From parasitic disease control to global health: New orientation of the National Institute of Parasitic Diseases, China CDC.

As the only specialized institution for research and control of parasitic diseases at the national level in China for almost 70 years, the National Institute of Parasitic Diseases (NIPD) at the Chinese Center for Disease Control and Prevention (China CDC) has been instrumental in supporting the remarkable progress from high prevalence to transmission interruption or low endemicity of several diseases, lymphatic filariasis, malaria and schistosomiasis in particular. This has taken place through technical guidance, emergency response and scientific research as well as providing technical service, education, training, health promotion and international cooperation. With China's increasing involvement in international cooperation and the increased risk for (re)emerging tropical diseases in mind, the Chinese Government designated in 2017 a new Chinese Center for Tropical Disease Research to NIPD. Responding to the expanded responsibilities, the institute is scaling up its activities in several ways: from parasitic diseases to the wider area of tropical diseases; from disease control to disease elimination; from biological research to policy evidences accumulation; and from public health to global health. Based on this new vision and China's previous accomplishments in the areas mentioned, the institute is in a position to move forward with respect to global health and equitable development according to the central principles of the United Nations' Sustainable Development Goals.

Infectious Diseases of Poverty, the first five years.

Although the focus in the area of health research may be shifting from infectious to non-communicable diseases, the infectious diseases of poverty remain a major burden of disease of global health concern. A global platform to communicate and share the research on these diseases is needed to facilitate the translation of knowledge into effective approaches and tools for their elimination. Based on the "One health, One world" mission, a new, open-access journal, Infectious Diseases of Poverty (IDP), was launched by BioMed Central in partnership with the National Institute of Parasitic Diseases (NIPD), Chinese Center for Disease Control and Prevention (China CDC) on October 25, 2012. Its aim is to identify and assess research and information gaps that hinder progress towards new interventions for a particular public health problem in the developing world. From the inaugural IDP issue of October 25, 2012, a total of 256 manuscripts have been published over the following five years. Apart from a small number of editorials, opinions, commentaries and letters to the editor, the predominant types of publications are research articles (69.5%) and scoping reviews (21.5%). A total of 1 081 contributing authors divided between 323 affiliations across 68 countries, territories and regions produced these 256 publications. The journal is indexed in major international biomedical databases, including Web of Science, PubMed, Scopus and Embase. In 2015, it was assigned its first impact factor (4.11), which is now 2.13. During the past five years, IDP has received manuscripts from 90 countries, territories and regions across six continents with an annual acceptance rate of all contributions maintained at less than 40%. Content analysis shows that neglected tropical diseases (NTDs), followed by the "Big Three" (HIV/AIDS, malaria and tuberculosis) and infectious diseases in general comprise 88% of all publications. In addition, a series of 10 thematic issues, covering 118 publications in all, was published as separate parts of the first five volumes. These publications were cited 975 times, which equals an average of 8.3 times per publication. The current challenge is to identify cutting-edge research topics and attract and to publish first-rate publications leading to increasing importance and impact of the journal in its field.

[An analysis on funded theses in the Chinese Journal of Parasitology and Parasitic Diseases in 2009-2012].

The published articles of the Chinese Journal of Parasitology and Parasitic Diseases in 2009-2012 (including original articles, experimental researches, field researches and clinical researches) were statistically analyzed. Together 258 research papers were published in the 4 years, and funded papers occupied 82.2% (212/258). The number of papers funded by 1, 2, 3, 4, and 5 foundations projects was 116, 58, 29, 7 and 2, respectively. 61.8% (131/212) of the foundations projects were at the national level; 28.3% (60/212) were at provincial and ministerial level. The papers supported by academy and international agencies accounted for 7.1% (15/212), 2.8% (6/212), respectively. The funded thesis mainly referred to schistosomiasis (35, 16.5%), cystic echinococcosis (29, 13.7%), malaria (24, 11.3%), toxoplasmosis (22, 10.4%), and cysticercosis (9, 4.2%). Five fields covered in these papers were as follows: epidemiology (29, 13.7%), immunology and diagnosis (53, 25%), molecular biology (75, 35.4%), etiology (28,13.2%), and pharmacology (24, 11.3%). The ratio of founded paper was 0.70, 0.67, 0.74, and 0.65 during 2009-2012, respectively. The high ratio of founded paper indicated that this journal is with domestic and abroad importance in the field of parasitology.

[Analysis of citing journals and cited journals of 3 core parasitological journals].

