Malaria situation in the People's Republic Of China in 2007.

Total 50148 malaria cases and 83551 suspected cases with 18 deaths were reported by the annual case reporting system in 1182 counties of 23 Provinces/Municipality/Autonomous Region (P/M/A) in 2007, and the annual incidence was 0.39/10000. Through the internet reporting system 46,988 malaria cases were reported from 1097 counties of 31 P/M/A. The number of malaria cases and the rank of P/M/A were basically in concordance in two systems. Among the 1182 counties with reported malaria cases, 26 counties with an incidence of more than 10/10000 distributed in Yunnan (9 counties), Hainan (5), Anhui (9), Henan (2), and Tibet (1). There were 72 counties in which the malaria incidence was between 1/10000 and 10/10000. 1830 Plasmodium falciparum malaria cases accounted for 3.6% of the total cases, of which 65.1% (1192) were imported cases reported in 187 counties/cities of 18 P/M/A. Indigenous falciparum malaria was found in 37 counties/cities of Yunnan and Hainan Provinces, of which 24 counties/cities were in Yunnan, decreased by 2, 13 counties/cities were in Hainan, 1 increased compared to that of 2006. Focal outbreaks occurred in 210 villages of 10 counties in Yunnan, Guizhou, Henan and Hubei provinces. 679 malaria cases resulting from outbreaks accounted for 1.4% of the total reported cases. Although a considerable decrease in malaria incidence contributed to the implementation of the National Malaria Control Program and a project supported by the Global Fund, Yunnan and Hainan Provinces were still the relatively high transmission areas. Yunnan ranked No.2 in the country in terms of the number of cases, while Hainan ranked down to No.2 by malaria incidence since 2006. 13157 malaria cases were reported from the two provinces in 2007, accounting for 26.2% of the total reported cases in the country. There were 9770 cases with 9 deaths reported from Yunnan, the incidence was 2.44/10000, a decrease of 37.3% than that in the last year. Among the reported cases, 1486 were falciparum malaria with 65.6% imported cases. The number of reported cases in Hainan was 3 387, with an incidence of 4.05/10000, 12.9% decrease than the last year. In central China, the re-emergence of malaria was held back on the whole in 2007, Anhui was still the number one in the country by either the number of cases or malaria incidence. 27 278 malaria cases were reported from Anhui Province in 2007, accounting for 54.4% of the total cases in the country, with an incidence of 5.0/10000 decreased by 21.9% than that in 2006. The number of reported cases in Henan Province was 4174, decreased by 21.4% in incidence. Hubei Province reported 1768 malaria cases with an incidence of 0.31/10000, same as the 2006. 940 cases were reported from Jiangsu Province, increased by 22.6% compared to that in 2006. Cases reported from other P/M/A occupied about 5.7% of the total. Several hundreds were reported from each of Guizhou, Sichuan, Guangdong, Zhejiang, Shandong and Shanghai. Less than 100 cases were reported from each of Guangxi, Fujian, Jiangxi, Hunan, Chongqing, Liaoning, Shaanxi, Shanxi, Gansu Provinces in 2007. In summary, the re-emergence of malaria has been basically contained through several years' effort, but it is still an important problem of public health in China, especially in the southern and central parts. Yunnan and Hainan still faced a severe situation of malaria endemic with the spread of Plasmodium falciparum, especially imported malaria in the border areas. In the central parts of the country, especially in Anhui, malaria was considerably serious with the highest incidence and most malaria cases in 2007. In addition, provinces not covered by the Global Fund Program such as Guizhou, Zhejiang, Guangdong were confronted an increasing disease burden by malaria, which may become a new challenge to the National Malaria Control Program.