[Epidemiological analysis of malaria prevalence in Jiangsu Province in 2017].

OBJECTIVE: To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2017, so as to provide the evidence for formulating the targeted strategy of malaria elimination. METHODS: The data of malaria cases in Jiangsu Province in 2016 were collected from China's Routine Diseases Surveillance Information System (CRDSIS). RESULTS: Totally, 239 imported malaria cases were reported in Jiangsu Province in 2017, and the cases decreased by 22.40% compared to 308 cases in 2015. Except 2 malaria case caused by blood transfusion, the rest patients were all imported. Among them, there were 163 falciparum malaria cases, 21 vivax malaria cases, 11 quartan malaria cases, 43 ovale malaria cases, and 1 mixed infection case (Plasmodium falciparum and P. ovale). The numbers of imported cases of Nantong (39 cases, 16.32%), Suzhou (26 cases, 10.88%), Taizhou (25 cases, 10.46%), Huai'an (24 cases, 10.04%), and Lianyungang (22 cases, 9.21%) ranked in the top 5 cities across Jiangsu Province, the malaria cases in the five cities accounted for 56.90% (136/239). The infection source areas of the imported malaria cases included Africa (225 cases), Asia (8 cases), Oceania (2 cases), and South America (2 cases). CONCLUSIONS: Jiangsu Province has no local malaria cases for 6 consecutive years. Despite the imported cases in 2017 decreased some-what compared to that in 2016, it is still necessary to strengthen the surveillance of imported malaria cases and improve malaria diagnosis and treatment in the whole province.

[Epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City].

OBJECTIVE: To retrospectively analyze the epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City, summarize the causes of severe falciparum malaria, and evaluate the effect of diagnosis and treatment, so as to provide the evidence for formulating the practical treatment measures for this disease. METHODS: All the data of falciparum malaria cases in Nantong City from 2009 to 2016 were collected and analyzed for the onset time, diagnosis process and treatment of the disease. RESULTS: A total of 359 malaria cases, including 289 falciparum malaria cases, were reported in Nantong City from 2009 to 2016, including 26 severe falciparum malaria cases. All the severe falciparum malaria cases were imported from Africa, including 57.70% of cases (15/26) from Angola. All of them were male labor exporting personnel. The incidence of malaria was not obviously seasonal. The average time from onset to definite diagnosis was 5.2 days, and 11 cases were diagnosed 5 days after the onset. All the 26 cases were cured by anti-malaria treatment and symptomatic treatment, and there was no death. CONCLUSIONS: Severe falciparum malaria seriously harm the people's health and its clinical manifestations are complicated. Therefore, the training of medical staff and health education in residents, especially in labor exporting personnel, should be further strengthened.

[Evaluation of malaria elimination surveillance in Liyang City from 2010 to 2016].

OBJECTIVE: To evaluate the effect of malaria elimination monitoring in Liyang City, so as to provide the evidence for formulating control strategies and measures of malaria elimination. METHODS: The monitoring data about the epidemic situation, blood tests of feverish patients and epidemiology investigation of individual malaria patients in Liyang City from 2010 to 2016 were collected and analyzed by the descriptive epidemiology method. RESULTS: From 2010 to 2016, there were 67 malaria cases in total. Totally 39 196 feverish patients had blood tests for Plasmodium, and 65 of them showed positive and the positive rate was 0.17%. The other 2 cases of microscopy negative were treated with anti-malarial drugs by themselves after the onset of fever, and no Plasmodium was detected in the microscopy, but the tests with malaria rapid diagnostic kit (RDTs) were positive. Among all the 67 cases, there were 49 falciparum malaria cases, 13 ovale malaria cases and 5 vivax malaria cases. All the 67 malaria cases were imported, and the number of cases from Africa was 63 (94.03%). Totally 97.01% (65/67) of the malaria patients were male and most of them were young adults. The patients aged 30 to 49 years accounted for 73.13% (49/67) and 80.60% (54/67) of them were farmers. There were malaria cases in all the 10 towns of the city, and the time of onset had no obvious seasonal characteristics. The timely rate of case report, timely rate of blood film review, standardized treatment rate, epidemiological case investigation rate, and epidemic focus investigation and disposal rate were all 100%. There were 18 076 people with the active case investigation, but no malaria parasite positive carriers were found. The mosquito vector monitoring was performed with the methods of mosquito trap lamp and human bait half night trap, and 187 and 78 Anopheles mosquitoes were captured respectively, and all the parasites were Anopheles sinensis. A total of 88 person-times were performed for the Plasmodium examinations with microscopy and RDTs (one blood sample, two detections) in Liyang City Center for Disease Prevention and Control from 2012 to 2016, and 35 person-times were positive, including 28 person-times of Plasmodium falciparum and 7 person-times of P. ovale, and there was no statistically significant difference between the detection rates of P. falciparum, and P. ovale (adjusted χ2 = 0.05, P > 0.05). There were 34 RDTs positive cases, including 14 cases of malignant malaria, and 17 cases of malignant malaria or mixed infections of P. falciparum with other three kinds of Plasmodium parasites, and 3 cases of single infection or mixed infections of other three kinds of Plasmodium parasites, and there was a statistically significant difference among them in the positive RDTs detection rates (adjusted χ2 = 13.75, P < 0.05). CONCLUSIONS: There are still imported malaria cases and there is the risk of malaria retransmission in Liyang City. Therefore, it is necessary to strengthen the malaria surveillance work and the management of infectious sources, so as to consolidate the achievements of malaria elimination in the future.

