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Peer reviewedOpen accessMalaria

Malaria cases in China acquired through international travel, 2013–2022

Journal of Travel Medicine·

Yan Zhu, Angela Cadavid Restrepo, Hai-Bo Wang, Deborah J Mills, Rong-Rong Liang, Zhi-Bin Liu, Colleen L Lau, Luis Furuya-Kanamori

DOI
10.1093/jtm/taae056
PMID
38591791
PMCID
PMC11646087
OpenAlex
W4394621342
Study type
Systematic review
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

Despite China achieving malaria-free certification in 2021, imported cases from returned travelers pose an ongoing risk of local transmission and re-introduction. The findings highlight the need to strengthen travel medicine services, including pre-travel prophylaxis and post-travel diagnostic capacity, to consolidate elimination gains.

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Structured evidence summary

Research question

The study examined trends in imported malaria cases in China from 2013 to 2022 following malaria elimination, and assessed the role of travel medicine in preventing re-introduction.

Study design

This was a systematic review of published articles and reports from international and Chinese databases covering the decade 2013–2022. Data on case counts, Plasmodium species, diagnostic methods, acquisition country, and high-risk provinces were collected and analyzed using descriptive statistics.

Population and setting

The study included 24,758 malaria cases reported in China over the ten-year period, predominantly among returned travelers from malaria-endemic countries. Cases were concentrated in provinces with large numbers of overseas workers, including Yunnan, Jiangsu, Sichuan, Guangxi, Shandong, Zhejiang, and Henan.

Main findings

Malaria cases in China declined from 4,128 in 2013 to 843 in 2022, with over 99% being imported and laboratory-confirmed. P. falciparum accounted for 65.5% of cases, followed by P. vivax (20.9%) and P. ovale (10.0%). The most common acquisition countries were Ghana, Angola, and Myanmar. The last locally acquired case was reported in 2017, and the case fatality rate was 0.5%.

Public-health relevance

Despite China achieving malaria-free certification in 2021, imported cases from returned travelers pose an ongoing risk of local transmission and re-introduction. The findings highlight the need to strengthen travel medicine services, including pre-travel prophylaxis and post-travel diagnostic capacity, to consolidate elimination gains.

Important limitations

This summary relies on the supplied single-article abstract and metadata. The original paper is required for decision-grade interpretation, including assessment of search strategy completeness, data quality across reporting systems, potential underascertainment of cases, and generalizability of findings.

GIDS interpretation

This article would be discoverable in GIDS through queries combining malaria with travel medicine, China, imported cases, or species-level surveillance in elimination settings. The systematic review design and multi-year trend data support use in understanding post-elimination challenges and informing travel health policy.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 10 auditable classifier relationships to diseases, places, topics, and study design.

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