Malaria transmission is highly related to the natural factors such as temperature, rainfall and topography.Recently, the GIS/RS/GPS techniques were developed based on computer science and spatial analysis technology, which were widely used in data collection and analysis, establishment of mathematics model.This paper reviews the applications and development of GIS/RS/GPS techniques in the studies of relationship between natural factors and malaria transmission.

Objective To investigate intra and inter species molecular variations and phylogeny of the five members of the Minimus Group of Anopheles subgenus Cellia in China: An. aconitus, An.varuna, An.jeyporiensis, An.minimus A and An.minimus C, and to report the DNA sequence divergence among these species at a mitochondrial locus (cytochrome oxidase II). Methods Single mosquito′s legs were digested to extract DNA. COII gene was amplified, sequenced and analysed; and the phylogenetic tree of members of An.minimus group was reconstructed by maximum likelihood method (DNAML). Results and Conclusion The data confirmed the presence of two cryptic species, A and C, within An.minimus complex in the research localities; and two species differed by 2.3% in the COII sequences owing to 16 nucleotide substitutions. There was less variation between the two species than other members of the Minimus Group.

Totally,42 319 malaria cases and 57 787 suspected cases with 48 deaths were reported by the Annual Case Repor-ting System in 1186 counties of 21 Provinces/Municipality/Autonomous Region(P/M/A) in 2005,and the annual incidence was 0.59/10 000,an increase of 55.3% than that of the last year.Through the Case Reporting Information System,an internet reporting process started in 2004,40 371 malaria cases were reported from 1 075 counties of 31 P/M/A.The number of malaria cases and the rank of P/M/A were basically in concordance by the two systems.Among the 1186 counties with reported malaria cases,27 counties had an incidence of more than 10/10 000 distributed in Yunnan(15 counties),Hainan(7 counties) and Anhui(5 counties).There were 80 counties in which the malaria incidence was between 1/10 000 and 10/10 000.The number of Plasmodium falciparum malaria cases was 4 146,accounting for 9.8% of the total cases,of which 63.5%(2 632) were imported cases in 178 counties/cities of 18 P/M/A.Indigenous falciparum malaria was found in 47 counties/cities of Yunnan and Hainan Provinces,of which 31 counties/cities were in Yunnan,increased by 29,16 counties/cities were in Hainan,same with that of 2004.Yunnan and Hainan Provinces are still relatively high transmission areas.Yunnan ranked No.2 in the country in terms of the number of cases while Hainan ranked No.1 by malaria incidence in 2005.19 588 malaria cases were reported from the two provinces in 2005,accounting for 46.3% of the total reported cases in the country.There were 15 072 cases with 38 deaths reported from Yunnan,the incidence was 4.95/10 000,an increase of 60.2% than that in the last year.Among the reported cases,3 497 were falciparum malaria with 69.0% imported from the bordering nations.The number of reported cases in Hainan was 4 516,with an incidence of 5.46/10 000,53.1% decrease than the last year.In central China,the resurgence of malaria was considerable in provinces along the Huai River,especially in Anhui Province.The number of malaria cases in Anhui came to the highest in the country in 2005,with 15 681 malaria cases and 7 662 suspected cases reported,accounting for 37.5% of the total cases in the country,and an incidence of 2.45/10 000,increased by 77.5% than that in 2004.The number of reported cases in Henan Province was 2 349,increased by 55.2% in incidence.Hubei Province reported 1 564 malaria cases with an incidence of 0.27/10 000,decreased by 42.6%.651 cases were reported from Jiangsu Province,almost the same as that in 2004.Focal outbreaks occurred in 277 villages of 20 counties in Anhui,Hubei and Jiangsu,where Anopheles sinensis is the principal transmission vector.Malaria cases reported from the above 4 provinces accounted for 47.8% of the national figure,increased approximately by 10% than the last year.Cases reported from P/M/A in the South and East China occupied about 4.9% of the total,similar to that in 2004.Several hundreds were reported from each of Guizhou,Sichuan,Guangxi,Guangdong,Zhejiang,Shanghai and Hunan.Less than 100 cases were reported from each of Fujian,Chongqing,Shandong,Shanghai,Jiangxi,Liaoning,Shaanxi,Shanxi and Gansu Provinces in 2005.High attention should be paid to Guizhou and Tibet.Focal outbreaks occurred in Guizhou for consecutive 4 years,and malaria cases in 2005 double increased than the last year.77.8% of the reported cases were indigenous patients,which implied that local transmission resulting from imported malaria cases has become a major problem in Guizhou.93 malaria cases were reported from Linzhi District of the Tibetan Autonomous Region in 2005,76 cases more than that in 2004.In summary,malaria is still an important problem of public health in China,especially in the southern and central parts.Yunnan and Hainan still faced a severe situation of malaria endemics with the spread of Plasmodium falciparum,especially imported malaria in the 25 border counties in Yunnan.In the central part of the country,especially Anhui Province,the malaria prevalence was highly unstable with frequent focal outbreaks in areas along the Huai River,which revealed new challenges to the malaria control program in China.In addition,more attention needs to be paid to the malaria control in Guizhou and Tibet.

