Malaria Ends with Us — Time to Reinvest, Reimagine, and Reignite

Simon I. Hay^1,#

1. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.

^# Corresponding author: Simon I. Hay, sihay@uw.edu.

On World Malaria Day 2025 under the banner “Malaria Ends with Us,” China’s experience offers timely lessons for global malaria elimination. Certified malaria-free in 2021, China achieved this milestone through decades of reinvestment, local innovation, and strong political will. This commentary highlights key strategies: reinvestment after resurgence in the Huai River Basin, adaptive local leadership in Hainan, and cross-border collaboration in Yunnan. China’s integrated approach — combining ecological vector control, community engagement, and sustained surveillance — shows that ending malaria requires more than technology. It demands long-term commitment, innovation, and collective action.

终结疟疾，从我做起：再投资、再构想、再承诺

Simon I. Hay^1,#

1. 健康测量科学系，医学院，华盛顿大学，西雅图，华盛顿州，美国。

^# 通信作者：Simon I. Hay, sihay@uw.edu。

在“终结疟疾，从我做起”主题下迎来的2025年世界防治疟疾日，中国在疟疾防控方面积累的丰富经验为全球迈向消除目标提供了重要借鉴。中国于2021年获得世界卫生组织“无疟疾国家”认证，这一成就得益于多年来持续的资源投入、本土化的防控创新以及坚定的政治承诺。本文重点回顾了中国具有代表性的战略举措，如：媒介幼虫的创新型控制、淮河流域疟疾反弹后的重投资源与策略调整、海南省因地制宜的灵活治理，以及云南省推动的跨境联防联控合作等。中国构建的综合防控体系 — 融合生态驱动的媒介控制、社区广泛参与、持续高效的监测机制 — 充分表明，消除疟疾不仅依赖科技手段，更有赖于长期的政策承诺、持续的创新实践以及社会各方的协同努力。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.099

Risk Factors for Imported Severe Malaria Cases — China, 2019–2023

Boyu Yi¹; Zhigui Xia^1,#

1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Health Commission Key Laboratory on Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China.

^# Corresponding author: Zhigui Xia, xiazg@nipd.chinacdc.cn.

To analyze the epidemiological characteristics of imported malaria in China from 2019 to 2023 and to explore risk factors for severe malaria cases, thereby providing a theoretical basis for early clinical identification and intervention of severe malaria. National malaria case data were retrospectively collected from 2019 to 2023 through the Chinese Center for Disease Control and Prevention Parasitic Disease Prevention and Control Information System. Study subjects were divided into severe and non-severe malaria cases, and the characteristics of both groups were analyzed. Multivariate logistic regression analysis was used to explore risk factors for developing severe malaria. From 2019 to 2023, a total of 7,892 imported malaria cases were reported nationwide, including 673 severe cases and 7,219 non-severe cases. There were 7,353 (93.2%) male and 539 (6.8%) female patients. Compared to non-severe malaria patients, severe malaria patients were older (43.9±10.4 years), predominantly originated from Africa (643/95.5%), had a higher frequency of recent overseas residence within the past month (609/90.5%), were typically infected with P. falciparum (527/78.3%), and had a higher mortality rate (47/7.0%). Severe cases had longer median time intervals from symptom onset to medical visit (4 days), from visit to diagnosis (2 days), and from diagnosis to treatment (2 days), and a longer median medication time (7 days), all P<0.05. This study identified risk factors for severe malaria and recommends focusing on monitoring patients' age, infection source, Plasmodium species, time from onset to hospital visit, and recent history of foreign residence. These findings provide a valuable reference for effectively managing malaria cases and reducing the incidence of severe malaria in the future.

输入性重症疟疾病例危险因素 — 中国，2019–2023年

易博禹¹；夏志贵^1#

1. 中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心），传染病溯源预警与智能决策全国重点实验室，国家卫生健康委员会寄生虫病原与媒介生物学重点实验室，世界卫生组织热带病合作中心，科技部国家级热带病国际联合研究中心，上海，中国。

^# 通信作者: 夏志贵，xiazg@nipd.chinacdc.cn。

分析 2019–2023 年我国全国输入性疟疾的流行病学特征，探讨重症疟疾病例的危险因素，为临床早期识别和干预重症病例提供理论依据。通过中国疾病预防控制中心寄生虫病预防控制信息系统，回顾性收集 2019–2023 年全国疟疾病例数据。将研究对象分为重症和非重症疟疾病例，分析两组病例特征，并采用多因素 Logistic 回归分析探讨发展为重症疟疾的危险因素。2019–2023 年全国共报告输入性疟疾病例 7,892 例，其中重症病例 673 例，非重症病例 7219 例。男性 7,353 例（93.2%），女性 539 例（6.8%）。与非重症患者相比，重症患者年龄更大（43.9±10.4 岁），感染来源以非洲为主（643/95.5%），近 1个月有境外居留史比例高（609/90.5%），感染虫种以恶性疟原虫为主（527/78.3%），死亡率更高（47/7.0%）。重症病例从症状出现到就诊的中位时间间隔为 4 天，就诊至确诊中位时间为 2 天，确诊至治疗中位时间为 2 天，用药疗程中位时间为 7 天，均显著长于非重症病例（均 P<0.05）。本研究明确了重症疟疾的危险因素，建议重点关注患者年龄、感染来源、疟原虫虫种、发病至就诊时间及近期境外居留史，为未来有效管理疟疾病例、降低重症疟疾发生率提供了重要参考。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.100