OBJECTIVE: To understand the achievement exchange and interpenetration situation between parasitological journals and the journals of other disciplines. METHODS: The citing journals and cited journals of Chinese parasitological journals were analyzed. Three Chinese core journals, namely Chinese Journal of Parasitology and Parasitic Diseases, Chinese Journal of Schistosomiasis Control, and Chinese Journal of Zoonoses, were selected as the study objects. The number and citation times of citing and cited journals from 2002 to 2012 were collected from CNKI. These journals were classified according to China Journal Citation Reports-Expand (2013), and analyzed by the method of bibliometrics. RESULTS: The number of published papers in Chinese Journal of Parasitology and Parasitic Diseases, Chinese Journal of Schistosomiasis Control, and Chinese Journal of Zoonoses were 1 160, 1 541 and 2 494 from 2002 to 2012, respectively. The numbers of citing journals of the 3 above journals included by the citation reports were 496, 547 and 592, respectively, the total citation frequencies were 4 778, 9 547 and 8 301, and the average citation frequencies per paper were 4.12, 6.20 and 3.33, respectively. The numbers of the cited journals were 532, 407 and 659, respectively, the total citation frequencies were 4 470, 7 206 and 7 885, and the average citation frequencies per paper were 3.85, 4.68 and 3.16, respectively. The top three disciplines of the citing journals and cited journals were medical and health, basic science, and agricultural sciences, and the top three secondary disciplines belonged to medical and health were general medical and health, preventive medicine and hygiene, and clinical medicine. CONCLUSION: There is an extensive exchange between parasitology journals and other journals, which promotes the exchange between parasitology and other relevant disciplines.

Combating infectious diseases of poverty: a year on.

The Infectious Diseases of Poverty journal, launched a year ago, is a platform to engage outside the traditional disciplinary boundaries, and disseminate high quality science towards the improvement of health. This paper reviews the milestone achievements during its first year of operation. The journal has filled an important niche, addressing some of the main priorities in the Global Report for Research on Infectious Diseases of Poverty. Highlights include the publication of three thematic issues on health systems, surveillance and response systems, as well as co-infection and syndemics. The thematic issues have foregrounded the importance and innovation that can be achieved through transdisciplinary research. The journal has been indexed by PubMed since April 2013, with the publication of a total of 38 articles. Finally, the journal is delivering to wider range readers both in developing and developed countries with sustained efforts with a focus on relevant and strategic information towards elimination of infectious diseases of poverty.

[Analysis on theses of the Chinese Journal of Parasitology and Parasitic Diseases in 2009-2012].

The published articles at the Chinese Journal of Parasitology and Parasitic Diseases in 2009-2012 were statistically analyzed. Among 547 papers published in the four years, original articles occupied 45.3% (248/547). The number of authors was 2712, with an average cooperation degree of 5.0, and the co-authorship accounted for 95.4% of the papers. Authors were mainly from colleges/universities (51.9%, 284/547), institutions for disease control (34.4%, 188/547) and hospitals health centers (13.7%, 75/547). The average publishing delay was 212, 141, 191 and 207 d in 2009-2012. Statistical analysis reflected the characteristics and academic level for improving the quality of the journal, and revealed the latest development and trends.

[Bibliometric analysis of the Chinese Journal of Parasitology and Parasitic Diseases in 2006-2008].

The published articles and citation of the Chinese Journal of Parasitology and Parasitic Diseases in 2006-2008 were statistically analyzed. Among 431 papers published in the three years, original articles and experimental researches occupied 31.8% and 17.6%, respectively. Authors were mainly from colleges/universities (53.8%) and institutions for disease control (34.1%). 71.5% of the articles received financial supports from research funds/foundations. Reference citation was mostly from periodicals. The average Price index was 46.5%. This Journal possesses a group of stable and qualified authors, covers substantial content with relatively broad citation, and is an important source of information in parasitological research.

[Potential risks for transmission of schistosomiasis caused by mobile population in Shanghai].

