The Control of Malaria among PLWHA in Calabar, Cross River State, Nigeria

The purpose of the study was to examine RBM programme＇s efforts at controlling malaria among PLWHA and explore their perception of the control strategies. The study was a descriptive survey involving guided interviews of top managers of Roll Back Malaria （RBM） programme. A structured questionnaire was administered to 108 PLWHA attending an HIV/AIDS clinic in a secondary health facility in Calabar. Data were analyzed using descriptive statistics. Thematic analysis revealed that RBM programme strategies include effective case management, promotion of Long Lasting Insecticide Treated Nets （LLINs）, intermittent preventive treatment （IPT） and integrated vector management （IVM）. Complementary results showed that 104 （92%） admitted accessibility to malarial treatment. Although 83 （57.7%） of PLWHA have LLINs, only 63 （42.3%） use them. Majority of the respondents 89 （60%） have not heard of indoor/outdoor residual spraying （IRS）. How to get IRS services and lack of money to buy it were listed as a barrier to its use. Malarial treatment was accessible to PLWHA. The barriers to the use of ITN and IRS could be addressed through free distribution of odorless ITN and IRS to PLWHA. Higher rates of utilization of the products can be achieved through behavioural change communication.

Human Habitats and Malaria Vector Control in Benin: Current Situation and Implications for Effective Control

Long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) are the main indoor malaria vector tools control tools. The study examined housing characteristics and investigated the relationship between the total volume of household possessions, the volume of the sleeping room, and the hanging of LLINs. A total of 831 bedrooms were randomly selected in Benin in 2015. The findings showed that mud walls were predominant in rural areas (more than 75%), while metal roofs were common (77.3% - 97.9%). Battery-powered lighting was prevalent in rural areas in Northern (97%), while open-flame oil lamps were commonly used in rural areas in Southern (86%). The availability of correct bedding was low, ranging from 1% to 10% in all households. 20% of the bedrooms had at least 50% of their volume occupied by household possessions in urban areas. In rural areas, bedrooms without LLINs had a lower mean rate ratio of the volume occupied by possessions per the total volume of the room compared to bedrooms with at least one LLIN installed (p < 0.0001). The characteristics of human habitats are not favourable to the correct use of vector control intervention indoors. It is therefore important to improve people’s living conditions as the next step for malaria elimination.

Evaluation of Malaria Transmission and Vector Control Strategies in the Dry Season in the Cotonou V Health Zone, Benin, West Africa

The anarchic urbanization of certain African cities favors the multiplication of the malaria parasite. Thus, the urgent mobilization of African cities is essential to combat this health risk. It is, therefore, with the objective of contributing to the investigation of problem areas that the present study evaluates malaria transmission and vector control strategies in the Cotonou V health zone in particular. This is a cross-sectional study taking into account four neighborhoods, including Wologuèdè, Sainte Rita, Gbèdjromèdé and the area around Etoile Rouge. Two nocturnal captures on voluntary humans and the method of spray were carried out in the dry season from December 2021 to February 2022. On the captured Anopheles, the ELISA Circum-Sporozoite Protein test was performed to determine the infectivity and calculate some transmission parameters. Finally, we conducted a survey using the second stage sampling method with one step to ask selected households about their knowledge of vector control methods, their use and the physical integrity of LLINs. We collected 2386 culicidae of which the majority was Culex quinquefasciatus. After the ELISA test, the 29 Anopheles tested, showed no infectivity, i.e. an EIR of 0 pi/h/n. In addition, 99% of the populations in the Cotonou V area use LLINs to protect themselves. However, coils, door and window screens, aerosol sprays, skin and household repellents, and periodic indoor spraying were used. Finally, the majority of nets observed had T1 tears, but there were also T2, T3 and T4 nets (P-value = 0.0). This study confirms that malaria transmission during the dry season in the Cotonou V health zone is almost negligible but not non-existent. Also, populations are exposed to the nuisance of Culex quinquefasciatus mosquitoes continuously throughout the year.

From control to eradication of malaria:the end of being stuck in second gear?

More than 2 billion people are at risk of malaria,which primarily affects poor populations in tropical and subtropical areas,including Southern Asia.As malaria incidence has been reduced strongly in some parts of endemic regions by combinations of interventions,including artemisinin-based therapies and insecticide-treated bed nets,a new goal has been established recently by charity foundations which support research on malaria:the worldwide eradication of the pathology.Doing away with control approaches which have been applied for the last 50 years and more focus on elimination objectives will deeply change priorities in the area of malaria treatment,chemoprevention,vector control,vaccine research and health system assessment.In this review,actual knowledge on pathogenesis and pharmacology is discussed,and new drugs, vaccines and insecticides are described.

