Chinese Journal of Vector Biology and Control ›› 2023, Vol. 34 ›› Issue (1): 94-100.DOI: 10.11853/j.issn.1003.8280.2023.01.017

• Investigation • Previous Articles     Next Articles

An investigation of technical capabilities for malaria control in China

Ren-dong YANG1,2,3, Yuan-sheng FANG2, Rong-na ZHANG2, Zuo-ru LIANG2, Xiao-peng QI1,2   

  1. 1. Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
    2. Center for Global Public Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
    3. Emergency Management Office, Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong 519060, China
  • Received:2022-08-20 Online:2023-02-20 Published:2023-02-16
  • Supported by:
    Assessment of Technical Capacity for Malaria Control in China


杨仁东1,2,3, 房元圣2, 张荣娜2, 梁作如2, 戚晓鹏1,2   

  1. 1. 中国疾病预防控制中心中国现场流行病学培训项目, 北京 102206;
    2. 中国疾病预防控制中心全球公共卫生中心, 北京 102206;
    3. 珠海市疾病预防控制中心应急管理办公室, 广东 珠海 519060
  • 通讯作者: 戚晓鹏,
  • 作者简介:杨仁东,男,硕士,科员,主管医师,主要从事传染病防控、学校卫生工作,
  • 基金资助:

Abstract: Objective To investigate the technical capabilities of malaria control institutions in China, and to provide a reference for malaria control in the post-eradication era as well as foreign medical aid. Methods Two self-made questionnaires were used to investigate the technical capabilities (malaria control and mosquito vector surveillance) of provincial centers for disease control and prevention and institutes of parasitic diseases. The capacity for malaria diagnosis and treatment of medical institutions was analyzed based on the data on malaria cases from the China Information System for Disease Control and Prevention. The relevant official websites were browsed to collect the antimalarial products and enterprises with prequalification certificates from the World Health Organization (WHO) or registration approvals from the National Medical Products Administration. By reviewing the literature to tease out the technical progress in vaccines, drugs, and other fields of malaria. The data of foundations and other institutions were collected by means of expert consultation and interview. Results National vector surveillance sites were set in all 31 provinces, autonomous regions, or municipalities directly under the central government and Xinjiang Production and Construction Corps ("province" below), with 5.35 sites per province. There were 178 staff members, with 5.74 persons per province. Over 26 provinces had mosquito vector laboratories and mosquito breeding rooms, and carried out mosquito density surveillance, mosquito species and ecology research, and insecticide types and resistance research. Forty-seven persons from 30 provinces had WHO certificates of microscopy. Twenty-four malaria endemic provinces had 227 staff members for malaria prevention and control, with 9.45 persons per province. Among them, 63.88% were aged 30 to 49 years, 52.42% had a senior or vice-senior title, and 58.59% had ≥ 10 years of working in malaria. All the 24 provinces had malaria laboratories, and there were 145 malaria laboratories in total (6.04 laboratories per province), all with the abilities of plasmodium blood smear microscopy and nucleic acid detection. Sixteen provinces had approvals of foreign aid projects or provincial/ministerial/above level research projects, with 56 projects in total, covering Asia, Africa, and Oceania. WHO-prequalified enterprises included 26 manufacturers of active pharmaceutical ingredients, three manufacturers of long-lasting insecticidal nets, one medicine manufacturer, and one insecticide manufacturer. Forty-eight companies of antimalarial drugs had registration approvals from the National Medical Products Administration. At least 77.30% of medical institutions had certain capacities for the diagnosis and treatment of falciparum malaria. Artemisinin and its derivatives developed by the China Academy of Chinese Medical Sciences were the only WHO-recognized specific antimalarial drugs. Pfcp-2.9 antigen developed by universities was approved for clinical trials. Two vaccines were put into preclinical studies. At least 31 customs ports were capable to monitor Anopheles mosquitoes, and four customs ports had malaria rapid diagnostic test abilities accredited by the College of American Pathologists. The WHO, Global Fund, Bill & Melinda Gates Foundation, Health Poverty Action, Chinese Preventive Medicine Association, and China Chamber of Commerce for Import & Export of Medicines & Health Products played important roles in malaria elimination in China by providing funds, organizing technical training, participating in malaria elimination assessment, and helping enterprises apply for WHO prequalification. Conclusion China has established multiple work networks nationwide, built joint prevention and control mechanisms involving multiple departments, and accumulated technical talents with high professional levels in various technical fields, but still with shortcomings in some technical fields.

Key words: Malaria, Technical capability, Medical aid, Mosquito vector surveillance, Antimalarial product, Social organization

摘要: 目的 梳理我国各类疟疾防控机构的技术能力水平,为疟疾消除后时代防控工作的延续以及对外医疗援助提供参考。方法 自制2套调查问卷,调查省级疾病预防控制中心(疾控中心)和寄生虫病防治研究所(寄研所)在疟疾防控、蚊媒监测方面的技术能力水平。从中国疾病预防控制信息系统导出疟疾病例个案数据,分析医疗卫生机构的诊疗能力。浏览官网,搜集通过世界卫生组织(WHO)预认证(PQ)、国家药监局批准注册的抗疟产品及企业名单。查阅文献,梳理疟疾疫苗、药物等其他领域的技术进展。采用专家咨询和访谈的方式搜集基金会等其他机构的资料。结果 31个省(直辖市、自治区)和新疆生产建设兵团(为了叙述方便,以下统称为省)共设有国家级病媒生物监测点166个,平均5.35个/省;配有工作人员178人,平均5.74人/省;超过26个省设有蚊媒实验室、蚊虫饲养室,并开展蚊媒密度监测、蚊媒种群和生态学研究、杀虫剂种类和抗性研究;30个省共47人获得WHO镜检技能评估证书。24个疟疾流行省配有疟疾防控人员227人,平均9.45人/省,其中30~49岁占63.88%,正、副高级职称合计占52.42%,从事疟疾工作10年及以上占58.59%;24个省都有疟疾相关实验室,共有145间,平均6.04间/省,且都有疟原虫血涂片镜检和核酸检测能力;16个省获批援外项目或省部级及以上课题项目(共56项),研究地域覆盖亚洲、非洲和大洋洲。通过WHO原料药预认证的企业26家、长效防虫蚊帐3家、制剂药1家、化学杀虫剂1家,通过国家药监局批准注册的抗疟药企业48家。至少77.30%的医疗卫生机构具备一定的恶性疟诊疗能力。中国中医科学院创制的青蒿素及其衍生物是WHO唯一认可的抗疟特效药,高校研发的PfCP-2.9抗原获批进入临床试验,另有2种疫苗进入临床前研究。至少31个海关口岸具备按蚊监测能力,4个海关口岸通过了美国病理家学会组织的疟原虫快速检测能力验证。WHO、全球基金、比尔及梅琳达盖茨基金、英国健康扶贫行动、中华预防医学会、中国医药保健品进出口商会等组织通过提供资金、组织技术培训、参与消除疟疾评估、帮助企业申请WHO预认证等多种形式,在我国消除疟疾历程中发挥了重要作用。结论 我国在全国范围内建立了多套疟疾防控工作网络,构建了多部门共同参与的联防联控机制,多个技术领域积累了专业水准较高的技术人才,但少部分技术领域仍存在短板。

关键词: 疟疾, 技术能力, 医疗援助, 蚊媒监测, 抗疟产品, 社会组织

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