OBJECTIVE: To understand the potential risk for schistosomiasis transmission caused by introduction of infection source from mobile population in Shanghai. METHODS: Field investigation was conducted in the suburb of Shanghai City by screening the mobile population living in Shanghai for more than 1 month and over 1 years old in a procedure of interviewing, serum indirect hemagglutination (IHA) test, and then fecal examination to detect the eggs with nylon sedimentation approach for those IHA positives. RESULTS: Among 2,931 mobile people investigated, 1,575 were male (53.74%) and 1356 were female(46.26%); 138 out of 2931 were positive in IHA test (4.71%). 1938 (66.12%) out of 2 931 came from Schistosoma japonicum-endemic provinces and its positive rate in mobile population (5.99%) was significantly higher than those from the transmission-interrupted provinces (2.6%) (chi2=10.28, P<0.01), and those from non-endemic provinces (1.68%) (chi2=12.86, P<0.01). The 138 IHA positives all showed negative in fecal examination. In accordance with the serum positive rate and egg-infection rate in the national reporting system in 2004, it was estimated that there would be about 13 356 and 1 699 potential serum positive cases respectively from endemic area and transmission controlled area, and about 2,168 and 255 egg-positive cases from the two kind areas respectively, majority of the cases were from Anhui Province. CONCLUSION: Schistosomiasis transmission risks potentially exist in Shanghai suburb due to the introduction of infected mobile people from other endemic provinces, and a surveillance system and quick response are needed for the possible re-emergence of the disease.

[Factors affecting malaria outbreak in Congjiang county of Guizhou Province].

OBJECTIVE: To make a field investigation on the affecting factors of malaria outbreak in a village of Congjiang County, Guizhou Province. METHODS: The investigation was made in August, 2006. Filter paper dry blood samples were taken for indirect fluorescent antibody test (IFAT) from all the 495 residents above 1 year-old in the village where an outbreak of malaria was reported. Questionnairing was conducted in 423 villagers over 10 years-old, covering malaria history in the past 2 years, knowledge on malaria and its control, use of mosquito nets, and out-door sleeping habit. Data on febrile outpatients were collected from the records of the township health center for analyzing the compliance of the patients in seeking medical services. Mosquito collecting by human-bait before mid-night, and in mosquito nets and cattle pens in early morning was performed for mosquito composition and man-biting rate. RESULTS: Re-examination of the 42 positive blood smears confirmed 12 positives of P. vivax infection. The malaria incidence in 18 d was 2.1%, including 4 cases clinically diagnosed. The antibody positive rate of IFAT in the population was 8.7% (43/495) with a positive GMRT of 20.6, overall GMRT of 10.6; the IFAT positive rate in the age group of under 5 was 7.5% (3/40) with a GMRT of 25.1. The rate of seeking medical advice among febrile patients was 81.3% (118/145), 78.8% (93/118) of which being in the village clinic. The average time of going to a doctor after fever was 3.9 days, 37.4% (195/521) and 3.3% (17/521) were in 4-6 days and over 10 days respectively, with the longest 26 days. The average knowledge rate on malaria was 25.5% (108/423), with 17.1%, 29.2% and 40.0% in the groups of illiteracy, primary school and high school education respectively. A statistical significance was found between primary school/high school education and the illiteracy (P<0.01). The average rate of using mosquito nets was 31.0% (131/423), out-door sleeping rate was40.7% (172/423). The radical cure rate in 2004 and 2005 was 68.2% (15/22) and 48.3% (14/29) respectively. In addition to Anopheles sinensis, An. anthropophagus and An. minimus also existed in rooms and nets with a man-biting rate of 0.0566 and 0.0755 respectively. CONCLUSIONS: Three species of anopheline mosquitoes are the important transmitting vectors. Poor self-protection, outdoor sleeping habit, delayed examination and treatment, and irregular chemotherapy among the residents are the main factors resulting malaria outbreak.

[Analysis on theses, funding ratio and impact factor of the "Chinese Journal of Parasitology and Parasitic Diseases" in 2000-2004].

Number of theses published and the major evaluation indicators of the (Chinese Journal of Parasitology and Parasitic Diseases) in 2000-2004 were analyzed. Together 833 papers and communications were published in the 5 years and the original articles, reviews and experiment reports occupied 39.4%, 9.1% and 4.4% respectively. The key authors were from universities (53.4%) and disease control institutions (29.4%). 20 universities/institutions published over 8 papers in the period occupying 38.1%. The average rate of papers supported by various funds and by international agencies was 0.50 and 0.09 respectively, and higher in 2004, 0.52 and 0.07 respectively. The ratio of national, ministry (provincial) and international projects was 29.9%, 43.9% and 20.4% respectively. The overall citation and impact factor of this journal increased from 325 and 0.377 in 2000 to 437 and 0.462 in 2004 respectively, being among the best of the periodicals and expressing its high academic level and its domestic and abroad importance in the field of parasitology.

[Analysis on theses and citation of the "Chinese Journal of Parasitology and Parasitic Diseases" in 2004-2005].