Assessment of strategic management practice of malaria control in the dangme west district, GhanaArticle submitted to the west african college of nursing for the award of a fellow

Strategic management (SM) practice was as-sessed in all HCFs both in the public and private and some chemical shops within the Dangme West district using semi-structured question-naires. In-depth interviews were carried out with healthcare managers in their clinical setting. The study utilized both qualitative and quantitative methods in describing the SM practice. Healthcare managers were using all the elements of SM in the management of malaria but these were not holistically coordinated. Present were short ranged informal planning based on the objectives of NMCP and day-to-day operation of the HCFs especially with Ghana Health Service facilities. Due to homogenous nature of Dangme West district, management of culture wasn’t given much attention by healthcare managers though healthcare providers were acutely aware of its importance to quality service delivery. Competition was woefully absent in the healthcare environment. No formal structure has been created for the management of malaria control activities with the exception of the involvement of Community Based agents. The district was widely implementing all the strategies of the NMCP with favourable outcomes.

A Mathematical Modelling of the Effect of Treatment in the Control of Malaria in a Population with Infected Immigrants

In this work, we developed a compartmental bio-mathematical model to study the effect of treatment in the control of malaria in a population with infected immigrants. In particular, the vector-host population model consists of eleven variables, for which graphical profiles were provided to depict their individual variations with time. This was possible with the help of MathCAD software which implements the Runge-Kutta numerical algorithm to solve numerically the eleven differential equations representing the vector-host malaria population model. We computed the basic reproduction ratio R0 following the next generation matrix. This procedure converts a system of ordinary differential equations of a model of infectious disease dynamics to an operator that translates from one generation of infectious individuals to the next. We obtained R0 = , i.e., the square root of the product of the basic reproduction ratios for the mosquito and human populations respectively. R0m explains the number of humans that one mosquito can infect through contact during the life time it survives as infectious. R0h on the other hand describes the number of mosquitoes that are infected through contacts with the infectious human during infectious period. Sensitivity analysis was performed for the parameters of the model to help us know which parameters in particular have high impact on the disease transmission, in other words on the basic reproduction ratio R0.

Mosquito Control, Killing off the Females

In addition to causing discomfort, female mosquitoes introduce disease-carrying viruses and bacteria into the bloodstream of their victims. There are numerous publications describing the uses of sugary mosquito baits with promising results. Without temperature control measures however, these methods are mainly useful for only nectar-feeding insects, including male mosquitoes, because the warmth of the blood is a condition for the females to locate their meals. The efforts required to keep the baits fresh against the natural spoiling process make them less attractive or impractical to implement. These experiments address these issues by using warm baits of water, sugar, boric acid, and antibiotics. Overnight, the general areas became clear of blood-sucking female mosquitoes while in numbers, the harmless males concentrated into the immediate vicinities. Control vs. experiment protocol established no other logical explanation for this phenomenon other than that females were attracted and killed by the bait. As expected, there was no female mosquito’s activity in these areas. There weren’t many left to do the work.

Mathematical Modelling of Sterile Insect Technology for Mosquito Control

Reduction of mosquito populations will, at least, reduce substantially the transmission of malaria disease. One potential method of achieving this reduction is the environmentally-friendly population control method known as the Sterile Insect Control (SIT) method. The SIT method has so far not been widely used against insect disease vectors, such as mosquitoes, because of various practical difficulties in rearing, sterilization and distribution of the parasite population. For mosquitoes, male-only release is considered essential since sterile females will bite and so may transmit disease, whereas male mosquitoes do not bite. This work concerns the mathematical modelling of the effectiveness of Sterile Insect Technique for Aedes aegypti mosquitoes, when the female sexual preference is incorporated. We found that for a released value of the sterile male mosquito below 40,000, the wild mosquito population decreases over time while the sterile male mosquito population increases. Therefore, the transmission of malaria and dengue infection declines because the sterile male mosquitoes dominated the environment. We also found that for a released value of the sterile male mosquito above 40,000, the wild mosquito population decreases and the sterile male mosquito population decreases as well. Therefore, if the injection of sterile male mosquitoes is large enough, the environment will be rid of mosquitoes over time. The result also shows that if sexual selection is incorporated into a reaction diffusion system, modelling the spread of Aedes aegypti mosquitoes, the Sterile Insect Technique (SIT) will still be a successful control measure.

