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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  14. Bhatt S, 2015. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature 526: 207211. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  19. Limongi JE, 2005. Malaria outbreaks in a non-endemic area of Brazil, 2005. Rev Soc Bras Med Trop 41: 232237. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  22. Barclay VC, Smith RA, Findeis JL, , 2012. Surveillance considerations for malaria elimination. Malar J 11: 304. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  27. McCarthy AE, Morgan C, Prematunge C, Geduld J, , 2015. Severe malaria in Canada, 2001–2013. Malar J 14: 151. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]

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  • Received : 16 Jun 2017
  • Accepted : 25 Dec 2017
  • Published online : 26 Feb 2018

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