Volume 98, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



To study the epidemiological distribution and the incident trends of imported malaria from 2012 to 2016 in Zhejiang Province, southeastern China, we collected data on malaria from the Information System for Parasitic Disease Control and Prevention. A total of 1,003 malaria cases were reported during 2012–2016, and all of these cases were imported. was the predominant species (76.3%) in Zhejiang Province. The percentage of decreased from 33.6% to 8.1%, whereas the percentage of and increased. Most cases were male (89.8%), mostly in the age group of 21–50 years (82.6%). Businessmen (33.0%), workers (21.0%), farmers (18.8%), and overseas laborers (11.7%) were at high risk. The origin of the largest number of imported cases was Africa (89.5%), followed by Asia (10.0%) and Oceania (0.5%). The time interval from illness onset to confirmation was found to be significantly associated with the complications of patients. Out of 3,461 febrile individuals tested during reactive case detection, 10 malaria-positive individuals were identified. Effective surveillance and response system should be strengthened to prevent the reintroduction of malaria.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. World Health Organization, 2016. World Malaria Report 2016. Geneva, Switzerland: WHO Press.
  2. Li YN, Wen L, Li CY, Zhang WY, Sun HL, Zou W, Li SL, Sun YS, , 2013. Descriptive analysis of trends of malaria prevalence in China from 2006 to 2010. Chin J Publ Health 29: 263265.
  3. Ministry of Health of the People’s Republic of China, 2010. Action Plan of China Malaria Elimination (2010–2020). Available at: http://www.gov.cn/gzdt/att/att/site1/20100526/001e3741a2cc0d67233801.doc. Accessed May 26, 2010.
  4. Chen HL, Yao LN, Zhang LL, Zhang X, Lu QY, Yu KG, Ruan W, , 2015. Malaria in Zhejiang Province, China, from 2005 to 2014. Am J Trop Med Hyg 93: 305309.
  5. Chinese Centre for Disease Control and Prevention, 2011. Technical Scheme of China Malaria Elimination, 2011th edition. Available at: http://www.chinacdc.cn/jkzt/crb/nj/jszl_2223/201109/U020110906536170416565.pdf. Accessed September 6, 2011.
  6. Zhou S, Li ZJ, Cotter C, Zheng CJ, Zhang Q, Li HZ, Zhou SS, Zhou XN, Yu HJ, Yang WZ, , 2016. Trends of imported malaria in China 2010–2014: analysis of surveillance data. Malar J 15: 39.
  7. Cao YY, Wang WM, Liu YB, Cotter C, Zhou HY, Zhu GD, Tang JX, Tang F, Lu F, Xu S, , 2016. The increasing importance of Plasmodium ovale and Plasmodium malariae in a malaria elimination setting: an observational study of imported cases in Jiangsu Province, China, 2011–2014. Malar J 15: 459.
  8. Pistone T, Guibert P, Gay F, Malvy D, Ezzedine K, Receveur MC, Siriwardana M, Larouzé B, Bouchaud O, , 2007. Malaria risk perception, knowledge and prophylaxis practices among travellers of African ethnicity living in Paris and visiting their country of origin in sub-Saharan Africa. Tran R Soc Trop Med Hyg 101: 990995.
  9. Zhang M, Liu ZY, He HT, Luo L, Wang SQ, Bu HL, Zhou X, , 2011. Knowledge, attitudes, and practices on malaria prevention among Chinese international travelers. J Travel Med 18: 173177.
  10. Ye XG, Zhu GF, Ji YJ, Xu J, Shi Q, , 2014. Investigation on knowledge of malaria among exit laborers at Anhui port [in Chinese]. Chin Front Health Quar 37: 154157.
  11. Jelinek T, 2002. Imported falciparum malaria in Europe: sentinel surveillance data from the European network on surveillance of imported infectious diseases. Clin Infect Dis 34: 572576.
  12. Liu YB, Hsiang MS, Zhou HY, Wang WM, Cao YY, Gosling RD, Cao J, Gao Q, , 2014. Malaria in overseas labourers returning to China: an analysis of imported malaria in Jiangsu Province, 2001–2011. Malar J 13: 29.
