| Popis: |
Background: Border malaria is always one of the most intractable problems in the path to malaria elimination worldwide. Movement of both human population and anophelines mosquitoes infected with Plasmodium spp can cause cross-border malaria transmission. The border areas of Yunnan were still malaria hyperendemicity in the early of this century.Methods: This case study collected all available data related to border malaria surveillance and control in 25 border counties from 2003 to 2020 to analyses strategies, interventions and their efficacy.Results: Number of malaria cases was a total of 10 349 cases with an annual parasite incidence (API) 17.10 per 10000 person-years in the border area in 2003. From 2003 to 2013, integrated interventions based on natural village-based stratification, including mass drug administration for radical cure and preventive treatment, presumptive treatment of all febrile patients for malaria and indoor residual spraying or dipping bed nets with insecticides were successfully carried out. By 2013, overall API was reduced to 0.62 per 10000 person-years, meanwhile, effective cross border collaboration for malaria control reduced malaria burden by 90% in neighbouring border areas of Myanmar. From 2017 with zero indigenous case forward, the comprehensive strategy, including universal coverage of surveillance to detect malaria cases, rapid response to any malaria cues and effective border collaboration with neighbouring successfully eliminated malaria and fully prevented reintroduction of malaria transmission in 25 border counties of Yunnan. Conclusions: Border malaria elimination is an intensive intervention. The local context based strategy contributes to malaria control and elimination, and then prevent reintroduction of malaria transmission. Other border areas should do their own intervention trials to develop their own strategy. |
