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Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study

BACKGROUND: Malaria control and elimination are challenged by diversity and complexity of the determinants on the international border in the Great Mekong Sub-region. Hekou, a Chinese county on the China–Vietnam border, was used to document Chinese experiences and lessons for malaria control and eli...

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Autores principales: Xu, Jian-Wei, Li, Jian-Jie, Guo, Hong-Ping, Pu, Shu-Wei, Li, Shu-Mei, Wang, Rong-Hua, Liu, Hui, Wang, Wei-Jia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297092/
https://www.ncbi.nlm.nih.gov/pubmed/28173802
http://dx.doi.org/10.1186/s12936-017-1709-z
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author Xu, Jian-Wei
Li, Jian-Jie
Guo, Hong-Ping
Pu, Shu-Wei
Li, Shu-Mei
Wang, Rong-Hua
Liu, Hui
Wang, Wei-Jia
author_facet Xu, Jian-Wei
Li, Jian-Jie
Guo, Hong-Ping
Pu, Shu-Wei
Li, Shu-Mei
Wang, Rong-Hua
Liu, Hui
Wang, Wei-Jia
author_sort Xu, Jian-Wei
collection PubMed
description BACKGROUND: Malaria control and elimination are challenged by diversity and complexity of the determinants on the international border in the Great Mekong Sub-region. Hekou, a Chinese county on the China–Vietnam border, was used to document Chinese experiences and lessons for malaria control and elimination. METHODS: The design was an ecological study. Malaria burden before 1951 and procedures of 64 years (1952–2015) from malaria hyperendemicity to elimination are described. Single and bilinear regression analysis was utilized to analyse the relationship between the annual malaria incidence (AMI) and gross domestic product (GDP), urbanization rate, and banana planting area (BPA). RESULTS: There was a huge malaria burden before 1951. AMI was reduced from 358.62 per 1000 person-years in 1953 to 5.69 per 1000 person-years in 1960. A system of primary health services, comprising three levels of county township hospitals and village health stations maintained malaria control and surveillance activities in changing political and social-economic settings. However, potential under-reported of malaria and market-oriented healthcare led to a malaria epidemic in 1987. Strong political commitment reoriented malaria from a control to an elimination programme. High coverage of malaria intervention and population access to intervention was crucial for malaria control and elimination; meanwhile, AMI was closely associated with socio-economic development, correlation coefficients (R) −0.6845 (95% CI −0.7978, −0.6845) for national GDP, −0.7014 (−0.8093, −0.7014) for national urbanization rate and −0.5563 (−0.7147, −0.3437) for BPA. CONCLUSIONS: Multifactor, including political commitment, effective interventions, social and economic development and changing ecological environment, and the complicated interactions between these factors contribute to malaria elimination in Hekou County. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-017-1709-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-52970922017-02-10 Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study Xu, Jian-Wei Li, Jian-Jie Guo, Hong-Ping Pu, Shu-Wei Li, Shu-Mei Wang, Rong-Hua Liu, Hui Wang, Wei-Jia Malar J Research BACKGROUND: Malaria control and elimination are challenged by diversity and complexity of the determinants on the international border in the Great Mekong Sub-region. Hekou, a Chinese county on the China–Vietnam border, was used to document Chinese experiences and lessons for malaria control and elimination. METHODS: The design was an ecological study. Malaria burden before 1951 and procedures of 64 years (1952–2015) from malaria hyperendemicity to elimination are described. Single and bilinear regression analysis was utilized to analyse the relationship between the annual malaria incidence (AMI) and gross domestic product (GDP), urbanization rate, and banana planting area (BPA). RESULTS: There was a huge malaria burden before 1951. AMI was reduced from 358.62 per 1000 person-years in 1953 to 5.69 per 1000 person-years in 1960. A system of primary health services, comprising three levels of county township hospitals and village health stations maintained malaria control and surveillance activities in changing political and social-economic settings. However, potential under-reported of malaria and market-oriented healthcare led to a malaria epidemic in 1987. Strong political commitment reoriented malaria from a control to an elimination programme. High coverage of malaria intervention and population access to intervention was crucial for malaria control and elimination; meanwhile, AMI was closely associated with socio-economic development, correlation coefficients (R) −0.6845 (95% CI −0.7978, −0.6845) for national GDP, −0.7014 (−0.8093, −0.7014) for national urbanization rate and −0.5563 (−0.7147, −0.3437) for BPA. CONCLUSIONS: Multifactor, including political commitment, effective interventions, social and economic development and changing ecological environment, and the complicated interactions between these factors contribute to malaria elimination in Hekou County. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-017-1709-z) contains supplementary material, which is available to authorized users. BioMed Central 2017-02-07 /pmc/articles/PMC5297092/ /pubmed/28173802 http://dx.doi.org/10.1186/s12936-017-1709-z Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Xu, Jian-Wei
Li, Jian-Jie
Guo, Hong-Ping
Pu, Shu-Wei
Li, Shu-Mei
Wang, Rong-Hua
Liu, Hui
Wang, Wei-Jia
Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study
title Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study
title_full Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study
title_fullStr Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study
title_full_unstemmed Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study
title_short Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study
title_sort malaria from hyperendemicity to elimination in hekou county on china–vietnam border: an ecological study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297092/
https://www.ncbi.nlm.nih.gov/pubmed/28173802
http://dx.doi.org/10.1186/s12936-017-1709-z
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