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. 2014 May 27;11(6):5651-64.
doi: 10.3390/ijerph110605651.

The epidemiology of imported malaria in Taiwan between 2002-2013: the importance of sensitive surveillance and implications for pre-travel medical advice

Shou-Chien Chen  1 , Hsiao-Ling Chang  2 , Kow-Tong Chen  3
Affiliations

The epidemiology of imported malaria in Taiwan between 2002-2013: the importance of sensitive surveillance and implications for pre-travel medical advice

Shou-Chien Chen et al. Int J Environ Res Public Health. .

Abstract

The purpose of this study was to assess the epidemiology of imported malaria in Taiwan between 2002 and 2013. We analyzed the national data recorded by the Taiwan Centers for Disease Control (Taiwan CDC). Malaria cases were diagnosed by blood films, polymerase chain reaction, or rapid diagnostic tests. The risk of re-establishment of malarial transmission in Taiwan was assessed. A total of 229 malaria cases were included in our analysis. All of the cases were imported. One hundred and ninety-two cases (84%) were diagnosed within 13 days of the start of symptoms/signs; 43% of these cases were acquired in Africa and 44% were acquired in Asia. Plasmodium falciparum was responsible for the majority (56%) of these cases. Travel to an endemic area was associated with the acquisition of malaria. The malaria importation rate was 2.36 per 1,000,000 travelers (range 1.20-5.74). The reproductive number under control (Rc) was 0. No endemic transmission of malaria in Taiwan was identified. This study suggests that a vigilant surveillance system, vector-control efforts, case management, and an educational approach focused on travelers and immigrants who visit malaria endemic countries are needed to prevent outbreaks and sustain the elimination of malaria in Taiwan.

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Figures

Figure 1
Figure 1
Annual number of imported malaria cases by species in Taiwan.
Figure 2
Figure 2
Malaria importation rate and number of imported cases in Taiwan by year.
Figure 3
Figure 3
(A) A map of imported malaria cases in Taiwan, 2002–2013, and (B) distribution of Anopheles minimus in Taiwan. The grey areas indicate the collection of An. minimus adults (at least once) based on the light trap data, 2003–2006.
See this image and copyright information in PMC

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