Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Spatiotemporal Trends of Malaria in Relation to Economic Development and Cross-Border Movement along the China-Myanmar Border in Yunnan Province

  • Zhao, Xiaotao (Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University) ;
  • Thanapongtharm, Weerapong (Veterinary Epidemiological Center, Bureau of Disease Control and Veterinary Services, Department of Livestock Development) ;
  • Lawawirojwong, Siam (Geo-Informatics and Space Technology Development Agency) ;
  • Wei, Chun (Yunnan Institute of Parasitic Diseases) ;
  • Tang, Yerong (Yunnan Institute of Parasitic Diseases) ;
  • Zhou, Yaowu (Yunnan Institute of Parasitic Diseases) ;
  • Sun, Xiaodong (Yunnan Institute of Parasitic Diseases) ;
  • Sattabongkot, Jestumon (Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University) ;
  • Kaewkungwal, Jaranit (Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University)
  • Received : 2019.09.24
  • Accepted : 2020.04.07
  • Published : 2020.06.30
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Abstract

The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.

Keywords

References

  1. Xu J, Liu H. The challenges of malaria elimination in Yunnan Province, People's Republic of China. Southeast Asian J Trop Med Public Health 2012; 43: 819-824.
  2. Xu X, Zhou G, Wang Y, Hu Y, Ruan Y, Fan Q, Yang Z, Yan G, Cui L. Microgeographic heterogeneity of border malaria during elimination phase, Yunnan Province, China, 2011-2013. Emerg Infect Dis 2016; 22: 1363-1370. https://doi.org/10.3201/eid2208.150390
  3. Yang D, Xu C, Wang J, Zhao Y. Spatiotemporal epidemic characteristics and risk factor analysis of malaria in Yunnan Province, China. BMC Public Health 2017; 17: 66. https://doi.org/10.1186/s12889-016-3994-9
  4. Zhang Y, Liu QY, Luan RS, Liu XB, Zhou GC, Jiang JY, Li HS, Li ZF. Spatial-temporal analysis of malaria and the effect of environmental factors on its incidence in Yongcheng, China, 2006-2010. BMC Public Health 2012; 12: 544. https://doi.org/10.1186/1471-2458-12-544
  5. Zhou SS, Zhang SS, Wang JJ, Zheng X, Huang F, Li WD, Xu X, Zhang HW. Spatial correlation between malaria cases and water-bodies in Anopheles sinensis dominated areas of Huang-Huai plain, China. Parasit Vectors 2012; 5: 106. https://doi.org/10.1186/1756-3305-5-106
  6. Bi Y, Yu W, Hu W, Lin H, Guo Y, Zhou XN, Tong S. Impact of climate variability on Plasmodium vivax and Plasmodium falciparum malaria in Yunnan Province, China. Parasit Vectors 2013; 6: 357. https://doi.org/10.1186/1756-3305-6-357
  7. Xia J, Cai S, Zhang H, Lin W, Fan Y, Qiu J, Sun L, Chang B, Zhang Z, Nie S. Spatial, temporal, and spatiotemporal analysis of malaria in Hubei Province, China from 2004-2011. Malar J 2015; 14: 145. https://doi.org/10.1186/s12936-015-0650-2
  8. Tusting LS, Rek J, Arinaitwe E, Staedke SG, Kamya MR, Cano J, Bottomley C, Johnston D, Dorsey G, Lindsay SW, Lines J. Why is malaria associated with poverty? Findings from a cohort study in rural Uganda. Infect Dis Poverty 2016; 5: 78. https://doi.org/10.1186/s40249-016-0164-3
  9. Teklehaimanot A, Mejia P. Malaria and poverty. Ann N Y Acad Sci 2008; 1136: 32-37. https://doi.org/10.1196/annals.1425.037
  10. Bi Y, Tong S. Poverty and malaria in the Yunnan province, China. Infect Dis Poverty 2014; 3: 32. https://doi.org/10.1186/2049-9957-3-32
  11. Worrall E, Basu S, Hanson K. Is malaria a disease of poverty? A review of the literature. Trop Med Int Health 2005; 10: 1047-1059. https://doi.org/10.1111/j.1365-3156.2005.01476.x
  12. Malaria Policy Advisory Committee Meeting. Evidence Review Group on Border Malaria [Internet]; Geneva, Switzerland: World Health Organization; [cited 2019 Aug 1]. Available from: https://www.who.int/malaria/mpac/mpac-october2018-session6-border-malaria.pdf.
