title: Malaria surveillance-response strategies in different transmission zones of the People's Republic of China: preparing for climate change.
abstract: BACKGROUND
  A sound understanding of malaria transmission patterns in the People's Republic of China (P.R. China) is crucial for designing effective surveillance-response strategies that can guide the national malaria elimination programme (NMEP). Using an established biology-driven model, it is expected that one may design and refine appropriate surveillance-response strategies for different transmission zones, which, in turn, assist the NMEP in the ongoing implementation period (2010-2020) and, potentially, in the post-elimination stage (2020-2050).
  
  
  METHODS
  Environmental data obtained from 676 locations across P.R. China, such as monthly temperature and yearly relative humidity (YRH), for the period 1961-2000 were prepared. Smoothed surface maps of the number of months suitable for parasite survival derived from monthly mean temperature and YRH were generated. For each decade, the final malaria prediction map was overlaid by two masked maps, one showing the number of months suitable for parasite survival and the other the length of YRH map in excess of 60%.
  
  
  RESULTS
  Considering multiple environmental factors simultaneously, the environmental variables suitable for malaria transmission were found to have shifted northwards, which was especially pronounced in northern P.R. China. The unstable suitable regions (transmission periods between five and six months) showed increased transmission intensity due to prolonged suitable periods, especially in the central part of the country.
  
  
  CONCLUSIONS
  Adequate and effective surveillance-response strategies for NMEP should be designed to achieve the goal of malaria elimination in P.R. China by 2020, especially in the zones predicted to be the most vulnerable for climate change.
authors.affiliation: Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, People’s Republic of China.
authors.forename: Guo-Jing
authors.initials: GJ
authors.lastname: Yang
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: John B
authors.initials: JB
authors.lastname: Malone
authors.forename: Robert
authors.initials: R
authors.lastname: Bergquist
authors.forename: Emily Y Y
authors.initials: EY
authors.lastname: Chan
authors.forename: Qi
authors.initials: Q
authors.lastname: Gao
authors.forename: Xiao-Nong
authors.initials: XN
authors.lastname: Zhou
mesh_terms: D000818:Animals; D000852:Anopheles / Q000469:parasitology; D002681:China / Q000453:epidemiology; D057231:Climate Change; D004777:Environment; D062665:Epidemiological Monitoring; D006801:Humans; D006813:Humidity; D007303:Insect Vectors / Q000469:parasitology; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D016778:Malaria, Falciparum / Q000635:transmission; D016780:Malaria, Vivax / Q000635:transmission; D012307:Risk Factors; D012621:Seasons; D013696:Temperature