[Progress of malaria elimination of Jiangsu Province, China].

There were vivax malaria, falciparum malaria, and malariae malaria epidemic in Jiangsu Province, and vivax malaria was the dominant disease. Anopheles sinensis and An. anthropophagus were malaria-transmitted vectors. Since the founding of People's Republic of China, there have been two major malaria outbreaks in Jiangsu Province, when the highest annual malaria incidence reached up to 24.95%. According to prevention and control principles of "adjusting measures to local conditions, giving different guidance to different categories and highlighting key points", during the epidemic outbreak stage, the largescale malaria prevention and control measures were implemented for all the residents who were target population in Jiangsu malaria-endemic areas. During the basic eradication stage, the targeted prevention and control measures had been carried out according to the different epidemic features to gradually consolidate the achievement of prevention and control in Jiangsu Province. In the malaria elimination stage, Jiangsu Province focused on controlling of the source of infection and malaria surveillance. According to the "1-3-7 targeted elimination" work model, the management of infectious sources and investigation and disposal of foci were carried out for each epidemic focus to block the malaria transmission. By the end of 2017, there had been no indigenous malaria cases for the six consecutive years in Jiangsu Province. All the 13 cities have passed the assessment of malaria elimination of Jiangsu Province. Although Jiangsu Province has achieved the goal of malaria elimination, it is urgent and necessary to maintain and improve malaria surveillance capabilities to prevent malaria reintroduction.

[Analysis of blood smear examination results of fever patients in Jiangsu Province from 2010 to 2016].

OBJECTIVE: To analyze the working conditions and evaluate the effectiveness of blood smear examinations in fever patients after the start of national malaria elimination program (NMEP), and explore the suitable strategy for malaria diagnosis and surveillance in NMEP, so as to provide the evidence for the development and adaptation of malaria elimination strategies and measures in Jiangsu Province. METHODS: The data of malaria epidemic situation reported by network, fever patients' blood test tables, and epidemiological surveys of malaria cases were collected and statistically analyzed by SPSS 16.0 in Jiangsu Province from 2010 to 2016. RESULTS: A total of 2 367 cases of malaria cases were reported from 2010 to 2016. Among the 3 691 188 person-times of fever patients tested, there were 2 252 positives (0.06%). The number of blood tests of fever patients decreased from 742 900 in 2010 to 277 000 in 2016. At the same time, the positive rate increased from 0.04% in 2010 to 0.16% in 2016. The positive rate of blood tests of fever patients in 2016 was significantly higher than that in 2010 (χ2 = 161.61, P < 0.01). From 2010 to 2016 in Jiangsu province, the centers for disease control and prevention of cities and counties, that completed the blood review within 3 days, deleted 273 negative cases. In 2010, the centers for disease control and prevention of cities and counties deleted 61 negative cases, but in 2016, the centers deleted only 14 negative cases, and the negative rate of blood review in 2010 was significantly higher than that in 2016 (χ2 = 22.99, P < 0.01). CONCLUSIONS: A large number of blood smear examinations have been tested in fever patients in Jiangsu Province. It not only conforms to the strong monitoring system requirements issued by World Health Organization (WHO) in malaria elimination, but also provides the evidence for no local malaria case in Jiangsu since 2012.