  13. Cui L, Cao Y, Kaewkungwal J, Khamsiriwatchara A, Lawpoolsri S, Soe TN, Kyaw MP, Sattabongkot J. Malaria elimination in the Greater Mekong Subregion: challenges and prospects. In Manguin S, Dev V eds, Towards Malaria Elimination. London, UK. IntechOpen. 2018, pp 179-200.
  14. Cui L, Yan G, Satabongkot J, Cao Y, Chen B, Chen X, Fan Q, Fang Q, Jongwutiwes S, Parker D, Sirichaisinthop J, Kyaw MP, Su XZ, Yang H, Yang Z, Wang B, Xu J, Zheng B, Zhong D, Zhou G. Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop 2012; 121: 227-239. https://doi.org/10.1016/j.actatropica.2011.02.016
  15. World Health Organization. Strategy for Malaria Elimination in the Greater Mekong Subregion (2015-2030) [Internet]; Geneva, Switzeland. World Health Organization.; [cited 2018 Jan 21]; Available from: http://iris.wpro.who.int/bitstream/handle/ 10665.1/10945/9789290617181_eng.pdf.
  16. Zhang S, Zhang L, Feng J, Yin J, Feng X, Xia Z, Frutos R, Manguin S, Zhou S. Malaria elimination in the People's Republic of China: current progress, challenges, and prospects. In Manguin S, Dev V eds, Towards Malaria Elimination: A Leap Forward. London, UK. IntechOpen. 2018, pp 233-255.
  17. Hu Y, Zhou G, Ruan Y, Lee MC, Xu X, Deng S, Bai Y, Zhang J, Morris J, Liu H, Wang Y, Fan Q, Li P, Wu Y, Yang Z, Yan G, Cui L. Seasonal dynamics and microgeographical spatial heterogeneity of malaria along the China-Myanmar border. Acta Trop 2016; 157: 12-19. https://doi.org/10.1016/j.actatropica.2016.01.022
  18. Chen T, Zhang S, Zhou SS, Wang X, Luo C, Zeng X, Guo X, Lin Z, Tu H, Sun X, Zhou H. Receptivity to malaria in the China- Myanmar border in Yingjiang County, Yunnan Province, China. Malar J 2017; 16: 478. https://doi.org/10.1186/s12936-017-2126-z
  19. Yang HL, Xiao N, Yang YM, Xu JW. Challenges, opportunities and strategies of malaria elimination along China-Myanmar and China- Laos border. China Trop Med 2017; 17: 321-335.
  20. Zhang Q, Sun J, Zhang Z, Geng Q, Lai S, Hu W, Clements AC, Li Z. Risk assessment of malaria in land border regions of China in the context of malaria elimination. Malar J 2016; 15: 546. https://doi.org/10.1186/s12936-016-1590-1
  21. Wang D, Cotter C, Sun X, Bennett A, Gosling RD, Xiao N. Adapting the local response for malaria elimination through evaluation of the 1-3-7 system performance in the China-Myanmar border region. Malar J 2017; 16: 54. https://doi.org/10.1186/s12936-017-1707-1
  22. Shi B, Zheng J, Qiu H, Yang GJ, Xia S, Zhou XN. Risk assessment of malaria transmission at the border area of China and Myanmar. Infect Dis Poverty 2017; 6: 108. https://doi.org/10.1186/s40249-017-0322-2
  23. Hewit S, Delacollete C, Chavez I. Malaria situation in the Greater Mekong Subregion. Southeast Asian J Trop Med Public Health 2013; 44 (suppl): 46-72.
