Tracking progress towards malaria elimination in China: estimates of reproduction numbers and their spatiotemporal variation

China reported zero locally-acquired malaria cases in 2017 and 2018. Understanding the spatio-temporal pattern underlying this decline, especially the relationship between locally-acquired and imported cases, can inform efforts to maintain elimination and prevent re-emergence. This is particularly pertinent in Yunnan province, where the potential for local transmission is highest. Using a geo-located individual-level dataset of cases recorded in Yunnan province between 2011 and 2016, we jointly estimate the case reproduction number, Rc, and the number of unobserved sources of infection. We use these estimates within spatio-temporal geostatistical models to map how transmission varied over time and space, estimate the timeline to elimination and the risk of resurgence. Our estimates suggest that, maintaining current intervention efforts, Yunnan is unlikely to experience sustained local transmission up to 2020. However, even with a mean Rc of 0.005 projected for the year 2019, locally-acquired cases are possible due to high levels of importation.

[1]  Kevin Marsh,et al.  Clinical Features of Malaria , 1999 .

[2]  Jun Zhang,et al.  Effectiveness and impact of the cross-border healthcare model as implemented by non-governmental organizations: case study of the malaria control programs by health poverty action on the China-Myanmar border , 2016, Infectious Diseases of Poverty.

[3]  Thibaut Jombart,et al.  epicontacts: Handling, visualisation and analysis of epidemiological contacts , 2018, F1000Research.

[4]  David L Smith,et al.  Quantitative, model-based estimates of variability in the generation and serial intervals of Plasmodium falciparum malaria , 2016, Malaria Journal.

[5]  Jianxing Yu,et al.  Malaria in China, 2011–2015: an observational study , 2017, Bulletin of the World Health Organization.

[6]  Fang Huang,et al.  Ready for malaria elimination: zero indigenous case reported in the People’s Republic of China , 2018, Malaria Journal.

[7]  Wei-kang Jiang,et al.  Monitoring of malaria vectors at the China-Myanmar border while approaching malaria elimination , 2018, Parasites & Vectors.

[8]  H. Rue,et al.  Approximate Bayesian inference for latent Gaussian models by using integrated nested Laplace approximations , 2009 .

[9]  Hongjun Qiu,et al.  Risk assessment of malaria transmission at the border area of China and Myanmar , 2017, Infectious Diseases of Poverty.

[10]  Li Zhang,et al.  China’s 1-3-7 surveillance and response strategy for malaria elimination: Is case reporting, investigation and foci response happening according to plan? , 2015, Infectious Diseases of Poverty.

[11]  Anthony N. Pettitt,et al.  Comment on the paper: ‘Approximate Bayesian inference for latent Gaussian models by using integrated nested Laplace approximations’ by Rue, H. Martino, S. and Chopin, N. , 2009 .

[12]  Jun Cao,et al.  Shrinking the malaria map in China: measuring the progress of the National Malaria Elimination Programme , 2016, Infectious Diseases of Poverty.

[13]  Amy Wesolowski,et al.  Using parasite genetic and human mobility data to infer local and cross-border malaria connectivity in Southern Africa , 2019, eLife.

[14]  Laura Tangley Preparing for Climate Change , 2010 .

[15]  T. Jombart,et al.  epicontacts: Handling, visualisation and analysis of epidemiological contacts , 2018, F1000Research.

[16]  Benjamin Letham,et al.  Forecasting at Scale , 2018, PeerJ Prepr..

[17]  Andrew J Tatem,et al.  Mapping residual transmission for malaria elimination , 2015, eLife.

[18]  Chengdong Xu,et al.  Spatiotemporal epidemic characteristics and risk factor analysis of malaria in Yunnan Province, China , 2017, BMC Public Health.

[19]  Ying Wang Malaria in China , 2014 .

[20]  Jun Feng,et al.  Lessons from malaria control to elimination: case study in Hainan and Yunnan provinces. , 2014, Advances in parasitology.

[21]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[22]  M. Tanner,et al.  Malaria surveillance-response strategies in different transmission zones of the People's Republic of China: preparing for climate change , 2012, Malaria Journal.

[23]  Andrew J. Tatem,et al.  Plasmodium falciparum malaria importation from Africa to China and its mortality: an analysis of driving factors , 2016, Scientific Reports.

[24]  Andrew J Tatem,et al.  Changing epidemiology and challenges of malaria in China towards elimination , 2019, Malaria Journal.

[25]  Jon Kleinberg,et al.  Maximizing the spread of influence through a social network , 2003, KDD '03.

[26]  Amy Wesolowski,et al.  Mapping imported malaria in Bangladesh using parasite genetic and human mobility data , 2019, eLife.

[27]  Shui-sen Zhou,et al.  Surveillance and response to drive the national malaria elimination program. , 2014, Advances in parasitology.

[28]  Samir Bhatt,et al.  Estimating spatiotemporally varying malaria reproduction numbers in a near elimination setting , 2018, Nature Communications.

[29]  Qi Gao,et al.  Communicating and Monitoring Surveillance and Response Activities for Malaria Elimination: China's “1-3-7” Strategy , 2014, PLoS medicine.

[30]  Bernhard Scholkopf,et al.  Submodular Inference of Diffusion Networks from Multiple Trees , 2012, ICML.

[31]  Zhongjie Li,et al.  Trends of imported malaria in China 2010–2014: analysis of surveillance data , 2016, Malaria Journal.

[32]  Xiao-Nong Zhou,et al.  Historical patterns of malaria transmission in China. , 2014, Advances in parasitology.

[33]  P. Fine The interval between successive cases of an infectious disease. , 2003, American journal of epidemiology.

[34]  John R. Olson,et al.  PreParing For Climate Change , 2009 .

[35]  Caroline O Buckee,et al.  Mapping malaria by combining parasite genomic and epidemiologic data , 2018, bioRxiv.

[36]  Ning Xiao,et al.  Analysis of Malaria Epidemiological Characteristics in the People's Republic of China, 2004-2013. , 2015, The American journal of tropical medicine and hygiene.

[37]  W. Wernsdorfer,et al.  The clinical features of malaria. , 1988 .

[38]  G. Lu,et al.  Malaria outbreaks in China (1990–2013): a systematic review , 2014, Malaria Journal.

[39]  J. Wallinga,et al.  Different Epidemic Curves for Severe Acute Respiratory Syndrome Reveal Similar Impacts of Control Measures , 2004, American journal of epidemiology.

[40]  Zhou Zj,et al.  The malaria situation in the People's Republic of China , 1981 .

[41]  Bernhard Schölkopf,et al.  Uncovering the structure and temporal dynamics of information propagation , 2014, Network Science.