[Investigation on malaria rapid diagnostic testing (RDT) - related knowledge, attitude and practice in primary healthcare professionals of Jiangsu Province].

OBJECTIVE: To investigate the malaria rapid diagnostic testing (RDT) - related knowledge, attitude, practice (KAP) of primary healthcare professionals in Jiangsu Province and analyze the corresponding influencing factors. METHODS: Four cities in Jiangsu Province were selected as the study sites by the typical sampling method to conduct a survey for the RDT related KAP and work satisfaction of primary healthcare professionals, and the multiple logistic regression model was used to explore the relevant influencing factors. RESULTS: Totally 1 150 questionnaires were issued and 949 valid questionnaires were collected with the recovery rate of 82.52%. The valid questionnaires included 453 questionnaires from laboratory technicians, 466 from clinicians, and 30 from malaria prevention and control workers. Totally 83.98% of the surveyed professionals had a low mastering level of essential RDT-related knowledge. A total of 52.17% of the surveyed laboratory technicians recognized that the application of RDT technology could effectively improve the current primary-level microscopy work, and the degree of recognition of RDT technological advantage in the laboratory technicians was higher than that in the clinicians. Totally 79.25% of the surveyed laboratory technicians regarded themselves to be capable of conducting the standardized RDT operation, and 84.55% of the surveyed clinicians regarded themselves to be capable of conducting the qualified malaria clinical diagnostic practice. The key influencing factors of RDT-related KAP of primary healthcare professionals included the laboratory technicians' gender, educational level, employer's institutional level, professional title, and working years, and the employer's institutional level of clinicians. CONCLUSIONS: The primary healthcare professionals in Jiangsu Province exhibita good acceptability towards RDT technology. However, their essential knowledge on RDT remains to be improved. Therefore, it is necessary to establish a specific training and educational system for primary healthcare professionals to better guarantee the advantageous impact of RDT technology on the consolidation of the malaria elimination work achievements.

[Evaluation of an optimization strategy for use and management of malaria rapid diagnostic testing (RDT) in Jiangsu Province].

OBJECTIVE: To evaluate the implementation effect of the optimization strategy for the use and management of malaria rapid diagnostic testing (RDT) technology in Jiangsu Province, so as to provide the empirical evidence and suggestions for promoting the standardized use of RDT technology. METHODS: Questionnaire surveys of primary-level health professionals' RDT-related knowledge, attitude, and practice (KAP) and work satisfaction were conducted in 4 pilot cities in Jiangsu Province before and after the intervention. RESULTS: After the implementation of the intervention, 13.9% of surveyed laboratory technicians, 21.9% of surveyed clinicians and 4.1% of surveyed staff of the centers for disease control and prevention (CDCs) had significant improvements in RDT-related knowledge. About 10.9% of the surveyed laboratory technicians and 25.6% of the surveyed CDC staff improved their attitudes toward RDT technology. About 38.4% of the surveyed laboratory technicians and 10.0% of the surveyed clinicians improved the standardized use of RDT technology. All types of primary-level health professionals had high evaluation in the satisfaction and effectiveness of the optimization strategy. However, the evaluation of the surveyed clinicians was slightly lower than that of the laboratory technicians and CDC staff. CONCLUSIONS: The optimization strategy in this project can effectively improve the knowledge, attitude and behavior of all types of primary-level health professionals and help to promote the standardized use of RDT technology.

[Vector surveillance in Jiangsu Province during the stage of malaria elimination].

OBJECTIVE: To analyze the vector surveillance results during the stage of malaria elimination, so as to provide the evidence for assessing the local transmission risk of imported malaria and carrying out the surveillance work after malaria elimination in Jiangsu Province. METHODS: From 2011 to 2017, the mosquito population was monitored and human biting rates were calculated by the half overnight human baiting trapping method and overnight lamp trapping method in 7 surveillance sites from June to October. The insecticide resistance level was tested by the force contact method recommended by WHO. RESULTS: A total of 5 106 Anopheles mosquitoes were captured by the half over-night human baiting trapping method in the 7 sites from 2011 to 2017, and all the mosquitoes were identified as Anopheles sinensis. The annual human biting rates were 1.075, 0.786, 1.057, 0.787, 0.790, 1.797 and 1.185 mosquitoes/ (human·hour), respectively. Totally 28 186 Anopheles mosquitoes were caught by the overnight lamp trapping method, and all the mosquitoes were An. sinensis. The densities of Anopheles mosquitoes were 57.950, 50.932, 14.800, 4.405, 58.070, 72.406, and 17.145 mosquitoes/ (night·lamp), respectively. In 2012, the resistance indexes of An. sinensis to deltamethrin, DDT and malathion were at R level in Jiangsu Province. CONCLUSIONS: The major vector is An. sinensis and no An. anthropophagus is found in Jiangsu Province. An. sinensis has a high level of resistance to deltamethrin, DDT and malathion.

[Challenges for maintaining achievements of malaria elimination in Jiangsu Province, China].

OBJECTIVE: To analyze the situation of malaria elimination, identify the current main challenges and difficulties of maintaining the achievements of malaria elimination, and find out feasible solutions in Jiangsu Province. METHODS: Through randomized grouping, the subject discussion and questionnaires were conducted by malaria control staffs from centers for diseases control and prevention of 13 cities of Jiangsu Province and Jiangsu Institute of Parasitic Diseases. The basic characteristics of participants and the effect of the discussion were analyzed through questionnaires. RESULTS: Twenty-seven professional participants were randomly divided into 3 groups. Totally 27 questionnaires were released and 24 valid questionnaires were retrieved. Among the 24 participants, 79.1% (19/24) of them were with mid-level and senior professional titles, and 66.7% (16/24) of them had worked for more than 10 years. Before the group discussion, only 16.7% (4/24) of the participants were aware of the current main challenges and difficulties in Jiangsu Province. After the discussion, 87.5% (21/24) of them thought the discussion increased their understanding of the challenges and difficulties. Through the subject discussion, the expert group summarized the current challenges and difficulties as well as the solutions in malaria prevention in Jiangsu Province in 4 aspects, namely the management guarantee of prevention work, diagnosis and treatment of the cases, field epidemiological investigation and others. Finally, a framework about these discussion results was established. CONCLUSIONS: During the post-stage of malaria elimination, Jiangsu Province still faced many challenges and difficulties, such as management guarantee, case diagnosis and treatment, epidemiology survey and focus disposals, and malaria surveillance sustainability. The feasible solutions of these challenges may provide examples for other provinces and regions which are undergoing malaria elimination or in post-stage of malaria elimination.

[Epidemiological analysis of malaria prevalence in Jiangsu Province in 2016].

OBJECTIVE: To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2016, so as to provide the evidence for formulating and adjusting the strategy and measures for malaria elimination. METHODS: The data of malaria cases in Jiangsu Province in 2016 were collected from China's Routine Diseases Surveillance Information System (CRD-SIS) and analyzed statistically. RESULTS: Totally, 308 malaria cases were reported in Jiangsu Province in 2016, and the cases decreased by 23.95% compared to 405 malaria cases in 2015. Except for 1 malaria case that was caused by blood transfusion, the rest patients were all imported. Among the 308 cases, 237 were infected with Plasmodium falciparum, 11 were infected with P. vivax, 8 were infected with P. malariae, 51 were infected with P. ovale, and 1 was mixed infection. Among all the cities in Jiangsu Province, the numbers of imported cases of Nantong (53 cases), Huai'an (41 cases), Taizhou (40 cases), Lianyungang (36 cases) and Yangzhou (29 cases) ranked in the top 5, and the total malaria cases in the five cities accounted for 64.61%. CONCLUSIONS: There were no local malaria cases in Jiangsu Province for 5 consecutive years up to 2016. Although the imported cases decreased slightly compared to those in 2015, we still should strengthen the surveillance of imported malaria cases as well as improve malaria diagnosis and treatment abilities for related personnel at all levels of medical institutions. Also we should focus on the Plasmodium check, focus survey and disposal to realize the aim of malaria elimination in Jiangsu Province in time.