The published articles and citation of the Chinese Journal of Parasitology and Parasitic Diseases in 2004-2005 were statistically analyzed. Among 312 papers published in the two years, original articles and experiment reports occupied 42.3% and 7.7% respectively. Authors were mainly from colleges/universities (61.5%) and institutions for disease control (28.5%). 51.9% of the articles received support by research funds/foundations. 82.3% were with reference citation mostly from periodicals, with 58.7% and 31.5% respectively from international and national (Chinese) journals. The average Price index was 44.9%. This Journal possesses a group of stable and qualified authors, covers substantial content with relatively broad citation, and is an important source of information in parasitological research.

[Malaria situation in the People' s Republic of China in 2004].

In 2004, 38,972 malaria cases and 106,704 suspected cases with 31 deaths were reported by the annual case reporting system in 1,005 counties of 23 Provinces/Municipality/Autonomous Region (P/ M/A) and the annual incidence was 0.38/10 000, a decrease of 4.2% than that of the last year, which is the year that the disease was slightly rolled back after consecutively increased since 2001. As an important development of the case reporting system, the internet reporting system started in 2004, majority of the malaria cases (38 254) were reported through internet from 1,074 counties of all the 30 P/M/A except Qinghai Province. Among the 1,005 counties with reported malaria cases, 32 counties were with an incidence of more than 10/10,000 distributing in Yunnan (19 counties), Hainan (10) and Anhui (3). There were 61 counties in which the malaria incidence was between 1/10,000 and 10/10,000. The number of Plasmodium falciparum malaria cases was 4,891, accounting for 12.6% of the total cases, of which 35.0% (1,714) were imported cases reported in 174 counties/cities of 18 P/M/A. Indigenous falciparum malaria was found in 45 counties/ cities of Yunnan and Hainan Provinces, of which 29 counties/cities were in Yunnan, decreased by 35, 16 were in Hainan, increased by 2 compared to that of 2003. Yunnan and Hainan Provinces are still the relatively high transmission areas. Yunnan has ranked No. 1 in the country in terms of the number of cases while Hainan ranked No. 1 by malaria incidence in recent years. 22 247 malaria cases were reported from the two provinces in 2004, accounting for 57.1% of the total reported cases in the country. There were 12,865 cases with 25 deaths reported from Yunnan, and the incidence was 3.09/10,000, a decrease of 16.6% than that in the last year. Among the reported cases, 3,251 were falciparum malaria, decreased by 7.9% in comparison to 2003. The number of reported cases in Hainan was 9 832, with an incidence of 11.64/10 000, 46.6% increase than the last year. In central China, the re-emergence of malaria was considerable in provinces along the Huai River, especially in Anhui Province. The case number in Anhui has been the second or third largest in the country since 2001. 8909 malaria cases and 14,542 suspected cases were reported from the Province in 2004, accounting for 22.9% of the total cases in the country, with an incidence of 1. 38/10,000 increased by 9.8% than that in 2003. Hubei reported 2,714 malaria cases with an incidence of 0.47/10,000, decreased by 60.8%. The number of reported cases in Henan was 2,211, decreased by 43.1%. 676 cases were reported from Jiangsu, almost the same as that in 2003. Focal outbreaks occurred in 109 villages of 13 counties in Anhui, Hubei and Jiangsu, where Anopheles sinensis is the principal transmission vector. Malaria cases reported from the above 4 provinces accounted for 37.2% of the national figure. Cases reported from Guizhou, Sichuan, Guangxi, Guangdong, Zhejiang, Shanghai and Hunan in southeast China occupied about 5% of the total cases, over 50% of which were imported cases. Less than 100 cases were reported from each of Fujian, Chongqing, Shandong, Jiangxi, Liaoning, Shaanxi, Shanxi, Gansu, Xinjiang and Heilongjiang Provinces in the year. In summary, although malaria cases slightly decreased after several years' consecutive increase, malaria is still an important problem of public health in China, especially in the southern and central parts. Yunnan and Hainan still face a critical situation of malaria endemics with the spread of P.falciparum, especially in the 25 border counties in Yunnan. In central parts of the country, especially in Anhui, malaria prevalence was highly unstable with frequent focal outbreaks in areas along the Huai River, which reveals new challenges to the national malaria control program.

[Malaria situation in the People's Republic of China in 2003].

