title: Perceptions of malaria control and prevention in an era of climate change: a cross-sectional survey among CDC staff in China.
abstract: Though there was the significant decrease in the incidence of malaria in central and southwest China during the 1980s and 1990s, there has been a re-emergence of malaria since 2000.
  
  
  
  A cross-sectional survey was conducted amongst the staff of eleven Centers for Disease Control and Prevention (CDC) in China to gauge their perceptions regarding the impacts of climate change on malaria transmission and its control and prevention. Descriptive analysis was performed to study CDC staff's knowledge, attitudes, perceptions and suggestions for malaria control in the face of climate change.
  
  
  
  A majority (79.8%) of CDC staff were concerned about climate change and 79.7% believed the weather was becoming warmer. Most participants (90.3%) indicated climate change had a negative effect on population health, 92.6 and 86.8% considered that increasing temperatures and precipitation would influence the transmission of vector-borne diseases including malaria. About half (50.9%) of the surveyed staff indicated malaria had re-emerged in recent years, and some outbreaks were occurring in new geographic areas. The main reasons for such re-emergence were perceived to be: mosquitoes in high-density, numerous imported cases, climate change, poor environmental conditions, internal migrant populations, and lack of health awareness.
  
  
  
  This study found most CDC staff endorsed the statement that climate change had a negative impact on infectious disease transmission. Malaria had re-emerged in some areas of China, and most of the staff believed that this can be managed. However, high densities of mosquitoes and the continuous increase in imported cases of malaria in local areas, together with environmental changes are bringing about critical challenges to malaria control in China. This study contributes to an understanding of climate change related perceptions of malaria control and prevention amongst CDC staff. It may help to formulate in-house training guidelines, community health promotion programmes and policies to improve the capacity of malaria control and prevention in the face of climate change in China.
authors.affiliation: School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA, 5005, Australia.
authors.forename: Michael Xiaoliang
authors.initials: MX
authors.lastname: Tong
authors.affiliation: School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA, 5005, Australia.
authors.forename: Alana
authors.initials: A
authors.lastname: Hansen
authors.affiliation: School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA, 5005, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: Hanson-Easey
authors.affiliation: School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA, 5005, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: Cameron
authors.affiliation: School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA, 5005, Australia.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Xiang
authors.affiliation: State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, Anhui Medical University, Hefei, 230032, Anhui, China.
authors.forename: Yehuan
authors.initials: Y
authors.lastname: Sun
authors.affiliation: School of Biological Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Weinstein
authors.affiliation: Communications and Media Studies, School of Media, Film and Journalism, Monash University, Clayton, VIC, 3800, Australia.
authors.forename: Gil-Soo
authors.initials: GS
authors.lastname: Han
authors.affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, 5001, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Williams
authors.affiliation: School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA, 5005, Australia. peng.bi@adelaide.edu.au.
authors.forename: Peng
authors.identifier: 0000-0002-3238-3427
authors.initials: P
authors.lastname: Bi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D057231:Climate Change; D003140:Communicable Disease Control / Q000379:methods* / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006077:Government Agencies; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Capacity building; Climate change; Imported cases; Infectious diseases; Malaria; Perception