[Results analysis of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017].

OBJECTIVE: To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. METHODS: The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. RESULTS: Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. CONCLUSIONS: In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.

[Epidemic characteristics of imported falciparum malaria in Huai'an City].

OBJECTIVE: To understand the situation and epidemic characteristics of imported falciparum malaria in Huai'an City from 2010 to 2016, so as to provide the evidence for formulating the prevention and control strategies of imported falciparum malaria in the city. METHODS: The epidemic data of imported falciparum malaria in Huai'an City from 2010 to 2016 were analyzed by using the descriptive epidemiological method. RESULTS: A total of 308 malaria cases were reported in Huai'an City from 2010 to 2016 with the average annual incidence of 0.88/105. A total of 240 imported falciparum malaria cases were reported, of which 18 cases (7.50%) developed into severe illness, and 2 severe patients died. The cases were reported in every county (district), and the incidence rates of Qingpu District and Huai'an District were higher than the city average level. The cases occurred every month, so there was no significant seasonal variation in the reporting time of the cases. Most of the patients were young men and aged 30-49 years. The occupational distribution revealed that the patients were mainly farmers, workers and migrant workers. The main source of infection was from African countries. The median interval from symptom appearing to definite diagnosis was 1 day, and the longest interval was 236 days. Twenty-nine cases were diagnosed within 24 hours, accounting for 12.08%. CONCLUSIONS: The epidemic situation of imported falciparum malaria in Huai'an City is grim. In order to consolidate the achievements of malaria eradication, it is necessary to further improve the multi-sectoral cooperation mechanism, strengthen the management of floating population and take effective measures to reduce the risk of imported falciparum malaria.

[Analysis of malaria epidemic situation in Changzhou City from 2010 to 2014].

OBJECTIVE: To grasp the malaria epidemic situation in Changzhou City from 2010 to 2014, so as to provide the evidence for formulating and adjusting malaria control strategies and measures. METHODS: The epidemiological data of malaria cases in the special report system from 2010 to 2014 were collected, and the malaria epidemic situation and the diagnosis and treatment of malaria patients were analyzed. RESULTS: There were 132 malaria cases reported in Changzhou City from 2010 to 2014, with a decrease of 27.47% compared to 182 cases from 2005 to 2009. Among the 132 cases, 2 cases were local infected cases and the remaining 130 cases were imported cases. Four cases were clinically diagnosed and 128 cases were laboratory confirmed, with 97 cases of malignant malaria, 14 cases of vivax malaria, 13 cases of ovale malaria, and 4 cases of quartan malaria. The 132 cases were distributed in five districts：56 cases in Jintan City, 51 cases in Liyang City, 19 cases in Tianning District, 3 cases in Wujin District, and 3 cases in Xinbei District. The median duration between the onset and treatment of the disease was 2 days, and the median duration between the diagnosis and treatment was 1 day. The diagnosing units were concentrated on the county-level disease control agencies, and medical institutions at county and municipal levels, accounting for 92.42% (122/132). From 2011 to 2014, there were no local malaria cases. CONCLUSIONS: From 2012 to 2014, there have been no local malaria cases in Changzhou City, and the goal of eliminating malaria has been achieved basically. However, there are still many imported malaria cases, and the infected species are diverse. Therefore, imported malaria is still the key of malaria prevention and control.

[Analysis of channels of going abroad of imported malaria patients in Jiangsu Province, China].

OBJECTIVE: To analyze the channels of going abroad of imported malaria patients in Jiangsu Province, so as to provide the evidence for the control of imported malaria and health intervention for high-risk population. METHODS: The data of imported malaria cases in Jiangsu Province in 2015 were collected and the channels of going abroad were analyzed. The Quantum GIS 1.7.4 software was applied to map. RESULTS: Totally 405 imported cases were reported in Jiangsu Province in 2015, and the cases increased by 14.1% compared with those in 2014. All the patients were migrant workers. The migrant workers were mostly sent abroad by construction companies [43.21% (175/405)]. The dispatching companies were mainly concentrated in Taizhou, Lianyungang, Zhenjiang and Yangzhou cities, accounting for 6.17% (25/405), 3.21% (13/405), 2.72% (11/405) and 2.22% (9/405), respectively. Totally 176 (43.46%) patients returned to China having accompanied workers, and 1.21% (9/745) of accompanied workers were found having symptoms of malaria later. CONCLUSIONS: It is difficult to monitor malaria in overseas migrant works in Jiangsu Province. The channels of going abroad of migrant workers are various and complicated, formulating the main difficulty and challenge of imported malaria control.