  24. Lyttleton C. Deviance and resistance: Malaria elimination in the Greater Mekong Subregion. Soc Sci Med 2016; 150: 144-152. https://doi.org/10.1016/j.socscimed.2015.12.033
  25. Jitthai N. Migration and malaria. Southeast Asian J Trop Med Public Health 2013; 44 (suppl 1): 166-200.
  26. Xia ZG, Yang MN, Zhou SS. Malaria situation in the People's Republic of China in 2011. Chin J Parasitol Parasit Dis 2012; 30: 419-422 (in Chinese).
  27. Xia ZG, Feng J, Zhou S. Malaria situation in the People's Republic of China in 2012. Chin J Parasitol Parasit Dis 2013; 31: 413-418 (in Chinese).
  28. Zhou SS, Wang Y, Li Y. Malaria situation in the People's Republic of China in 2010. Chin J Parasitol Parasit Dis 2011; 29: 401-403 (in Chinese).
  29. Wei C, Du LF, Zhao XT, Sun XD. Analysis of epidemic situation of malaria in Yunnan Province from 2011 to 2013Chin J Parasitol Parasit Dis 2016; 28: 26-29 (in Chinese).
  30. Zhou SS, Wang Y, Fang W, Tang LH. Malaria situation in the People's Republic of China in 2008. Chin J Parasitol Parasit Dis 2009; 27: 455-456 (in Chinese).
  31. Zhou G, Lo E, Zhong D, Wang X, Wang Y, Malla S, Lee MC, Yang Z, Cui L, Yan G. Impact of interventions on malaria in internally displaced persons along the China-Myanmar border: 2011-2014. Malar J 2016; 15: 471. https://doi.org/10.1186/s12936-016-1512-2
  32. China.org.cn. Yunnan [Internet]; [cited 2018 Feb 10]. Available from: http://www.china.org.cn/e-xibu/2JI/3JI/yunnan/yunnan-ban.htm.
  33. Song L. Refugees or Border Residents from Myanmar? The Status of Displaced Ethnic Kachins and Kokangs in Yunnan Province, China. Int J Refugee Law 2017; 29; 466-487. https://doi.org/10.1093/ijrl/eex031
  34. Liu H, Xu JW, Bi Y. Malaria burden and treatment targets in Kachin Special Region II, Myanmar from 2008 to 2016: A retrospective analysis. PLoS One 2018; 13: e0195032. https://doi.org/10.1371/journal.pone.0195032
  35. Feng J, Liu J, Feng X, Zhang L, Xiao H, Xia Z. Towards malaria elimination: Monitoring and evaluation of the "1-3-7" approach at the China-Myanmar Border. Am J Trop Med Hyg 2016; 95: 806-810. https://doi.org/10.4269/ajtmh.15-0888
  36. Xu JW, Li Y, Yang HL, Zhang J, Zhang ZX, Yang YM, Zhou HN, Havumaki J, Li HX, Liu H, Zhou H, Xie XY, Dong JX, Zhang Y, Sun XY, Li B, Li JY, Tian YH, Wang PY, Li BF. Malaria control along China-Myanmar Border during 2007-2013: an integrated impact evaluation. Infect Dis Poverty 2016; 5: 75. https://doi.org/10.1186/s40249-016-0171-4
  37. Zhao X, Thanapongtharm W, Lawawirojwong S, Sattabongkot J, Wei C, Tang Y, Zhou Y, Li J, Kaewkungwal J. Spatio-temporal analysis of malaria cases along China-Myanmar border of Yunnan Province, 2011-2016. JITMM Proceedings 2019; 8: 41-50. https://doi.org/10.3390/proceedings2019008041
  38. Hui FM, Xu B, Chen ZW, Cheng X, Liang L, Huang HB, Fang LQ, Yang H, Zhou HN, Yang HL, Zhou XN, Cao WC, Gong P. Spatio-temporal distribution of malaria in Yunnan Province, China. Am J Trop Med Hyg 2009; 81: 503-509. https://doi.org/10.4269/ajtmh.2009.81.503
  39. Feng J, Zhang L, Huang F, Yin JH, Tu H, Xia ZG, Zhou SS, Xiao N, Zhou XN. Ready for malaria elimination: zero indigenous case reported in the People's Republic of China. Malar J 2018; 17: 315. https://doi.org/10.1186/s12936-018-2444-9
  40. Yang He-xian Lij. Correlation of malaria infection with the meteorological factors in Baoshan city from 2005 to 2012. Chin Trop Med 2014; 14: 289-292.
