title: The epidemiology of Plasmodium vivax and Plasmodium falciparum malaria in China, 2004-2012: from intensified control to elimination.
abstract: BACKGROUND
  In China, the national malaria elimination programme has been operating since 2010. This study aimed to explore the epidemiological changes in patterns of malaria in China from intensified control to elimination stages.
  
  
  METHODS
  Data on nationwide malaria cases from 2004 to 2012 were extracted from the Chinese national malaria surveillance system. The secular trend, gender and age features, seasonality, and spatial distribution by Plasmodium species were analysed.
  
  
  RESULTS
  In total, 238,443 malaria cases were reported, and the proportion of Plasmodium falciparum increased drastically from <10% before 2010 to 55.2% in 2012. From 2004 to 2006, malaria showed a significantly increasing trend and with the highest incidence peak in 2006 (4.6/100,000), while from 2007 onwards, malaria decreased sharply to only 0.18/100,000 in 2012. Males and young age groups became the predominantly affected population. The areas affected by Plasmodium vivax malaria shrunk, while areas affected by P. falciparum malaria expanded from 294 counties in 2004 to 600 counties in 2012.
  
  
  CONCLUSIONS
  This study demonstrated that malaria has decreased dramatically in the last five years, especially since the Chinese government launched a malaria elimination programme in 2010, and areas with reported falciparum malaria cases have expanded over recent years. These findings suggest that elimination efforts should be improved to meet these changes, so as to achieve the nationwide malaria elimination goal in China in 2020.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.forename: Shengjie
authors.initials: S
authors.lastname: Lai
authors.forename: Canjun
authors.initials: C
authors.lastname: Zheng
authors.forename: Honglong
authors.initials: H
authors.lastname: Zhang
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhou
authors.forename: Wenbiao
authors.initials: W
authors.lastname: Hu
authors.forename: Archie C A
authors.initials: AC
authors.lastname: Clements
authors.forename: Xiao-Nong
authors.initials: XN
authors.lastname: Zhou
authors.forename: Weizhong
authors.initials: W
authors.lastname: Yang
authors.forename: Simon I
authors.initials: SI
authors.lastname: Hay
authors.affiliation: Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China. yuhj@chinacdc.cn.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
authors.forename: Zhongjie
authors.initials: Z
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult