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. 2022 May 10;11(1):51.
doi: 10.1186/s40249-022-00972-2.

Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

Hui Liu  1 , Yaowu Zhou  1 , Yan Deng  1 , Zurui Lin  1 , Canglin Zhang  1 , Qiyan Chen  1 , Chun Wei  1 , Kaixia Duan  1 , Peng Tian  1 , Hongning Zhou  2 , Jianwei Xu  1
Affiliations

Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

Hui Liu et al. Infect Dis Poverty. .

Abstract

Background: Border malaria is one of the most intractable problems hindering malaria elimination worldwide. Movement of both the human population and anopheline mosquitoes infected with Plasmodium spp. can cause cross-border malaria transmission. The Yunnan border area was still hyperendemic for malaria in the early part of this century. The objective of this case study was to analyze the strategies, interventions and impacts of malaria control and elimination in the Yunnan border area.

Main text: A total of 10,349 malaria cases and 17.1 per 10,000 person-years of annual parasite incidence (API) were reported in the border area in 2003. Based on natural village-based stratification, integrated interventions, including mass drug administration for radical cures and preventive treatment, clinically presumptive treatment of all febrile patients for malaria and indoor residual spraying or dipping bed nets with insecticides were successfully carried out from 2003 to 2013. The overall API was reduced to 0.6 per 10,000 person-years by 2013, while effective cross-border collaboration interventions dramatically reduced the malaria burden in the neighbouring border areas of Myanmar. From 2014 forward, the comprehensive strategy, including universal coverage of surveillance to detect malaria cases, a rapid response to possible malaria cases and effective border collaboration with neighbouring areas, successfully eliminated malaria and prevented reintroduction of malaria transmission in the Yunnan border area.

Conclusions: In Yunnan malaria burden has successfully reduced by dynamically accurate stratification and comprehensive interventions; and then the region achieved elimination and prevented reintroduction of malaria transmission through intensive surveillance, rapid response and border collaboration. Other border areas should perform their own intervention trials to develop their own effective strategy.

Keywords: Border area; China; Control; Elimination; International collaboration; Malaria; Yunnan.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The malaria intervention flow from hyperendemicity to elimination in the Yunnan border area. API annual parasite incidence, IRS indoor residual spraying with insecticides, ITNs insecticide-treated bed nets, LLINS long lasting insecticidal bed nets
Fig. 2
Fig. 2
The annual coverage of laboratory tests for malaria parasites and preventive treatment in the Yunnan border area, 2003‒2020
Fig. 3
Fig. 3
The annual parasite incidence (API) in the Yunnan border area, 2003‒2013
Fig. 4
Fig. 4
The number of malaria cases detected and the categories in the Yunnan border area, 2014‒2020. The last indigenous case (P. vivax) occurred in Yingjiang County on the China–Myanmar border in April 2016. It is also the last indigenous case in China
See this image and copyright information in PMC

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