately eliminate malaria by 2020.
Methods We analysed the spatiotemporal and demographic features of autochthonous and imported malaria using disaggregated surveillance data on malaria from 2011 to 2015, covering the range of dominant malaria vectors in China. The total and mean costs for malaria elimination were calculated by funding sources, interventions, and population at risk.
Findings A total of 17,745 malaria cases, including 123 deaths (0.7%), were reported in mainland China from 2011-2015, with 89% being imported cases, mainly from Africa and Southeast Asia. Most counties (99.9%) have achieved their elimination goals by 2015, and autochthonous cases dropped from 1,469 cases in 2011 to 43 cases in 2015, mainly occurring in the regions bordering Myanmar where Anopheles minimus and An. dirus are the dominant vector species. A total of US$134.6 million was spent in efforts to eliminate malaria during 2011-2015, with US$57.2 million (42.5%) from the Global Fund and US$77.3 million (57.5%) from the Chinese Central Government. The average annual investment per person at risk was $0.05 (SD 0.03) with the highest ($0.09) in 2012 and subsequent reductions between 2013 and 2015 after the Global Fund ceased providing investments.
Conclusion The autochthonous malaria burden in China has decreased significantly, and malaria elimination is an achievable prospect in China. The key challenge is to address the remaining autochthonous transmission, as well as simultaneously reducing importation from Africa and Southeast Asia. Continued efforts and appropriate levels of investment are needed in the 2016-2020 period to achieve elimination.
Keywords: Malaria; epidemiology; elimination; cost; importation; China.
Malaria; epidemiology; elimination; cost; importation; China
0042-9686
545-608
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Li, Zhongjie
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Wardrop, Nicola A.
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Sun, Junling
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Head, Michael G.
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Huang, Zhuojie
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Zhou, Sheng
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Yu, Jianxing
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Zhang, Zike
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Zhou, Shui-Sen
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Xia, Zhigui
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Wang, Rubo
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Zheng, Bin
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Ruan, Yao
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Zhang, Li
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Zhou, Xiao-Nong
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Tatem, Andrew J.
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Yu, Hongjie
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Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Li, Zhongjie
f89a98f7-f6d3-4312-995a-bc658ae9a93f
Wardrop, Nicola A.
8f3a8171-0727-4375-bc68-10e7d616e176
Sun, Junling
4f56058d-f603-4758-9b92-873ac36de30f
Head, Michael G.
67ce0afc-2fc3-47f4-acf2-8794d27ce69c
Huang, Zhuojie
07e288b7-51b3-414a-82b7-28d83b114be6
Zhou, Sheng
7e1366af-4a36-4d9b-b5b0-9b6f73131d7a
Yu, Jianxing
992198dd-6055-4905-ab28-11ced790c57c
Zhang, Zike
85c05276-59dd-4033-82c9-4d33e872906b
Zhou, Shui-Sen
1e5e0a43-4d9f-433c-b936-cc653f801427
Xia, Zhigui
9e5b25ff-df79-49a0-8db0-aaa6831bc231
Wang, Rubo
8ee1c518-dfe6-414c-8f16-54ec9aadbd65
Zheng, Bin
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Ruan, Yao
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Zhang, Li
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Zhou, Xiao-Nong
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Tatem, Andrew J.
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c

Lai, Shengjie, Li, Zhongjie, Wardrop, Nicola A., Sun, Junling, Head, Michael G., Huang, Zhuojie, Zhou, Sheng, Yu, Jianxing, Zhang, Zike, Zhou, Shui-Sen, Xia, Zhigui, Wang, Rubo, Zheng, Bin, Ruan, Yao, Zhang, Li, Zhou, Xiao-Nong, Tatem, Andrew J. and Yu, Hongjie (2017) Malaria in China 2011-2015: an observational study. Bulletin of the World Health Organization, 95 (8), 545-608. (doi:10.2471/BLT.17.191668).

Record type: Article

Abstract

Objective To ascertain the trends and burden of malaria in China and the costs of intervention for 2011-2015 while experiencing transitions between funders during a national plan launched to interrupt malaria transmission in most counties by 2015 and ultimately eliminate malaria by 2020.
Methods We analysed the spatiotemporal and demographic features of autochthonous and imported malaria using disaggregated surveillance data on malaria from 2011 to 2015, covering the range of dominant malaria vectors in China. The total and mean costs for malaria elimination were calculated by funding sources, interventions, and population at risk.
Findings A total of 17,745 malaria cases, including 123 deaths (0.7%), were reported in mainland China from 2011-2015, with 89% being imported cases, mainly from Africa and Southeast Asia. Most counties (99.9%) have achieved their elimination goals by 2015, and autochthonous cases dropped from 1,469 cases in 2011 to 43 cases in 2015, mainly occurring in the regions bordering Myanmar where Anopheles minimus and An. dirus are the dominant vector species. A total of US$134.6 million was spent in efforts to eliminate malaria during 2011-2015, with US$57.2 million (42.5%) from the Global Fund and US$77.3 million (57.5%) from the Chinese Central Government. The average annual investment per person at risk was $0.05 (SD 0.03) with the highest ($0.09) in 2012 and subsequent reductions between 2013 and 2015 after the Global Fund ceased providing investments.
Conclusion The autochthonous malaria burden in China has decreased significantly, and malaria elimination is an achievable prospect in China. The key challenge is to address the remaining autochthonous transmission, as well as simultaneously reducing importation from Africa and Southeast Asia. Continued efforts and appropriate levels of investment are needed in the 2016-2020 period to achieve elimination.
Keywords: Malaria; epidemiology; elimination; cost; importation; China.

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Manuscript_revised_tracked Malaria in China - Accepted Manuscript
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Accepted/In Press date: 9 May 2017
e-pub ahead of print date: 26 May 2017
Published date: August 2017
Keywords: Malaria; epidemiology; elimination; cost; importation; China

Identifiers

Local EPrints ID: 413209
URI: http://eprints.soton.ac.uk/id/eprint/413209
ISSN: 0042-9686
PURE UUID: 4f08e6cb-0d0f-486d-a943-d9bdf9e4f6ff
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148
ORCID for Michael G. Head: ORCID iD orcid.org/0000-0003-1189-0531
ORCID for Andrew J. Tatem: ORCID iD orcid.org/0000-0002-7270-941X

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Date deposited: 17 Aug 2017 16:30
Last modified: 07 Oct 2020 02:21

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Contributors

Author: Shengjie Lai ORCID iD
Author: Zhongjie Li
Author: Junling Sun
Author: Michael G. Head ORCID iD
Author: Zhuojie Huang
Author: Sheng Zhou
Author: Jianxing Yu
Author: Zike Zhang
Author: Shui-Sen Zhou
Author: Zhigui Xia
Author: Rubo Wang
Author: Bin Zheng
Author: Yao Ruan
Author: Li Zhang
Author: Xiao-Nong Zhou
Author: Andrew J. Tatem ORCID iD
Author: Hongjie Yu

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