Sustaining the gains made in malaria control and elimination

Significant progress has been made in the last 25 years to reduce the malaria burden,but considerable challenges remain.These gains have resulted from large investments in a range of control measures targeting malaria.Fana and co-authors find a strong relationship between education level and net usage with malaria parasitemia in pregnant women,suggesting the need for targeted control strategies.Mayala and co-workers find important links between agriculture and malaria with implications for inter-sectoral collaboration for malaria control.

Impact of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria

In this paper,we aim to evaluate the effectiveness of community-based interventions(CBIs)for the prevention and management of malaria.We conducted a systematic review and identified 42 studies for inclusion.Twenty-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets(ITNs),indoor residual spraying(IRS),or impregnated bed sheets;14 studies evaluated intermittent preventive therapy(IPT)delivered in community settings;two studies focused on community-based education for malaria prevention;and one study evaluated environmental management through drain cleaning.Our analysis suggests that,overall,the community-based delivery of interventions to prevent and control malaria resulted in a significant increase in ITNs ownership(RR:2.16,95%CI:1.86,2.52)and usage(RR:1.77,95%CI:1.48,2.11).However,usage of ITNs was limited to two-thirds of the population who owned them.Community-based strategies also led to a significant decrease in parasitemia(RR:0.56,95%CI:0.42,0.74),malaria prevalence(RR:0.46,95%CI:0.29,0.73),malaria incidence(RR:0.70,95%CI:0.54,0.90),and anemia prevalence(RR:0.79,95%CI:0.64,0.97).We found a non-significant impact on splenomegaly,birth outcomes(low birth weight,prematurity,stillbirth/miscarriage),anthropometric measures(stunting,wasting,and underweight),and mortality(all-cause and malaria-specific).The subgroup analysis suggested that community-based distribution of ITNs,impregnated bed sheets and IRS,and IPT are effective strategies.Qualitative synthesis suggests that high coverage could be achieved at a lower cost with the integration of CBIs with existing antenatal care and immunization campaigns.Community-based delivery of interventions to prevent and control malaria are effective strategies to improve coverage and access and reduce malaria burden,however,efforts should also be concerted to prevent over diagnosis and drug resistance.

Lessons on malaria control in the ethnic minority regions in Northern Myanmar along the China border, 2007–2014

Background:For many countries where malaria is endemic,the burden of malaria is high in border regions.In ethnic minority areas along the Myanmar-China border,residents have poor access to medical care for diagnosis and treatment,and there have been many malaria outbreaks in such areas.Since 2007,with the support of the Global Fund to Fight AIDS,Tuberculosis and Malaria(GFATM),a malaria control project was introduced to reduce the malaria burden in several ethnic minority regions.Methods:A malaria control network was established during the period from 2007 to 2014.Multiple malaria interventions,including diagnosis,treatment,distribution of LLINs and health education,were conducted to improve the accessibility and quality of malaria control services for local residents.Annual cross-sectional surveys were conducted to evaluate intervention coverage and indicators of malaria transmission.Results:In ethnic minority regions where a malaria control network was established,both the annual malaria incidence(19.1 per thousand per year,in 2009;8.7,in 2014)and malaria prevalence(13.6%in 2008;0.43%in 2014)decreased dramatically during the past 5–6 years.A total of 851393 febrile patients were detected,202598 malaria cases(including confirmed cases and suspected cases)were treated,and 759574 LLINs were delivered to populations at risk.Of households in 2012,73.9%had at least one ITNs/LLINs(vs.28.3%,in 2008),and 50.7%of children less than 5 years and 50.3%of pregnant women slept under LLINs the night prior to their visit.Additionally,malaria knowledge was improved in 68.4%of residents.Conclusion:There has been great success in improving malaria control in these regions from 2007 to 2014.Malaria burdens have decreased,especially in KOK and WA.The continued maintenance of sustainable malaria control networks in these regions may be a long-term process,due to regional conflicts and the lack of funds,technology,and health workers.Furthermore,information and scientific support from the international community should be offered to these ethnic minority regions to uphold recent achievements.