Objective To explore the application of seasonal time series ARIMA model in prediction of malaria incidence in an unstable malaria area. Methods SPSS13.0 software was used to construct the ARIMA model based on the monthly malaria incidence of Huaiyuan and Tongbai counties in Huaihe River Valley, from Jan. 1998 to Dec. 2005, with consideration of residual un-correlation and concision. Akaike′s information criterion (AIC) and Bayesian information criterion (BIC) were used to confirm the fitness of model. The constructed model was then applied to predict the monthly malaria incidence in 2006 and the incidence from ARIMA model was compared with the actual incidence, so as to evaluate the model′s validity. Malaria incidence of 2007 was predicted by ARIMA model based on malaria incidence from 1998 to 2006. Results Statistics assisted estimation of the significance of the fitted autoregressive and seasonal moving average coefficients (AR1=0.512, SMA1=0.609, P

Objective To determine the key interventions transferring from the control to elimination of malaria in China so as to provide the basic information for achieving malaria elimination. Methods Based on the data collected from the document entitled of The National Annual Report on Schistosomiasis,Malaria and Echinococcosis,published by the National Institute of Parasitic Diseases of Chinese Center for Disease Control and Prevention,the malaria incidence and intervention data were se?lected only in the typical endemic provinces during the period of 2004-2010. The correlation between the incidence and interven?tions in the target provinces was analyzed based on the Panel Data Regression Model,and the key interventions were deter?mined. Results Four provinces namely Anhui,Yunnan,Hainan and Henan were targeted with 87.56%of the national malaria figures from 2004 to 2010. When Y was given as vivax malaria incidence,X1 as the log of the number of historical cases receiving radical treatment in the pre?transmission stage(RTPT)(F=14.53,P<0.01,R2=0.72),X2 as the log of risk population receiv?ing RTPR(F=15.90,P<0.01,R2=0.71)and X3 as the number of technicians trained in microscopy(F=11.53,P<0.01,R2=0.61),three space?fixed effect models were established respectively,and X1,X2,as well as X3 had negative effects on Y value. When Y was given as falciparum malaria incidence,X1 as the accumulated technicians trained in microscopy(F=11.06,P<0.01,R2=0.87),X2 as the log of technicians trained in entomology(F=15.28,P<0.01,R2=0.89),two two?way(space and time)fixed effect models were established respectively,and both X1 and X2 had negative effects on Y value. Conclusion RTPT among historical patients and at?risk populations as well as microscopy training influences the variation of vivax malaria inci? dence,while the significant interventions of microscopy training and vector control training indicate that the integrated measures with strengthened capacity in diagnosis and vector control are of importance in the control of falciparum malaria transmission.

Objective To analyze the epidemiological characteristics of the imported malaria cases in 20 counties at the bor?der region of Yunnan Province from 2012 to 2014,so as to provide the evidence?based proof for adjusting the strategies in the elimination stage. Methods The malaria epidemic data of the 20 border counties in Yunnan Province from 2012 to 2014 were collected and analyzed by using Microsoft Excel 2010. Results From 2012 to 2014,a total of 1 558 malaria cases were report?ed in the 20 border counties in Yunnan Province,among which,1 336 were imported cases,accounting for 85.75%(1 336/1 558),and 222 were indigenous cases,accounting for 14.25%(222/1 558). The number of the imported cases in the above years took up 80.00%(544/680),89.10%(425/477)and 91.52%(367/401)of the total reported cases in the whole year,re?spectively. Among all the 1 336 imported cases,1 045(78.22%)were infected with Plasmodium vivax,284(21.26%)were in?fected with P. falciparum,3 were infected with P. malariae,3 were mixed infection and 1 was an unclassified case;2 patients died. And 95.58%of the cases were mainly infected in Myanmar(1 277 cases). Young and middle?aged adult of 20-40 years who worked overseas were the predominant(802 cases,60.03%)and most of the cases occurred from April to June of the year (679 cases,50.82%). Those cases mainly distributed in Tengchong(459 cases),Ruili(366 cases),Yingjiang(191 cases)and Mangshi(78 cases). Conclusions The epidemic situation of imported malaria is serious in the border region of Yunnan Prov?ince. Therefore,the surveillance system of malaria control needs to be well planned and managed to ensure timely case detection and prompt response at the elimination and post?elimination stage.

