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. 2014 Nov 3:13:419.
doi: 10.1186/1475-2875-13-419.

The epidemiology of Plasmodium vivax and Plasmodium falciparum malaria in China, 2004-2012: from intensified control to elimination

Qian Zhang, Shengjie Lai, Canjun Zheng, Honglong Zhang, Sheng Zhou, Wenbiao Hu, Archie C A Clements, Xiao-Nong Zhou, Weizhong Yang, Simon I Hay, Hongjie Yu  1 , Zhongjie Li
Affiliations

The epidemiology of Plasmodium vivax and Plasmodium falciparum malaria in China, 2004-2012: from intensified control to elimination

Qian Zhang et al. Malar J. .

Abstract

Background: In China, the national malaria elimination programme has been operating since 2010. This study aimed to explore the epidemiological changes in patterns of malaria in China from intensified control to elimination stages.

Methods: Data on nationwide malaria cases from 2004 to 2012 were extracted from the Chinese national malaria surveillance system. The secular trend, gender and age features, seasonality, and spatial distribution by Plasmodium species were analysed.

Results: In total, 238,443 malaria cases were reported, and the proportion of Plasmodium falciparum increased drastically from <10% before 2010 to 55.2% in 2012. From 2004 to 2006, malaria showed a significantly increasing trend and with the highest incidence peak in 2006 (4.6/100,000), while from 2007 onwards, malaria decreased sharply to only 0.18/100,000 in 2012. Males and young age groups became the predominantly affected population. The areas affected by Plasmodium vivax malaria shrunk, while areas affected by P. falciparum malaria expanded from 294 counties in 2004 to 600 counties in 2012.

Conclusions: This study demonstrated that malaria has decreased dramatically in the last five years, especially since the Chinese government launched a malaria elimination programme in 2010, and areas with reported falciparum malaria cases have expanded over recent years. These findings suggest that elimination efforts should be improved to meet these changes, so as to achieve the nationwide malaria elimination goal in China in 2020.

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Figures

Figure 1
Figure 1
The seasonal distribution of malaria cases by month in China, 2004–2012. (A) The epidemic curve of cases by plasmodium species. Others contained Plasmodium ovale, Plasmodium malariae, mixed infection cases and untyped cases. (B) The seasonal index of P. vivax and P. falciparum malaria. The index was calculated by month, and it was the average case number for a given month (i.e. May) divided by the mean of case number in that corresponding month (i.e. May) during the whole nine years of 2004-2012. No obvious seasonal fluctuation was expected if the seasonal index of each month was close to 1.0.
Figure 2
Figure 2
The gender and age distribution of P. vivax and P. falciparum malaria in China, 2004–2012. (A) The proportion of cases by gender of P. vivax malaria. (B) The proportion of cases by gender of P. falciparum malaria. (C) The proportion of cases by age group of P. vivax malaria. (D) The proportion of cases by age group of P. falciparum malaria.
Figure 3
Figure 3
The geographical distribution of P. vivax and P. falciparum malaria by year in China, 2004–2012.
Figure 4
Figure 4
The changing of counties affected by P. vivax and P. falciparum malaria in China, 2004–2012.
See this image and copyright information in PMC

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