Sun Jun-Ling, Zhou Sheng, Geng Qi-Bin, Zhang Qian, Zhang Zi-Ke, Zheng Can-Jun, Hu Wen-Biao, Clements Archie C A, Lai Sheng-Jie, Li Zhong-Jie
Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan, 430072, China.
Infect Dis Poverty. 2016 Jun 27;5(1):65. doi: 10.1186/s40249-016-0163-4.
The elimination of malaria requires high-quality surveillance data to enable rapid detection and response to individual cases. Evaluation of the performance of a national malaria surveillance system could identify shortcomings which, if addressed, will improve the surveillance program for malaria elimination.
Case-level data for the period 2005-2014 were extracted from the China National Notifiable Infectious Disease Reporting Information System and Malaria Enhanced Surveillance Information System. The occurrence of cases, accuracy and timeliness of case diagnosis, reporting and investigation, were assessed and compared between the malaria control stage (2005-2010) and elimination stage (2011-2014) in mainland China.
A total of 210 730 malaria cases were reported in mainland China in 2005-2014. The average annual incidence declined dramatically from 2.5 per 100 000 people at the control stage to 0.2 per 100 000 at the elimination stage, but the proportion of migrant cases increased from 9.8 % to 41.0 %. Since the initiation of the National Malaria Elimination Programme in 2010, the overall proportion of cases diagnosed by laboratory testing consistently improved, with the highest of 99.0 % in 2014. However, this proportion was significantly lower in non-endemic provinces (79.0 %) than that in endemic provinces (91.4 %) during 2011-2014. The median interval from illness onset to diagnosis was 3 days at the elimination stage, with one day earlier than that at the control stage. Since 2011, more than 99 % cases were reported within 1 day after being diagnosed, while the proportion of cases that were reported within one day after diagnosis was lowest in Tibet (37.5 %). The predominant source of cases reporting shifted from town-level hospitals at the control stage (67.9 % cases) to city-level hospitals and public health institutes at the eliminate stage (69.4 % cases). The proportion of investigation within 3 days after case reporting has improved, from 74.6 % in 2010 to 98.5 % in 2014.
The individual case-based malaria surveillance system in China operated well during the malaria elimination stage. This ensured that malaria cases could be diagnosed, reported and timely investigated at local level. However, domestic migrants and overseas populations, as well as cases in the historically malarial non-endemic areas and hard-to-reach area are new challenges in the surveillance for malaria elimination.
消除疟疾需要高质量的监测数据，以便能够快速发现并应对个别病例。评估国家疟疾监测系统的性能可以找出不足之处，若加以解决，将改进疟疾消除监测计划。
从中国国家法定传染病报告信息系统和疟疾强化监测信息系统中提取2005 - 2014年期间的病例级数据。评估并比较了中国大陆疟疾控制阶段（2005 - 2010年）和消除阶段（2011 - 2014年）病例的发生情况、病例诊断、报告和调查的准确性及及时性。
2005 - 2014年中国大陆共报告210730例疟疾病例。年平均发病率从控制阶段的每10万人2.5例大幅下降至消除阶段的每10万人0.2例，但输入性病例的比例从9.8%增至41.0%。自2010年启动国家疟疾消除计划以来，实验室检测确诊病例的总体比例持续提高，2014年达到最高的99.0%。然而，在2011 - 2014年期间，非流行省份的这一比例（79.0%）显著低于流行省份（91.4%）。消除阶段从发病到诊断的中位间隔时间为3天，比控制阶段早1天。自2011年以来，超过99%的病例在确诊后1天内报告，而西藏确诊后1天内报告的病例比例最低（37.5%）。病例报告的主要来源从控制阶段的镇级医院（67.9%的病例）转变为消除阶段的市级医院和公共卫生机构（69.4%的病例）。病例报告后3天内开展调查的比例有所提高，从2010年的