[Establishment of malaria early warning system in Jiangsu Province â § Malaria vector monitoring in Jiangsu Province].

OBJECTIVE: To understand the population, density, seasonal fluctuation and nocturnal pattern of malaria vectors in Jiangsu Province, thus to provide evidences for malaria elimination in this province. METHODS: Seven counties (cities, districts) were selected as the monitoring sites for malaria vectors in Jiangsu Province from 2013 to 2015. The mosquitoes were captured by human bait trapping in bed nets and mosquito-lured lamp overnight, and the seasonal fluctuation and nocturnal pattern of malaria vectors were observed. RESULTS: A total of 11 041 Anopheles sinensis mosquitoes were captured by the mosquito-lured lamps in 7 counties of Jiangsu Province from 2013 to 2015, and no An. anthropophagous was found. Among all the 7 monitoring sites, the number of An. sinensis captured in Sihong County was the most (6 742 mosquitoes), while that in Xuyu County was the least (34 mosquitoes). During this period, the density peaks of An. sinensis were the first half of July, the first half of August and the second half of July. A total of 2 421 An. sinensis were collected in 7 monitoring sites from 2013 to 2015 by human bait trapping in bed nets overnight. Among all the 7 monitoring sites, the captured number of An. sinensis in Sihong County was the most (1 085 mosquitoes), while that in Ganyu County was the least (13 mosquitoes). The nocturnal peak of An. sinensis was from 19：00 to 20：00 and 525 An. sinensis mosquitoes were captured during this period of time, which accounted for 21.68% of the total. Hereafter, the captured number of An. sinensis reduced over time. CONCLUSIONS: The density of An. sinensis mosquitoes is still high in individual areas in Jiangsu Province, so the epidemic and vector monitoring still should be strengthened to prevent the local transmission of imported malaria.

[Preliminary exploration of mobile terminal data acquisition in malaria control].

OBJECTIVE: To develop a mobile terminal data acquisition for data collection of malaria prevention and control in the field. METHODS: Based on 3G, Bluetooth, GPS and/or Bei Dou Navigation Satellite System (BDS) and wireless network communication technology (WIFI), a mobile terminal data acquisition for data collection of malaria prevention and control was developed. RESULTS: The developed system included 2 functional modules：a terminal and iCloud, and had examination, modification and deletion functions of malaria epidemiological data. By using GPS and GIS, the target population or institution could be accurately positioned to determine whether the distribution of malaria cases had a spatial aggregation. CONCLUSIONS: A mobile terminal data acquisition in malaria prevention and control is successfully developed, which is very convenient for data collection and submission of malaria prevention and control.

[Effect of prevention and control system for malaria eliminating in Huai'an City].

OBJECTIVE: To investigate the execution and effect of the prevention and control system for malaria eliminating in Huai'an City from 2010 to 2015, so as to provide the evidence for formulating and adjusting the strategy and measures for malaria elimination. METHODS: The data of network malaria reports, blood tests of feverish patients, epidemiology investigation forms of case study of malaria patients in the report system, and the investigation and disposition forms of epidemic foci were collected and analyzed statistically. RESULTS: From 2010 to 2015, there were 267 malaria cases in total in Huai'an City. Totally 303 016 feverish patients had blood tests, and 231 of them showed positive and the positive rate was 0.08%. The epidemiological case studies showed that all the patients were foreign imported cases except 22 local infected vivax malaria cases in 2010 and 2011. All the malaria cases were reported after diagnosis within 24 hours through the directly reported network, and the implementation rate was 100%. All the malaria cases had an epidemiological investigation within 3 days with 100% implementation rate, in which 261 (97.95%) cases were investigated within 2 days. All the cases had an epidemical investigation and disposition within 7 days with 100% implementation rate, in which 252 (94.38%) cases were completed within 5 days. CONCLUSIONS: The implementation rate of malaria elimination work mode has reached 100% in Huai'an City from 2010 to 2015, and there are no local infected cases in recent four years.

