[Malaria situation in the People's Republic of China in 2006].

Totally 64,178 malaria cases and 52,082 suspected cases with 38 deaths were reported by the annual case reporting system in 917 counties of 23 Provinces/Municipality/Autonomous Regions (P/M/A) in 2006, and the annual incidence was 0.50/10,000. Through the internet reporting system 60,382 malaria cases were reported from 1,097 counties of 30 P/M/A. The number of malaria cases and the rank of P/M/A were basically in concordance in the two systems. Among the 917 counties with reported malaria cases, 29 counties with an incidence more than 10/10,000 distributed in Yunnan (15 counties), Hainan (6), Anhui (7), Henan (1). There were 76 counties in which the malaria incidence was between 1/10,000 and 10/10,000. 3,469 Plasmodium falciparum malaria cases accounted for 5.4% of the total cases, of which 60.4% (2,097) were imported cases in 206 counties/cities of 17 P/M/A. Indigenous falciparum malaria was found in 38 counties/cities of Yunnan and Hainan Provinces, of which 26 counties/cities were in Yunnan, and 12 counties/cities were in Hainan, decreased by 5 and 4 respectively in comparison to that of 2005. Focal outbreaks occurred in 183 villages of 16 counties in Yunnan, Anhui, Henan and Guizhou Provinces. 3,058 malaria cases from the outbreaks accounted for 4.8% of the total reported cases. Although a considerable decrease in malaria incidence was contributed to the implementation of the Global Fund Programme, Yunnan and Hainan Provinces were still relatively high transmission areas. Yunnan ranked No.2 in the country in terms of the number of cases, while Hainan ranked down to No.2 by malaria incidence for the first time after ranking No.1 for years. 19,385 malaria cases were reported from the two provinces in 2006, accounting for 30.2% of the total reported cases in the country. There were 15,532 cases with 32 deaths reported from Yunnan, the incidence was 3.89/ 10,000, a decrease of 21.4% than that in the last year. Among the reported cases, 3,090 were falciparum malaria with 60.4% imported cases. The number of reported cases in Hainan was 3,858, with an incidence of 4.65/10,000, 14.8% decrease than the last year. In central China, the re-emergence of malaria was considerable in provinces along the Huai River, especially in the provinces of Anhui and Henan. Not only the number of malaria cases but also the incidence in Anhui became the No.1 in the country in 2006. 34,984 malaria cases and 11,064 suspected cases were reported from Anhui in 2006, accounting for 54.5% of the total cases in the country, with an incidence of 6.4/10,000 increased by 113% than that in 2005. The number of reported cases in Henan was 5,093, increased by 86.7% in incidence. Hubei Province reported 1,782 cases with an incidence of 0.31/10,000, increased by 14.8%. 767 cases were reported from Jiangsu Province, a slight increase than that in 2005. Cases reported from other P/M/A occupied about 3.4% of the total. Several hundreds were reported from each of Guizhou, Sichuan, Guangdong, Zhejiang, Shandong and Shanghai. Less than 100 cases were reported from each of Guangxi, Fujian, Jiangxi, Hunan, Chongqing, Liaoning, Shaanxi, Shanxi, and Gansu in 2006. In summary, malaria is still an important problem of public health in the country, especially in the southern and central parts. Yunnan and Hainan still faced a severe situation of malaria endemic with the spread of Plasmodium falciparum, particularly the imported malaria cases in 25 border counties in Yunnan. In the central parts of the country, especially in Anhui Province the malaria prevalence increased considerably with the highest incidence and over half of the total malaria cases in 2006, rank of P/M/A were basically in concordance in the two systems, which revealed new challenges to the National Malaria Control Program in China.