Total 40,681 malaria cases and 129,147 suspected cases with 52 deaths were reported by the case reporting system in 910 counties of 21 Provinces/Municipality/Autonomous Region (P/M/A) in 2003, and the annual incidence was 0.39/10000, an increase of 15.3% than that of the last year, which is the third year that malaria incidence consecutively increased since 2001. Based on a baseline survey in the project funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the estimated number of malaria cases was about 740,000 in 2003, 18 times more than reported. Among the 910 counties with reported malaria cases, 29 counties with an incidence more than 10/10000 distributed in Yunnan (17 counties), Hainan (9), Anhui (1), Hubei (1) and Henan (1). There were 69 counties in which the malaria incidence was between 1/10000 and 10/10000. The number of Plasmodium falciparum malaria cases was 4727, accounting for 11.6% of the total cases, of which 13.1% (621) were imported cases reported in 107 counties/cities of 16 P/M/A. Indigenous falciparum malaria was found in 78 counties/cities of Yunnan and Hainan Provinces, of which 64 counties/cities were in Yunnan, increased by 22, 14 counties/cities were in Hainan, decreased by 2 compared to that of 2002. Yunnan and Hainan are stil the relatively high transmission areas. Yunnan has ranked No. 1 in the country in terms of the number of cases while Hainan ranked No. 1 by malaria incidence in recent years. 21,788 malaria cases were reported from the two provinces in 2003, accounting for 53.6% of the total reported cases in the country. There were 15 431 cases with 43 deaths reported from Yunnan, the incidence was 4.24/10000, with an increase of 26.3% than that in the last year. Among the reported cases, 3529 were falciparum malaria, increased by 22.9% in comparison to 2002. The number of reported cases in Hainan was 6357, with an incidence of 7.94/10000, 19.6% increase than the last year. In central China, the re-emergence of malaria was considerable in provinces along the Huai River, especially in Anhui Province. It should be stressed that the proportion of malaria cases was increasing in Anopheles sinensis transmitted areas where malaria was almost under control in the 1990s. The number of malaria cases in Anhui has been the second largest in the country since 2001. 8025 malaria cases and 18533 suspected cases were reported from Anhui in 2003, accounting for 19.7% of the total cases in the country, with an incidence of 1.53/10000 increased by 59.4% than that in 2002. Hubei Province reported 5 334 malaria cases with an incidence of 1.2/10000, increased by 33.3%. The number of reported cases in Henan and Jiangsu Provinces was 2 448 and 638 and the incidence decreased by 24.1% and 12.7% respectively. Focal outbreaks occurred in 222 villages of 9 counties in Anhui, Hubei and Jiangsu, where Anopheles sinensis is the principal transmission vector. Malaria cases reported from the above 4 provinces accounted for over 40% of the national figure. Cases reported from other P/M/A in the South and East China occupied about 6% of the total with certain degree of decrease, several hundreds from each of Guizhou, Guangxi, Sichuan, Guangdong, Fujian, Chongqing, Zhejiang, Shanghai and Hunan, more than 50% of which were imported cases. Less than 100 cases were reported from each of Shandong, Jiangxi, Liaoning, Shaanxi, Shanxi and Gansu Provinces in 2003. In summary, malaria is still an important problem of public health in China, especially in the southern and central parts where the incidence has been increasing since 2001. Yunnan and Hainan still faced critical situation of malaria endemics with a spread of Plasmodium falciparum, especially in the 25 border counties in Yunnan. In the central part of the country including Anhui, Hubei, Henan and Jiangsu, where Anopheles sinensis was the principal vector, the malaria prevalence was highly unstable with frequent focal outbreaks in areas along the Huai River, which revealed new challenges to the malaria control program in China. Meanwhile, opportunities also exist with the support of the GFATM and the government, the latter paid much closer attention recently to issues in relation to public health.

[Malaria situation in the People's Republic of China in 2002].