Mathematical modeling of malaria transmission dynamics in humans with mobility and control states

Malaria importation is one of the hypothetical drivers of malaria transmission dynamics across the globe.Several studies on malaria importation focused on the effect of the use of conventional malaria control strategies as approved by the World Health Organization(WHO)on malaria transmission dynamics but did not capture the effect of the use of traditional malaria control strategies by vigilant humans.In order to handle the aforementioned situation,a novel system of Ordinary Differential Equations(ODEs)was developed comprising the human and the malaria vector compartments.Analysis of the system was carried out to assess its quantitative properties.The novel computational algorithm used to solve the developed system of ODEs was implemented and benchmarked with the existing Runge-Kutta numerical solution method.Furthermore,simulations of different vigilant conditions useful to control malaria were carried out.The novel system of malaria models was well-posed and epidemiologically meaningful based on its quantitative properties.The novel algorithm performed relatively better in terms of model simulation accuracy than Runge-Kutta.At the best model-fit condition of 98%vigilance to the use of conventional and traditional malaria control strategies,this study revealed that malaria importation has a persistent impact on malaria transmission dynamics.In lieu of this,this study opined that total vigilance to the use of the WHO-approved and traditional malaria management tools would be the most effective control strategy against malaria importation.

Zooprophylaxis as a control strategy for malaria caused by the vector Anopheles arabiensis(Diptera:Culicidae):a systematic review

Background:Zooprophylaxis is the use of wild or domestic animals,which are not the reservoir host of a given disease,to divert the blood-seeking malaria vectors from human hosts.In this paper,we systematically reviewed zooprophylaxis to assess its efficacy as a malaria control strategy and to evaluate the possible methods of its application.Methods:The electronic databases,PubMed Central^(■),Web of Science,Science direct,and African Journals Online were searched using the key terms:“zooprophylaxis”or“cattle and malaria”,and reports published between January 1995 and March 2016 were considered.Thirty-four reports on zooprophylaxis were retained for the systematic review.Results:It was determined that Anopheles arabiensis is an opportunistic feeder.It has a strong preference for cattle odour when compared to human odour,but feeds on both hosts.Its feeding behaviour depends on the available hosts,varying from endophilic and endophagic to exophilic and exophagic.There are three essential factors for zooprophylaxis to be effective in practice:a zoophilic and exophilic vector,habitat separation between human and host animal quarters,and augmenting zooprophylaxis with insecticide treatment of animals or co-intervention of long-lasting insecticide-treated nets and/or indoor residual spraying.Passive zooprophylaxis can be applied only in malaria vector control if cattle and human dwellings are separated in order to avoid the problem of zoopotentiation.Conclusions:The outcomes of using zooprophylaxis as a malaria control strategy varied across locations.It is therefore advised to conduct a site-specific evaluation of its effectiveness in vector control before implementing zooprophylaxis as the behaviour of Anopheles arabiensis mosquitoes varies across localities and circumstances.

Would ivermectin for malaria control be beneficial in onchocerciasis-endemic regions?

Background:There is accumulating evidence supporting the use of ivermectin as a malaria control tool.Recent findings from the repeat ivermectin mass drug administrations for control of malaria trial demonstrated a reduced incidence of malaria in villages which received repeated ivermectin mass drug administration(MDA;six doses)compared to those who had only one round of ivermectin.Several other studies investigating the benefits of ivermectin for malaria purposes are ongoing/planned.Main text:While ivermectin MDA offers promising perspectives in the fight against malaria,we highlight the added benefits and anticipated challenges of conducting future studies in onchocerciasis-endemic regions,which are confronted with a substantial disease burden including onchocerciasis-associated epilepsy.Increasing the frequency of ivermectin MDA in such places may reduce the burden of both malaria and onchocerciasis,and allow for more entomological investigations on both the Anopheles mosquitoes and the blackflies.Upfront,acceptability and feasibility studies are needed to assess the endorsement by the local populations,as well as the programmatic feasibility of implementing ivermectin MDA several times a year.Conclusions:Onchocerciasis-endemic sites would doubly benefit from ivermectin MDA interventions,as these will alleviate onchocerciasis-associated morbidity and mortality,while potentially curbing malaria transmission.Involving onchocerciasis programs and other relevant stakeholders in the malaria/ivermectin research agenda would foster the implementation of pluri-annual MDA in target communities.

