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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Malaria | Research

Establishing and applying an adaptive framework for imported malaria: a field practice in Anhui Province, China from 2012 to 2022

Authors: Tao Zhang, Xian Xu, Bowen Liu, Duoquan Wang, Xiangguang Ye, Jingjing Jiang, Shuqi Wang, Xiaofeng Lyu, Chen Yu, Cuicui Tian, Zijian Liu, Xuechun Lu, Shizhu Li, Weidong Li

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Anhui Province is currently facing an increase in imported malaria cases as a result of globalization and international travel. In response, Anhui Province has implemented a comprehensive adaptive framework to effectively address this threat.

Methods

This study collected surveillance data from 2012 to 2022 in Anhui Province. Descriptive statistics were used to analyze the epidemiological characteristics of imported malaria cases. Additionally, multivariate logistic regression was employed to identify factors associated with severe malaria. Documents were reviewed to document the evolution of the adaptive framework designed to combat imported malaria. The effectiveness of the adaptive framework was evaluated based on the rates of timely medical visits, timely diagnosis, and species identification.

Results

During the study period, a total of 1008 imported malaria cases were reported across 77 out of 105 counties in Anhui Province, representing a coverage of 73.33%. It was found that 10.52% of imported cases went undiagnosed for more than seven days after onset. The multivariate analysis revealed several potential risk factors for severe malaria, including increasing age (OR = 1.049, 95%CI:1.015–1.083), occupation (waitperson vs. worker, OR = 2.698, 95%CI:1.054–6.906), a longer time interval between onset and the initial medical visit (OR = 1.061, 95%CI:1.011–1.114), and misdiagnosis during the first medical visit (OR = 5.167, 95%CI:2.535–10.533). Following the implementation of the adaptive framework, the rates of timely medical visits, timely diagnosis, and species identification reached 100.00%, 78.57%, and 100.00%, respectively.