Objective: To analyze the performance of the 5 Global Fund Malaria Programmes in China from 2003 to 2013. Methods: All of the proposals, summaries, progress reports, survey reports, Monitoring& Evaluation reports, and performance rating reports of the 5 Global Fund Malaria Programmes in China and the epidemic data of program areas were collected for statistical analysis from 2012 to 2014. Symposiums were held with relevant experts from national and provincial Centers for Disease Control and Prevention, program managers and staffs from national and provincial Global Fund Malaria Programme offices. The completion of the relevant programme indicators (including the general grant information such as program areas, beneficiaries and funding; the implementation of malaria control measures; the performance of malaria control measures; the malaria incidence in the program areas; the prevalence of malaria parasites; and program management and performance evaluation) were analyzed, and the results: of the symposiums were summarized. Results The implementation period of the 5 Global Fund Malaria Programs were as follows: Round 1 from 2003 to 2008, Round 5 from 2006 to 2010, Round 6 from 2007 to 2012, Round 10 from 2012 to 2013, and National Strategy Application (NSA) from 2010 to 2012. Under the support of all the Global Fund Malaria Programs, a total of 11 936 726 fever cases received microscopic tests, 1 485 915 confirmed and suspected malaria cases were treated, 1 579 773 Long Lasting Insecticide-treated Nets were distributed, 3 414 633 regular nets were treated by insecticide, 40 298 284 primary and middle school students received health education on malaria control. Compared with the baseline value, the completion rates of each indicator increased after the implementation of the programs. The growth value ranged from 12.83% to 83.11%, among which the biggest growth was the value of the indicator'Percentage of households with at least one LLIN/ITN in target areas’, and it increased from 9.2% (baseline value of 2006) to 92.31% (value of 2012). The malaria incidence in program areas has dropped significantly year by year, the annual reported malaria incidence in Yunnan and Hainan provinces decreased from 1 950/100 000, 3 850/100 000 in 2002 to 3.31/100 000, 0.15/100 000 in 2012, the P. falciparum malaria incidence in target counties in Hainan province decreased from 90.6/100 000 in 2002 to 0/100 000 in 2012. As from the implementation of NSA grant in 2010 to 2012, the annual reported malaria incidence in 92% of the 75 Type 1 counties was less than 1 per 10 000, 60.00% of Type 1 counties and 98.69% of the 687 Type 2 counties reported zero locally transmitted malaria cases. The Global Fund Secretariat had conducted a total of 37 performance evaluations, of which 9 have been rated as A1, 4 rated as A2, 19 rated as B1 and 5 rated as B1. Conclusions The Global Fund Malaria Program in China has been closely integrated with the goal and task of National Malaria Control Program, reducing malaria burden in target areas, and pushing Chinese malaria control efforts to move from control to elimination.

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.
Humans ; Malaria/prevention & control* ; China/epidemiology*

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.
China/epidemiology* ; Clinical Laboratory Techniques ; Global Health ; Humans ; Laboratories ; Malaria/prevention & control*

The dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) genes of Plasmodium vivax, as antifolate resistance-associated genes were used for drug resistance surveillance. A total of 375 P. vivax isolates collected from different geographical locations in China in 2009-2019 were used to sequence Pvdhfr and Pvdhps. The majority of the isolates harbored a mutant type allele for Pvdhfr (94.5%) and Pvdhps (68.2%). The most predominant point mutations were S117T/N (77.7%) in Pvdhfr and A383G (66.8%) in Pvdhps. Amino acid changes were identified at nine residues in Pvdhfr. A quadruple-mutant haplotype at 57, 58, 61, and 117 was the most frequent (57.4%) among 16 distinct Pvdhfr haplotypes. Mutations in Pvdhps were detected at six codons, and the double-mutant A383G/A553G was the most prevalent (39.3%). Pvdhfr exhibited a higher mutation prevalence and greater diversity than Pvdhps in China. Most isolates from Yunnan carried multiple mutant haplotypes, while the majority of samples from temperate regions and Hainan Island harbored the wild type or single mutant type. This study indicated that the antifolate resistance levels of P. vivax parasites were different across China and molecular markers could be used to rapidly monitor drug resistance. Results provided evidence for updating national drug policy and treatment guidelines.
Antimalarials/pharmacology* ; China/epidemiology* ; Drug Combinations ; Drug Resistance/genetics* ; Folic Acid Antagonists/pharmacology* ; Humans ; Mutation ; Plasmodium vivax/genetics* ; Prevalence