Long-lasting microbial larvicides for controlling insecticide resistant and outdoor transmitting vectors:a cost-effective supplement for malaria interventions

The issues of pyrethroid resistance and outdoor malaria parasite transmission have prompted the WHO to call for the development and adoption of viable alternative vector control methods.Larval source management is one of the core malaria vector interventions recommended by the Ministry of Health in many African countries,but it is rarely implemented due to concerns on its cost-effectiveness.New long-lasting microbial larvicide can be a promising cost-effective supplement to current vector control and elimination methods because microbial larvicide uses killing mechanisms different from pyrethroids and other chemical insecticides.It has been shown to be effective in reducing the overall vector abundance and thus both indoor and outdoor transmission.In our opinion,the long-lasting formulation can potentially reduce the cost of larvicide field application,and should be evaluated for its cost-effectiveness,resistance development,and impact on non-target organisms when integrating with other malaria vector control measures.In this opinion,we highlight that long-lasting microbial larvicide can be a potential cost-effective product that complements current front-line long-lasting insecticidal nets(LLINs)and indoor residual spraying(IRS)programs for malaria control and elimination.Microbial larviciding targets immature mosquitoes,reduces both indoor and outdoor transmission and is not affected by vector resistance to synthetic insecticides.This control method is a shift from the conventional LLINs and IRS programs that mainly target indoor-biting and resting adult mosquitoes.

Optimal control analysis of hepatocytic-erythrocytic dynamics of Plasmodium falciparum malaria

This paper presents an in-host malaria model subject to anti-malarial drug treatment and malaria vaccine antigens combinations.Pontryagin's Maximum Principle is applied to establish optimal control strategies against infected erythrocytes,infected hepatocytes and malaria parasites.Results from numerical simulation reveal that a combination of preerythrocytic vaccine antigen,blood schizontocide and gametocytocide drugs would offer the best strategy to eradicate clinical P.falciparum malaria.Sensitivity analysis,further reveal that the efficacy of blood schizontocides and blood stage vaccines are crucial in the control of clinical malaria infection.Futhermore,we found that an effective blood schizontocide should be used alongside efficacious blood stage vaccine for rapid eradication of infective malaria parasites.The authors hope that the results of this study will help accelerate malaria elimination efforts by combining malaria vaccines and anti-malarial drugs against the deadly P.falciparum malaria.

Malaria control along China-Myanmar Border during 2007–2013: an integrated impact evaluation

Background:Implementing effective interventions remain a lot of difficulties along all border regions.The emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great concern.China has effectively controlled cross-border transmission of malaria and artemisinin resistance of P.falciparum along the China-Myanmar border.Methods:A combined quantitative and qualitative study was used to collect data,and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during 2007-2013.Results:The parasite prevalence rate(PPR)in the five special regions of Myanmar was decreased from 13.6%in March 2008 to 1.5%in November 2013.Compared with the baseline(PPR in March 2008),the risk ratio was only 0.11[95%confidence interval(CI),0.09-0.14]in November 2013,which is equal to an 89%reduction in the malaria burden.Annual parasite incidence(API)across 19 Chinese border counties was reduced from 19.6 per 10000 person-years in 2006 to 0.9 per 10000 person-years in 2013.Compared with the baseline(API in 2006),the API rate ratio was only 0.05(95%CI,0.04-0.05)in 2013,which equates to a reduction of the malaria burden by 95.0%.Meanwhile,the health service system was strengthened and health inequity of marginalized populations reduced along the international border.Conclusion:The effective collaboration between China,Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified processes.The integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.

Investigation and control of a Plasmodium falciparum malaria outbreak in Shan Special Region II of Myanmar along the China-Myanmar Border from June to December 2014