Conclusions

Anhui Province has successfully developed and implemented an adaptive framework for addressing imported malaria, focusing on robust surveillance, prompt diagnosis, and standardized treatment. The experiences gained from this initiative can serve as a valuable reference for other non-endemic areas.
Literature
3.
go back to reference Tang L. Progress in malaria control in China. Chin Med J (Engl). 2000;113(1):89–92.PubMed Tang L. Progress in malaria control in China. Chin Med J (Engl). 2000;113(1):89–92.PubMed
4.
go back to reference [Malaria situation in the People’s Republic of China in 1999]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2000;18(3):129–31. [Malaria situation in the People’s Republic of China in 1999]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2000;18(3):129–31.
5.
go back to reference Ministry of Health of the People’s Republic of China. Action plan of China malaria elimination (2010–2020).2010. http://www.gov.cn/zwgk/ 2010-05/ 26/ conte nt_ 16141 76. htm. Accessed 2 July 2023. Ministry of Health of the People’s Republic of China. Action plan of China malaria elimination (2010–2020).2010. http://​www.​gov.​cn/​zwgk/​ 2010-05/ 26/ conte nt_ 16141 76. htm. Accessed 2 July 2023.
6.
go back to reference Feng J, Zhang L, Huang F, Yin JH, Tu H, Xia ZG, Zhou SS, Xiao N, Zhou XN. Ready for malaria elimination: zero indigenous case reported in the people’s Republic of China. Malar J. 2018;17(1):315.CrossRefPubMedPubMedCentral Feng J, Zhang L, Huang F, Yin JH, Tu H, Xia ZG, Zhou SS, Xiao N, Zhou XN. Ready for malaria elimination: zero indigenous case reported in the people’s Republic of China. Malar J. 2018;17(1):315.CrossRefPubMedPubMedCentral
7.
go back to reference Zhou XN. China declared malaria-free: a milestone in the world malaria eradication and Chinese public health. Infect Dis Poverty 2021, 10(1). Zhou XN. China declared malaria-free: a milestone in the world malaria eradication and Chinese public health. Infect Dis Poverty 2021, 10(1).
8.
go back to reference Zhang T, Xu X, Jiang J, Yu C, Tian C, Xie Q, Li W. Risk factors of severe imported malaria in Anhui province, China. Acta Trop. 2019;197:104934.CrossRefPubMed Zhang T, Xu X, Jiang J, Yu C, Tian C, Xie Q, Li W. Risk factors of severe imported malaria in Anhui province, China. Acta Trop. 2019;197:104934.CrossRefPubMed
9.
go back to reference Li W, Zhang T, Xu X, Jiang J, Yu C, Tian C, Wang S, Lyu X, Liu Z. Problems Associated with the diagnosis of Imported Malaria in Anhui Province, China. Am J Trop Med Hyg. 2020;102(1):142–6.CrossRefPubMed Li W, Zhang T, Xu X, Jiang J, Yu C, Tian C, Wang S, Lyu X, Liu Z. Problems Associated with the diagnosis of Imported Malaria in Anhui Province, China. Am J Trop Med Hyg. 2020;102(1):142–6.CrossRefPubMed
12.
13.
go back to reference Cao J, Sturrock HJ, Cotter C, Zhou S, Zhou H, Liu Y, Tang L, Gosling RD, Feachem RG, Gao Q. Communicating and monitoring surveillance and response activities for malaria elimination: China’s 1-3-7 strategy. PLoS Med. 2014;11(5):e1001642.CrossRefPubMedPubMedCentral Cao J, Sturrock HJ, Cotter C, Zhou S, Zhou H, Liu Y, Tang L, Gosling RD, Feachem RG, Gao Q. Communicating and monitoring surveillance and response activities for malaria elimination: China’s 1-3-7 strategy. PLoS Med. 2014;11(5):e1001642.CrossRefPubMedPubMedCentral
14.
go back to reference Zhang T, Wang DQ, Qian YJ, Ruan W, Liu Y, Xia J, Yan H, Sui Y, Lu SN, Xu X et al. Profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria: a retrospective study in China, 2014–2021. Infect Dis Poverty 2022, 11(1). Zhang T, Wang DQ, Qian YJ, Ruan W, Liu Y, Xia J, Yan H, Sui Y, Lu SN, Xu X et al. Profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria: a retrospective study in China, 2014–2021. Infect Dis Poverty 2022, 11(1).
15.
go back to reference Lu GY, Cao YY, Chen Q, Zhu GD, Muller O, Cao J. Care-seeking delay of imported malaria to China: implications for improving post-travel healthcare for migrant workers. J Travel Med 2022, 29(4). Lu GY, Cao YY, Chen Q, Zhu GD, Muller O, Cao J. Care-seeking delay of imported malaria to China: implications for improving post-travel healthcare for migrant workers. J Travel Med 2022, 29(4).
16.
go back to reference Newman RD, Parise ME, Barber AM, Steketee RW. Malaria-related deaths among US travelers, 1963–2001. Ann Intern Med. 2004;141(7):547–55.CrossRefPubMed Newman RD, Parise ME, Barber AM, Steketee RW. Malaria-related deaths among US travelers, 1963–2001. Ann Intern Med. 2004;141(7):547–55.CrossRefPubMed
17.
go back to reference Daily JP, Minuti A, Khan N. Diagnosis, treatment, and Prevention of Malaria in the US A Review. Jama-J Am Med Assoc. 2022;328(5):460–71.CrossRef Daily JP, Minuti A, Khan N. Diagnosis, treatment, and Prevention of Malaria in the US A Review. Jama-J Am Med Assoc. 2022;328(5):460–71.CrossRef
18.
go back to reference Bastaki H, Carter J, Marston L, Cassell J, Rait G. Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review. Travel Med Infect Di. 2018;21:21–7.CrossRef Bastaki H, Carter J, Marston L, Cassell J, Rait G. Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review. Travel Med Infect Di. 2018;21:21–7.CrossRef
19.
go back to reference Lu GY, Cao YY, Chai LY, Li YP, Li SY, Heuschen AK, Chen Q, Muller O, Cao J, Zhu GD. Barriers to seeking health care among returning travellers with malaria: a systematic review. Trop Med Int Health. 2022;27(1):28–37.CrossRefPubMed Lu GY, Cao YY, Chai LY, Li YP, Li SY, Heuschen AK, Chen Q, Muller O, Cao J, Zhu GD. Barriers to seeking health care among returning travellers with malaria: a systematic review. Trop Med Int Health. 2022;27(1):28–37.CrossRefPubMed
