Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 12;18(1):235.
doi: 10.1186/s12936-019-2865-0.

Monitoring and evaluation of intervals from onset of fever to diagnosis before "1-3-7" approach in malaria elimination: a retrospective study in Shanxi Province, China from 2013 to 2018

Ting Wang  1 , Shui-Sen Zhou  2 , Jun Feng  2 , Myo Minn Oo  3 , Jing Chen  1 , Chang-Fu Yan  1 , Yi Zhang  4 , Ping Tie  5
Affiliations

Monitoring and evaluation of intervals from onset of fever to diagnosis before "1-3-7" approach in malaria elimination: a retrospective study in Shanxi Province, China from 2013 to 2018

Ting Wang et al. Malar J. .

Abstract

Background: China's 1-3-7 approach was extensively implemented to monitor the timeframe of case reporting, case investigation and foci response in the malaria elimination. However, activities before diagnosis and reporting (before '1') would counteract the efficiency of 1-3-7 approach but few data have evaluated this issue. This study aims to evaluate the timelines between onset of fever and diagnosis at healthcare facilities in Shanxi Province.

Methods: Routine data were extracted from IDIRMS and NMISM database from 2013 to 2018. Time intervals between onset of fever and healthcare-seeking and between healthcare-seeking and diagnosis were calculated. Each of the documented malaria cases was geo-coded and paired to the county-level layers of polygon.

Results: A total of 90 cases were reported in 2013-2018 in Shanxi Province, and 73% of cases reported at provincial health facilities. All malaria cases were imported from Africa (90%) and Southeast Asia (10%) especially around the Chinese Spring Festival (n = 46, 51%). The median days between fever and healthcare-seeking and between healthcare-seeking and diagnosis of malaria were 3 and 2, respectively.

Conclusions: The current "1-3-7" approach is well executed in Shanxi Province, but delays intervals observed in case finding before 1-3-7 approach occurred in all levels of facilities in Shanxi Province, which imply that more efforts are highlighted for timely case finding. Health education should be provided for improving awareness of healthcare-seeking, and various technical training aiming at the physicians should be carried out to improve diagnosis of malaria.

Keywords: Case diagnosis; Elimination; Malaria; Shanxi.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The number of the origin of imported cases (a) and distribution of imported cases in Shanxi Province of China stratified by species (b) between 1th January 2013 and 31th December 2018
Fig. 2
Fig. 2
Quarter distribution of malaria cases reported in Shanxi Province, China between 1th January 2013 and 31th December 2018. *The dotted line in the figure indicates the Spring Festival time
Fig. 3
Fig. 3
Malaria cases reported in Shanxi Province, China between 1th January 2013 and 31th December 2018
Fig. 4
Fig. 4
The interval from onset of fever to healthcare-seeking and the interval from healthcare-seeking to diagnosis among malaria cases in Shanxi province, China between 1th January 2013 and 31th December 2018
See this image and copyright information in PMC

References

    1. WHO. World malaria report 2018. Geneva: World Health Organization; 2018. https://www.who.int/malaria/publications/world-malaria-report-2018/en/2018. Accessed 19 Nov 2018.
    1. Feng J, Tu H, Zhang L, Zhang S, Jiang S, Xia Z, et al. Mapping transmission foci to eliminate malaria in the People's Republic of China, 2010–2015: a retrospective analysis. BMC Infect Dis. 2018;18:115. doi: 10.1186/s12879-018-3018-8. - DOI - PMC - PubMed
    1. Lai S, Li Z, Wardrop NA, Sun J, Head M, Huang Z, et al. Malaria in China, 2011–2015: an observational study. Bull World Health Organ. 2017;95:564–573. doi: 10.2471/BLT.17.191668. - DOI - PMC - PubMed
    1. Zhang Q, Lai S, Zheng C, Zhang H, Zhou S, Hu W, et al. The epidemiology of Plasmodium vivax and Plasmodium falciparum malaria in China 2004–2012: from intensified control to elimination. Malar J. 2014;13:419. doi: 10.1186/1475-2875-13-419. - DOI - PMC - PubMed
    1. Feng J, Zhang L, Huang F, Yin J, Tu H, Xia Z, et al. Ready for malaria elimination: zero indigenous case reported in the People's Republic of China. Malar J. 2018;17:315. doi: 10.1186/s12936-018-2444-9. - DOI - PMC - PubMed