  41. Liu Y, Hsiang MS, Zhou H, Wang W, Cao Y, Gosling RD, Cao J, Gao O. Malaria in overseas labourers returning to China: an analysis of imported malaria in Jiangsu Province, 2001-2011. Malar J 2014; 13: 29. https://doi.org/10.1186/1475-2875-13-29
  42. Wang D, Li S, Cheng Z, Xiao N, Cotter C, Hwang J, Li X, Yin S, Wang J, Bai L, Zheng Z, Wang S. Transmission risk from imported Plasmodium vivax malaria in the China-Myanmar Border Region. Emerg Infect Dis 2015; 21: 1861-1864. https://doi.org/10.3201/eid2110.150679
  43. Li Z, Zhang Q, Zheng C, Zhou S, Sun J, Zhang Z, Geng Q, Zhang H, Wang L, Lai S, Hu W, Clements A, Zhou XN, Yang W. Epidemiologic features of overseas imported malaria in the People's Republic of China. Malar J 2016; 15: 141. https://doi.org/10.1186/s12936-016-1188-7
  44. Wang X, Yang L, Jiang T, Zhang B, Wang S, Wu X, Wang T, Li Y, Liu M, Peng Q, Zhang W. Effects of a malaria elimination program: a retrospective study of 623 cases from 2008 to 2013 in a Chinese county hospital near the China-Myanmar border. Emerg Microbes Infect 2016; 5: e6. https://doi.org/10.1038/emi.2016.6
  45. Yang D, Xu C, Wang J, Zhao Y. Spatiotemporal epidemic characteristics and risk factor analysis of malaria in Yunnan Province, China. BMC Public Health 2017; 17: 66. https://doi.org/10.1186/s12889-016-3994-9
  46. Jia-Zhi W, Sheng-Guo L, Xi-Shang L, Zong-Yan T. Malaria epidemiological analysis in Tengchong City from 2010 to 2015. Chin J Schistosomiasis Control 2016. 28: 566-568 (in Chinese).
  47. Xu JW, Liu H. The relationship of malaria between Chinese side and Myanmar's five special regions along China-Myanmar border: A linear regression analysis. Malar J 2016; 15: 368. https://doi.org/10.1186/s12936-016-1413-4
  48. Wang RB, Dong JQ, Xia ZG, Cai T, Zhang QF, Zhang Y, Tian YH, Sun XY, Zhang GY, Li QP, Xu XY, Li JY, Zhang J. Lessons on malaria control in the ethnic minority regions in Northern Myanmar along the China border, 2007-2014. Infect Dis Poverty 2016; 5: 95. https://doi.org/10.1186/s40249-016-0191-0
  49. Xu JW, Liu H, Zhang Y, Guo XR, Wang JZ. Risk factors for border malaria in a malaria elimination setting: a retrospective case-control study in Yunnan, China. Am J Trop Med Hyg 2015; 92: 546-551. https://doi.org/10.4269/ajtmh.14-0321
  50. Al Zahrani MH, Omar AI, Abdoon AMO, Ibrahim AA, Alhogail A, Elmubarak M, Elamin YE, AlHelal MA, Alshahrani AM, Abdelgader TM, Saeed I, El Gamri TB, Alattas MS, Dahlan AA, Assiri AM, Maina J, Li XH, Snow RW. Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia. BMC Med 2018; 16: 98. https://doi.org/10.1186/s12916-018-1081-z
  51. Panvisavas S. Poverty and malaria: A study in a Thai-Myanmar border area. Southeast Asian J Trop Med Public Health 2001; 32: 608-614.
  52. Tang L. Malaria in China: from control to elimination. Int J Med Parasit Dis 2009; 36: 258-265. https://doi.org/10.3760/cma.j.issn.1673-4122.2009.05.001
  53. Nkegbe PK, Kuunibe N, Sekyi S. Poverty and malaria morbidity in the Jirapa District of Ghana: A count regression approach. Cogent Econ Finance 2017; 5: 1293472. https://doi.org/10.1080/23322039.2017.1293472

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