Background:From 2007 to 2013,intensive control measures reduced malaria burden by 90%along the China-Myanmar border.However,despite these measures a P.falciparum malaria outbreak was reported in the Shan Special Region II of Myanmar in June of 2014.Methods:Epidemiological,parasitological and entomological investigations were performed.Dihydroartemisinin piperaquine(DAPQ)was immediately administered to treat parasite positive individuals.Long lasting insecticidal nets(LLIN),indoor residual spraying(IRS)with insecticides and behavior change communication(BCC)were also provided for outbreak control.An embedded efficacy study was conducted evaluating DP.Molecular genotyping via polymerase chain reaction(PCR)was performed on the Kelch gene on chromosome 13.Results:All infections were identified as Plasmodium falciparum by RDT and microscopy.Two fatalities resulted from the outbreak.The attack rate was 72.8%(67/92)and the incidence density rate was 14.2 per 100 person-weeks.The positive rate of rapid diagnostic test(RDT)was 72.2%(65/90)and microscopically-determine parasite rate 42.2%(38/90).Adjusted odds ratio(OR)of multivariate logistic regression analysis for aged<15 years,15–45 years,inappropriate treatment from a private healer and lack of bed nets were 13.51(95%confidence interval,2.21–105.89),7.75(1.48–44.97),3.78(1.30–46.18)and 3.21(1.21–15.19)respectively.In the six surrounding communities of the outbreak site,positive RDT rate was 1.2%(4/328)and microscopically-determine parasite rate 0.6%(2/328).Two light traps collected a total of 110 anopheline mosquitoes including local vectors,An.minimus,An.sinensis and An.maculates.After intensive control,the detection of malaria attacks,parasites and antigen were reduced to zero between July 1 and December 1,2014.The cure rate of P.falciparum patients at day 42 was 94.3%(95%CI,80.8–99.3%).The PCR did not detect K13-propeller mutations.Conclusion:Imported P.falciparum caused the outbreak.Age,seeking inappropriate treatment and lack of bed nets were risk factors for infection during the outbreak.P.falciparum was sensitive to treatment with DAPQ.The integrated measures controlled the outbreak and prevented the spread of P.falciparum effectively.The results of this study indicate that malaria control on the China-Myanmar border,especially among special populations,needs further collaboration between China,Myanmar and international societies.

From control to elimination:a spatial-temporal analysis of malaria along the China-Myanmar border

Background: Malaria cases have declined significantly along the China-Myanmar border in the past 10 years and this region is going through a process from control to elimination.The aim of this study is to investigate the epidemiology of malaria along the border,will identify challenges in the progress from control to elimination.Methods:: National reported malaria cases from China and Myanmar,along with the data of 18 Chinese border counties and 23 townships in Myanmar were obtained from a web-based diseases information reporting system in China and the national malaria control program of Myanmar,respectively.Epidemiological data was analyzed,including the number of reported cases,annual parasite index and proportion of vivax infection.Spatial mapping of the annual parasite index(API)at county or township level in 2014 and 2018 was performed by ArcGIS.The relationship of malaria endemicity on both sides of the border was evaluated by regression analysis.Results: The number of reported malaria cases and API declined in the border counties or townships.In 2014,392 malaria cases were reported from 18 Chinese border counties,including 8.4%indigenous cases and 91.6%imported cases,while the highest API(0.11)was occurred in Yingjiang County.There have been no indigenous cases reported since 2017,but 164 imported cases were reported in 2018 and 97.6%were imported from Myanmar.The average API in 2014 in 23 Myanmar townships was significantly greater than that of 18 Chinese counties(P<0.01).However,the API decreased significantly in Myanmar side from 2014 to 2018(P<0.01).The number of townships with an API between 0 and 1 increased to 15 in 2018,compared to only five in 2014,while still four townships had API>10.Plasmodium vivax was the predominant species along the border.The number of reported malaria cases and the proportion of vivax infection in the 18 Chinese counties were strongly correlated with those of the 23 Myanmar townships(P<0.05).Conclusions: Malaria elimination is approaching along the China-Myanmar border.However,in order to achieve the malaria elimination in this region and prevent the re-establishment of malaria in China after elimination,continued political,financial and scientific commitment is required.

Achievements of the national malaria control and elimination program in the People’s Republic of China:the Atlas of Malaria Transmission in China

In 2017,China achieved the target of zero indigenous malaria case for the first time,and has been certified as malaria free by World Health Organization in 2021.To further summarize the historical achievements and technical experiences of the elimination program,a project on the Roadmap Analysis and Verification for Malaria Elimination in China was carried out.Results of the project were compiled and published as the Atlas of Malaria Transmission in China(The Atlas).The Atlas using modern digital information technologies,has been supported by various data from 24 malaria endemic provinces of China since 1950,to assess the changes in malaria epidemic patterns from 1950 to 2019 at national and provincial levels.The Atlas is designed as two volumes,including a total of 1850 thematic maps and more than 130 charts,consisting of introductory maps,thematic maps of malaria epidemic and control at national and provincial levels.It objectively and directly shows the epidemic history,evolution process,and great achievements of the national malaria control and elimination program in China.The Atlas has important reference value for summing up historical experience in the national malaria elimination program of China,and malaria control and elimination in other endemic countries in the world.