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Malaria surveillance-response strategies in different transmission zones of the People's Republic of China: preparing for climate change

Guo-Jing Yang123, Marcel Tanner45, Jürg Utzinger45, John B Malone6, Robert Bergquist7, Emily YY Chan3, Qi Gao12 and Xiao-Nong Zhou89*

Author Affiliations

1 Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, 214064, People’s Republic of China

2 Key Laboratory on Control Technology for Parasitic Diseases, Ministry of Health, Wuxi, Jiangsu, 214064, People’s Republic of China

3 School of Public Health and Primary Care, The Jockey Club Chinese University of Hong Kong, Shatin, Hong Kong

4 Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland

5 University of Basel, P.O. Box, CH-4003, Basel, Switzerland

6 Pathobiological Sciences, Skip Bertman Drive, Louisiana State University, Baton Rouge, LA, 70803, USA

7  , Ingerod, Brastad, Sweden

8 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People’s Republic of China

9 Key Laboratory on Biology of Parasite and Vector, Ministry of Health, People’s Republic of China, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, 200025, People’s Republic of China

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Malaria Journal 2012, 11:426  doi:10.1186/1475-2875-11-426

Published: 21 December 2012



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).


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%.


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.


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.

Malaria; Climate change; Surveillance-response; Elimination; People’s Republic of China