  13. Cotter C, Sturrock HJ, Hsiang MS, Liu J, Phillips AA, Hwang J, Gueye CS, Fullman N, Gosling RD, Feachem RG, , 2013. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet 382: 900911.
  14. Bhatt S, 2015. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature 526: 207211.
  15. Doderer-Lang C, 2014. The ears of the African elephant: unexpected high seroprevalence of Plasmodium ovale and Plasmodium malariae in healthy populations in Western Africa. Malar J 13: 240.
  16. Betson M, Sousa-Figueiredo JC, Atuhaire A, Arinaitwe M, Adriko M, Mwesigwa G, Nabonge J, Kabatereine NB, Sutherland CJ, Stothard JR, , 2014. Detection of persistent Plasmodium spp. infections in Ugandan children after artemether-lumefantrine treatment. Parasitology 141: 18801890.
  17. Birkenmeyer L, Muerhoff AS, Dawson GJ, Desai SM, , 2010. Isolation and characterization of the MSP1 genes from Plasmodium malariae and Plasmodium ovale. Am J Trop Med Hyg 82: 9961003.
  18. Yao LN, 2006. Identification on the malaria vector with sequence analysis of the ribosomal DNA ITS2 region in Zhejiang Province [in Chinese]. J Pathog Biol 1: 217218, 228.
  19. Limongi JE, 2005. Malaria outbreaks in a non-endemic area of Brazil, 2005. Rev Soc Bras Med Trop 41: 232237.
  20. Liu H, 2016. Investigation and control of a Plasmodium falciparum malaria outbreak in Shan Special Region II of Myanmar along the China-Myanmar Border from June to December 2014. Infect Dis Poverty 5: 32.
  21. Zoller T, Naucke TJ, May J, Hoffmeister B, Flick H, Williams CJ, Frank C, Bergmann F, Suttorp N, Mockenhaupt FP, , 2009. Malaria transmission in non-endemic areas: case report, review of the literature and implications for public health management. Malar J 8: 71.
  22. Barclay VC, Smith RA, Findeis JL, , 2012. Surveillance considerations for malaria elimination. Malar J 11: 304.
  23. Cao J, Sturrock HJ, Cotter C, Zhou SS, Zhou HY, Liu Y, Tang LH, Gosling RD, Feachem RG, Gao Q, , 2014. Communicating and monitoring surveillance and response activities for malaria elimination: China’s “1-3-7” strategy. PLoS Med 11: e1001642.
  24. Clements AC, Reid HL, Kelly GC, Hay SI, , 2013. Further shrinking the malaria map: how can geospatial science help to achieve malaria elimination? Lancet Infect Dis 13: 709718.
  25. Chen SC, Chang HL, Chen KT, , 2014. The epidemiology of imported malaria in Taiwan between 2002–2013: the importance of sensitive surveillance and implications for pre-travel medical advice. Int J Environ Res Public Health 11: 56515664.
  26. Sturrock HJ, Roberts KW, Wegbreit J, Ohrt C, Gosling RD, , 2015. Tackling imported malaria: an elimination endgame. Am J Trop Med Hyg 93: 139144.
  27. McCarthy AE, Morgan C, Prematunge C, Geduld J, , 2015. Severe malaria in Canada, 2001–2013. Malar J 14: 151.
  28. Li KJ, Huang GQ, Zhang HX, Lin W, Dong XR, Pi Q, Pei SJ, Hu LQ, , 2013. Epidemic situation and control strategy of imported malaria in Hubei Province from 2006 to 2011. Chin J Schisto Control 25: 259262.
  29. Wang DQ, Cotter C, Sun XD, Bennett A, Gosling RD, Xiao N, , 2017. Adapting the local response for malaria elimination through evaluation of the 1-3-7 system performance in the China–Myanmar border region. Malar J 16: 54.
  30. Cheng ZB, Wang DQ, Tian XY, Sun Y, Sun XD, Xiao N, Zheng Z, , 2015. Capture and ligation probe-PCR (CLIP-PCR) for molecular screening, with application to active malaria surveillance for elimination. Clin Chem 61: 821828.
  31. Feng J, Liu J, Feng XY, Zhang L, Xiao HH, Xia ZG, , 2016. Towards malaria elimination: monitoring and evaluation of the “1-3-7” approach at the China–Myanmar border. Am J Trop Med Hyg 95: 806810.

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  • Received : 16 Jun 2017
  • Accepted : 25 Dec 2017

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