Malaria in the Guangxi Zhuang Autonomous Region in China: A Twelve-Year Surveillance Data Study

Kangming Lin Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Haiyan Wei Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Weikang Jiang National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China;
Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China;
WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China;
National Center for International Research on Tropical Diseases, Shanghai 200025, China

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Jun Li Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Weiwei Zhang Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Shujiao Wei Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Yichao Yang Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Yaming Huang Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Xiangyang Feng Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi 530021, China;

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Hong Tu National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China;
Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China;
WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China;
National Center for International Research on Tropical Diseases, Shanghai 200025, China

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Jun Feng National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China;
Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China;
WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China;
National Center for International Research on Tropical Diseases, Shanghai 200025, China

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The incidence of an indigenous malaria, defined as malaria acquired by a local mosquito transmission, declined from 2004 to 2015 in the Guangxi Zhuang Autonomous Region. However, imported malaria, defined as malaria acquired from other endemic regions outside of China, has been increasing in the region, as in the rest of the country, particularly the disease caused by Plasmodium falciparum. A retrospective study was conducted to explore malaria-endemic characteristics in Guangxi during the 2004–2015 timeframe; a total of 2,726 confirmed malaria cases were reported, and the majority (90.3%) were due to P. falciparum (N = 1,697 [62.2%]) and Plasmodium vivax (N = 765 [28.1%]). Thirty-four indigenous cases (1.2%) were observed, with no cases of transmission recorded since 2012. Imported P. vivax and Plasmodium ovale infections increased since 2013. The interval between returning to China and the onset of illness was longer for P. vivax and P. ovale infections than for P. falciparum and Plasmodium malariae infections. The difference interval among the species is likely because of the relapse of P. vivax and P. ovale caused by the activation of the latent hypnozoites. Therefore, health clinics should raise awareness and carry out epidemiological studies and follow-up surveys on migrant workers to avoid misdiagnosis and mistreatment. The evaluation of radical treatment should be carried out using a genotyping technology based on glucose-6-phosphate dehydrogenase deficiency levels, and some new drugs active against the hypnozoites should be developed to mitigate malaria in the region.

Author Notes

Address correspondence to Jun Feng, 207 Ruijin Rd., Shanghai 200025, China. E-mail: fjphilip1983@hotmail.com

Authors’ addresses: Kangming Lin, Haiyan Wei, Jun Li, Weiwei Zhang, Shujiao Wei, Yichao Yang, Yaming Huang, and Xiangyang Feng, Institute of Parasitic Diseases, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Guangxi, People’s Republic of China, E-mails: linkangming814@163.com, whym_006@163.com, lijun-68@21cn.com, 27330579@qq.com, weijiu-197@163.com, yychao@tom.com, 1724501964@qq.com, and 981458660@qq.com. Weikang Jiang, Hong Tu, and Jun Feng, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, People’s Republic of China, Key Laboratory of Parasite and Vector Biology, MOH, Shanghai 200025, People’s Republic of China, WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, People’s Republic of China, and National Center for International Research on Tropical Diseases, Shanghai 200025, People’s Republic of China, E-mails: cdcshjwk2002@yahoo.com.cn, tuhong372@163.com, and fjphilip1983@hotmail.com.

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