20.
go back to reference Zhang M, Liu ZY, He HT, Luo L, Wang SQ, Bu HL, Zhou X. Knowledge, attitudes, and practices on Malaria Prevention among Chinese International travelers. J Travel Med. 2011;18(3):173–7.CrossRefPubMed Zhang M, Liu ZY, He HT, Luo L, Wang SQ, Bu HL, Zhou X. Knowledge, attitudes, and practices on Malaria Prevention among Chinese International travelers. J Travel Med. 2011;18(3):173–7.CrossRefPubMed
22.
go back to reference Yu T, Fu Y, Kong X, Liu X, Yan G, Wang Y. Epidemiological characteristics of imported malaria in Shandong Province, China, from 2012 to 2017. Sci Rep. 2020;10(1):7568.CrossRefPubMedPubMedCentralADS Yu T, Fu Y, Kong X, Liu X, Yan G, Wang Y. Epidemiological characteristics of imported malaria in Shandong Province, China, from 2012 to 2017. Sci Rep. 2020;10(1):7568.CrossRefPubMedPubMedCentralADS
23.
go back to reference Lin K, Wei H, Jiang W, Li J, Zhang W, Wei S, Yang Y, Huang Y, Feng X, Tu H, et al. Malaria in the Guangxi Zhuang Autonomous Region in China: a twelve-year Surveillance Data Study. Am J Trop Med Hyg. 2017;97(4):1163–9.CrossRefPubMedPubMedCentral Lin K, Wei H, Jiang W, Li J, Zhang W, Wei S, Yang Y, Huang Y, Feng X, Tu H, et al. Malaria in the Guangxi Zhuang Autonomous Region in China: a twelve-year Surveillance Data Study. Am J Trop Med Hyg. 2017;97(4):1163–9.CrossRefPubMedPubMedCentral
24.
go back to reference Zhang X, Yao L, Sun J, Pan J, Chen H, Zhang L, Ruan W. Malaria in Southeastern China from 2012 to 2016: analysis of Imported cases. Am J Trop Med Hyg. 2018;98(4):1107–12.CrossRefPubMedPubMedCentral Zhang X, Yao L, Sun J, Pan J, Chen H, Zhang L, Ruan W. Malaria in Southeastern China from 2012 to 2016: analysis of Imported cases. Am J Trop Med Hyg. 2018;98(4):1107–12.CrossRefPubMedPubMedCentral
25.
go back to reference Feng J, Zhang L, Tu H, Zhou SS, Xia ZG. From elimination to post-elimination: characteristics, challenges and re-transmission preventing strategy of imported malaria in China. Chin Trop Med. 2021;21(01):5–10. Feng J, Zhang L, Tu H, Zhou SS, Xia ZG. From elimination to post-elimination: characteristics, challenges and re-transmission preventing strategy of imported malaria in China. Chin Trop Med. 2021;21(01):5–10.
26.
go back to reference Xu JW, Lin ZR, Zhou YW, Lee RG, Shen HM, Sun XD, Chen QY, Duan KX, Tian P, Ding CL et al. Intensive surveillance, rapid response and border collaboration for malaria elimination: China Yunnan’s ‘’3 + 1’’strategy. Malar J 2021, 20(1). Xu JW, Lin ZR, Zhou YW, Lee RG, Shen HM, Sun XD, Chen QY, Duan KX, Tian P, Ding CL et al. Intensive surveillance, rapid response and border collaboration for malaria elimination: China Yunnan’s ‘’3 + 1’’strategy. Malar J 2021, 20(1).
27.
go back to reference Jelinek T, TropNetEurop. Imported Falciparum malaria in Europe: 2007 data from TropNetEurop. Euro Surveill 2008, 13(23). Jelinek T, TropNetEurop. Imported Falciparum malaria in Europe: 2007 data from TropNetEurop. Euro Surveill 2008, 13(23).
28.
go back to reference Cullen KA, Arguin PM, Division of Parasitic D, Malaria, CfGHCfDC. Prevention: Malaria surveillance–United States, 2011. MMWR Surveill Summ 2013, 62(5):1–17. Cullen KA, Arguin PM, Division of Parasitic D, Malaria, CfGHCfDC. Prevention: Malaria surveillance–United States, 2011. MMWR Surveill Summ 2013, 62(5):1–17.
29.
go back to reference Zhang T, Wang S, Wang D, Auburn S, Lu S, Xu X, Jiang J, Lyu X, Yu C, Tian C, et al. Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012–2019. Malar J. 2021;20(1):15.CrossRefPubMedPubMedCentral Zhang T, Wang S, Wang D, Auburn S, Lu S, Xu X, Jiang J, Lyu X, Yu C, Tian C, et al. Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012–2019. Malar J. 2021;20(1):15.CrossRefPubMedPubMedCentral
30.
go back to reference Delaigue S, Signolet I, Consigny PH, de Gentile L, D’Ortenzio E, Gautret P, Sorge F, Strady C, Bouchaud O. New guidelines for the prevention of imported malaria in France. Med Mal Infect. 2020;50(2):113–26.CrossRefPubMed Delaigue S, Signolet I, Consigny PH, de Gentile L, D’Ortenzio E, Gautret P, Sorge F, Strady C, Bouchaud O. New guidelines for the prevention of imported malaria in France. Med Mal Infect. 2020;50(2):113–26.CrossRefPubMed
31.
go back to reference Li W, Zhang X, Feng J, Zhang T, Xu X, Jiang J, Wang S, Lyu X, Li S, Lu M. Evaluation of the combination of rapid diagnostic tests and microscopy for imported malaria surveillance in Anhui Province, China. Acta Trop. 2021;222:106042.CrossRefPubMed Li W, Zhang X, Feng J, Zhang T, Xu X, Jiang J, Wang S, Lyu X, Li S, Lu M. Evaluation of the combination of rapid diagnostic tests and microscopy for imported malaria surveillance in Anhui Province, China. Acta Trop. 2021;222:106042.CrossRefPubMed
33.
go back to reference Mace KE, Lucchi NW, Tan KR. Malaria Surveillance - United States, 2018. MMWR Surveill Summ 2022, 71(8):1–35. Mace KE, Lucchi NW, Tan KR. Malaria Surveillance - United States, 2018. MMWR Surveill Summ 2022, 71(8):1–35.
Metadata
Title
Establishing and applying an adaptive framework for imported malaria: a field practice in Anhui Province, China from 2012 to 2022
Authors
Tao Zhang
Xian Xu
Bowen Liu
Duoquan Wang
Xiangguang Ye
Jingjing Jiang
Shuqi Wang
Xiaofeng Lyu
Chen Yu
Cuicui Tian
Zijian Liu
Xuechun Lu
Shizhu Li
Weidong Li
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Malaria
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18239-w

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