Malaria control along China-Myanmar Border during 2007–2013: an integrated impact evaluation

摘要

Background:Implementing effective interventions remain a lot of difficulties along all border regions.The emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great concern.China has effectively controlled cross-border transmission of malaria and artemisinin resistance of P.falciparum along the China-Myanmar border.Methods:A combined quantitative and qualitative study was used to collect data,and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during 2007-2013.Results:The parasite prevalence rate(PPR)in the five special regions of Myanmar was decreased from 13.6%in March 2008 to 1.5%in November 2013.Compared with the baseline(PPR in March 2008),the risk ratio was only 0.11[95%confidence interval(CI),0.09-0.14]in November 2013,which is equal to an 89%reduction in the malaria burden.Annual parasite incidence(API)across 19 Chinese border counties was reduced from 19.6 per 10000 person-years in 2006 to 0.9 per 10000 person-years in 2013.Compared with the baseline(API in 2006),the API rate ratio was only 0.05(95%CI,0.04-0.05)in 2013,which equates to a reduction of the malaria burden by 95.0%.Meanwhile,the health service system was strengthened and health inequity of marginalized populations reduced along the international border.Conclusion:The effective collaboration between China,Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified processes.The integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.