[Epidemic situation of malaria and progress of malaria elimination in Nantong City from 2008 to 2014].

OBJECTIVE: To analyze the epidemic status and progress of malaria elimination in Nantong City, so as to provide evidences for adjusting the control measures and guiding the work of malaria elimination. METHODS: The data about the epidemic situation of malaria and malaria elimination in Nantong City from 2008 to 2014 were collected and analyzed by the method of descriptive epidemiology. RESULTS: From 2008 to 2014, a total of 305 malaria cases were reported in Nantong City, with an annual average incidence of 0.57/100 000. Among all the cases, 26 (8.52%) were local tertian malaria cases and 279 (91.48%) were imported cases; 276 cases (90.49%) were male and most of them were young adults, and those aged in 20-59 accounted for 91.48% (279/305). There were cases reported in each month, with no obvious seasonality. The imported cases were mainly distributed in Hai'an County (80 cases), Haimen City (71 cases) and Tongzhou District (41 cases), and the total percentage of them was 68.82% among all the imported malaria cases in Nantong City. There were no local malaria cases reported in Nantong City since 2011. Qidong City, Rudong County, Chongchuan District, Development Zone and Gangzha District have reached the criteria of malaria elimination in Jiangsu Province. CONCLUSIONS: From 2008 to 2014, the malaria cases in Nantong City are mainly imported cases, the number of local cases has decreased significantly, and there has been no local infected cases reported in the continuous 4 years of 2011-2014. Totally 5 counties (cities, districts) among the 9 have reached the criteria of malaria elimination in Jiangsu City. In the future, the control of imported malaria should still be strengthened, and the work of malaria elimination should still be promoted.

[Assessment and authentication of malaria elimination in Changzhou City].

OBJECTIVE: To analyze the results of assessment and authentication of malaria elimination of 7 county-level cities and districts in Changzhou City, Jiangsu Province, and explore the suitable monitoring methods for malaria after the elimination in this region, so as to provide the evidence for formulating and adjusting the malaria elimination strategies and measures. METHODS: The data from the network reports of malaria epidemic situation, blood examinations of febrile patients, epidemiological questionnaires of malaria cases, investigation of epidemic focuses and disposal tables were collected and analyzed in Changzhou City from 2009 to 2014. The clinicians were assessed with the closed-book written examinations for their ability of the diagnosis and treatment of malaria. The inspection personnel were assessed by the microscopical examinations of Plasmodium. Totally 30 negative blood slides were reviewed. In the natural village where the last local case of malaria was located, 200 blood filter papers were collected for gene detection of Plasmodium. RESULTS: From 2009 to 2014, 145 malaria cases were reported in Changzhou City. Totally 170 638 febrile patients received blood detections for malaria, of which 137 cases were positive and the positive rate was 0.08%. The majority of malaria cases were imported except 8 local malaria infection cases in 2009 and 2 local malaria infection cases in 2010. Four of seven county-level cities (districts) gained an average score of 20 points on the microscopical examinations of Plasmodium. Liyang City got a minimum average score of 18.8 points. In capacity assessment of malaria diagnosis and treatment, Liyang City gained the highest average score of 19.8 points, and Qishuyan District got the lowest average score of 18.0 points. The malaria elimination assessment scores of the 7 county-level cities (districts) were all above 93 points. Four county-level cities (districts) (Xinbei District, Wujin District, Liyang City, and Jintan City) carried out the active case detections. A total of 731 cases were detected and the results were all negative. Liyang City in 2012, Zhonglou District and Jintan City in 2013, Tianning District, Qishuyan District, Xinbei District and Wujin District in 2014, passed the malaria elimination assessment at county (district) level, respectively. CONCLUSIONS: All the 7 county-level cities (districts) of Changzhou City have passed the malaria elimination assessment at a high score. After the malaria elimination, the monitoring should continue to consolidate the achievements.