Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China.
Infect Dis Poverty. 2022 May 10;11(1):51. doi: 10.1186/s40249-022-00972-2.
Border malaria is one of the most intractable problems hindering malaria elimination worldwide. Movement of both the human population and anopheline mosquitoes infected with Plasmodium spp. can cause cross-border malaria transmission. The Yunnan border area was still hyperendemic for malaria in the early part of this century. The objective of this case study was to analyze the strategies, interventions and impacts of malaria control and elimination in the Yunnan border area.
A total of 10,349 malaria cases and 17.1 per 10,000 person-years of annual parasite incidence (API) were reported in the border area in 2003. Based on natural village-based stratification, integrated interventions, including mass drug administration for radical cures and preventive treatment, clinically presumptive treatment of all febrile patients for malaria and indoor residual spraying or dipping bed nets with insecticides were successfully carried out from 2003 to 2013. The overall API was reduced to 0.6 per 10,000 person-years by 2013, while effective cross-border collaboration interventions dramatically reduced the malaria burden in the neighbouring border areas of Myanmar. From 2014 forward, the comprehensive strategy, including universal coverage of surveillance to detect malaria cases, a rapid response to possible malaria cases and effective border collaboration with neighbouring areas, successfully eliminated malaria and prevented reintroduction of malaria transmission in the Yunnan border area.
In Yunnan malaria burden has successfully reduced by dynamically accurate stratification and comprehensive interventions; and then the region achieved elimination and prevented reintroduction of malaria transmission through intensive surveillance, rapid response and border collaboration. Other border areas should perform their own intervention trials to develop their own effective strategy.
边境疟疾是全球疟疾消除工作面临的最棘手问题之一。人口流动和携带疟原虫的按蚊的迁移均可导致跨境疟疾传播。本世纪初，云南边境地区仍存在疟疾高度流行。本病例研究旨在分析云南边境地区疟疾控制和消除的策略、干预措施及其影响。
2003 年，边境地区共报告疟疾病例 10349 例，年发病率（API）为 17.1/10000 人年。基于自然村的分层，2003 年至 2013 年期间，成功实施了综合干预措施，包括根治性药物治疗和预防性治疗的大规模药物治疗、对所有发热患者进行疟疾临床疑似治疗以及室内滞留喷洒或浸泡杀虫剂处理的蚊帐。到 2013 年，API 总体降至 0.6/10000 人年，而有效的跨境合作干预措施显著降低了缅甸邻国边境地区的疟疾负担。自 2014 年以来，包括全面监测以发现疟疾病例、对可能的疟疾病例做出快速反应以及与邻国有效合作的综合战略成功消除了疟疾，并防止了云南边境地区疟疾传播的再次发生。
云南通过动态精准分层和综合干预措施成功降低了疟疾负担；通过强化监测、快速反应和边境合作，该地区实现了消除疟疾并防止疟疾传播的再次发生。其他边境地区应开展自身的干预试验，制定有效的策略。
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