This summary was made on the basis of the annual reports of malaria control from the professional institutions in the 21 Provinces/Municipality/Autonomous Region (P/M/A). The number of malaria cases reported in the country was 35,298 in the year 2002 and the incidence rate was 0.348/10,000, an increase of 68.2% than that of the last year and the largest increase since 1994. The total number of suspected cases was 136,902, and the death toll due to malaria was 42. Based on the numbers of malaria cases and suspected cases from the case reporting system of P/M/A, and on the field investigations of the cases missed (failed to report), the estimated total number of malaria cases was 387,000 in 2002. In the South, the provinces of Yunnan and Hainan have been the major area of malaria historically. About 50% of the reported cases in the country were from the two provinces in 2002. There were 12,218 cases reported from Yunnan with 33 deaths, the incidence was 3.026/10,000, 31.6% increase than that in the last year. Among the reported cases, 2,922 were cases of falciparum malaria. The estimated number of malaria cases was 18 times more than that reported. The number of reported cases in Hainan was 5,354 with an incidence of 6.645/10,000, 15.5% increase than that of the last year; there were 1,210 cases of falciparum malaria, and 1 death. The estimated number of malaria cases was 100,000. Covered were also the other P/M/A in the South: Fujian, Guizhou, Guangxi, Guangdong, Sichuan and Chongqing. In Fujian province, 92 malaria cases were reported, all imported, with an incidence of 0.028/10,000 which increased by 272.8% than that in the last year. There were 713 cases reported in Guizhou with an incidence of 0.193/10,000, increased by 17.1%. The number of reported malaria cases was 392 in Guangxi, with an incidence rate of 0.082/10,000, increased by 14.0%. The incidence slightly decreased in Sichuan, Guangdong and Chongqing, and the case number was 443, 403 and 130 respectively. The cases from the 6 provinces/municipality occupied 6.2% of all cases reported from the country. The 5 provinces in central China were also important in malaria control program. Hubei province reported 5,101 malaria cases (incidence 0.895/10,000), increased by 161.6% than that of the last year; plus suspected cases of 5,614, the total number of malaria cases was estimated to be 11,000. The number of reported cases in Anhui province was 5,999 (0.958/10,000), second largest to that of Yunnan province, increased by 123.6%; with 22,615 suspected cases, the total number of malaria cases was estimated to be 28,000. The case number reported in Henan and Jiangsu provinces was 2,921 and 686 respectively, the incidence decreased by 35.1% and 41.7% respectively, but in Shandong province, 52 cases reported with an increase of 23.8%. Focal outbreaks occurred in 81 villages of 17 counties in the provinces of Hubei, Anhui, Henan and Jiangsu, where Anopheles sinensis is the principal transmitting vector. Malaria cases reported from the 5 provinces in central China accounted for 42% of the national figure. Three hundred and thirteen and 229 cases respectively reported from Hunan and Zhejiang provinces, the incidence increased by 44.2% and 288.1% with 3 and 1 death respectively. There were 28 cases in Jiangxi province with a little fluctuation situation. In Shanghai, 135 cases were recorded with an increase of incidence by 66.7%; 16 were infected locally and others all imported. In the provinces of Shaanxi, Shanxi, Liaoning and Gansu, sporadical malaria cases were still reported. The number of Plasmodium falciparum malaria cases was 4,319, accounting for 12.2% of the total cases; of which 13.4% (556) were imported cases. The locally infected falciparum malaria was found in 61 counties/cities of Hainan, Yunnan, Guangxi, and Shaanxi; of which 42 counties/cities were in Yunnan, increased by 11, 16 counties/cities in Hainan, increased by 5, 2 counties in Guangxi and 1 county in Shaanxi. Imported falciparum malaria cases were reported in 114 counties of 14 P/M/A, 2 provinces less but 6 counties more than that in 2001. Due to the strengthening of surveillance and effective management of dubious epidemic conditions, there was no local transmission of falciparum malaria in the above provinces except 2 locally infected cases in Guangxi and 1 in Shaanxi. In areas where the transmission of falciparum malaria has been interrupted but vectors and transmission conditions exist, it is of great importance to prevent the transmission of falciparum malaria by imported source of infection. The main reasons for the considerable increase of malaria transmission in 2002 were as follows: the provinces of Yunnan and Hainan still faced a severe situation of malaria epidemic with a spread of Plasmodium falciparum, especially in the mountainous area of Hainan and the 25 frontier counties in the south and west of Yunnan. Following the development of economy and trade, more frequent population movement occurred among the provinces and between Yunnan and bordering countries, malaria situation becomes more challenging. In central part of the country including Hubei, Anhui, Henan and Jiangsu, where Anopheles sinensis was the principal vector, the malaria situation was highly unstable and local outbreaks took place from time to time. Meanwhile, the increase of the floating population brought more imported cases into Guangdong, Guangxi, Guizhou, Hunan, Fujian, Jiangxi, Chongqing, Shangdong, Zhejiang, and Shanghai, which accounted for 47%-100% of the cases reported in the P/M/A. Furthermore, because of the faultiness in the public health system and the network of the case reporting system, more malaria cases failed to be reported and it is therefore a challenge in implementing the program of malaria control and prevention.