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

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 . 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 ( = 1,697 [62.2%]) and ( = 765 [28.1%]). Thirty-four indigenous cases (1.2%) were observed, with no cases of transmission recorded since 2012. Imported and infections increased since 2013. The interval between returning to China and the onset of illness was longer for and infections than for and infections. The difference interval among the species is likely because of the relapse of and 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.