Application of Remote Sensing Methods in Predicting the Dynamics of Anopheles sinensis — Anhui Province, China, 2019–2023

Jingjing Jiang^1,&; Zijian Liu^1,&; Hongzheng Lu²; Tao Zhang¹; Xiaofeng Lyu¹; Xian Xu¹; Shuqi Wang¹; Qinshu Chu¹; Weidong Li^1,#; Duoquan Wang^3,#

1. Anhui Provincial Center for Disease Control and Prevention, Hefei City, Anhui Province, China;

2. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei City, Anhui Province, China;

3. National Institute of Parasitic Diseases (Chinese Center for Tropical Diseases Research), Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China.

^& Joint first authors.

^# Corresponding author: Weidong Li, lwd@ahcdc.com.cn; Duoquan Wang, wangdq@nipd.chinacdc.cn .

Malaria is a mosquito-borne infectious disease that poses a serious threat to human health. Although Anhui Province achieved malaria elimination in 2019, the risk of retransmission from imported cases persists due to cross-border human mobility. Given the strong correlation between meteorological and environmental factors and malaria transmission, this study selected four distinct geographic regions in Anhui Province to investigate the relationship between these factors and malaria vector abundance using remote sensing technology. We collected density data of An. sinensis, meteorological parameters (temperature, humidity, rainfall), and normalized difference vegetation index (NDVI) from 18 surveillance sites in Anhui Province from 2019 to 2023. The data underwent preprocessing through multi-band composition, image mosaicking, and surface reflectance calibration to construct a spatiotemporal database. A generalized additive model (GAM) was developed using data from 2019 to 2022 and subsequently validated by predicting mosquito vector density in 2023. Univariate GAM analysis revealed that nonlinear models provided better fit than linear models based on Akaike Information Criterion (AIC) values. Temperature, lagged temperature (temperature_1), humidity, lagged humidity (humidity_1), rainfall, lagged rainfall (rainfall_1), NDVI, and lagged NDVI (NDVI_1) all demonstrated significant nonlinear relationships with An. sinensis density (P<0.05). Specifically, NDVI (0.34–0.81), temperature (10.55 ℃–30.68 ℃), humidity (46.82%–97.61%), and rainfall (9.67 mm–440.52 mm) showed significant positive correlations with An. sinensis density. The optimal multivariate GAM incorporated lagged variables: humidity_1, NDVI_1, rainfall_1, and temperature_1. This model achieved an R² value of 0.76 on the test set, with a mean squared error (MSE) of 0.19 and a mean absolute error (MAE) of 0.28. NDVI, temperature, humidity, and rainfall constitute the key environmental drivers influencing temporal patterns of Anopheles sinensis density in Anhui Province. The GAM-based prediction model provides quantitative decision support for dynamic mosquito vector monitoring and resource allocation for malaria control.

遥感技术在中华按蚊动态预测中的应用

姜静静^1,&；刘子健^1,&；卢宏正²；张滔¹；吕晓凤¹；许娴¹；王淑琪¹；储琴书¹；李卫东^1,#；王多全^3,#

1. 安徽省疾病预防控制中心，合肥市，安徽省，中国；

2. 安徽医科大学公共卫生学院，合肥市，安徽省，中国；

3. 寄生虫病预防控制所（国家热带病研究中心），中国疾病预防控制中心，国家卫生健康委员会寄生虫病原与媒介生物学重点实验室，传染病溯源预警与智能决策全国重点实验室，上海交通大学医学院-国家热带病研究中心全球健康学院，上海，中国。

^& 共同第一作者。

^# 通信作者：李卫东，lwd@ahcdc.com.cn；王多全，wangdq@nipd.chinacdc.cn。

疟疾是一种严重危害人类健康的蚊媒传染病。安徽省已于2019年实现消除疟疾，然而随着人员跨境流动，全省仍将长期面临疟疾输入再传播风险。鉴于气象环境要素与疟疾传播的高度相关性，本研究选取安徽省四种典型地形区域为研究现场，基于遥感技术解析中华按蚊密度与气象环境因子的关联机制。整合2019-2023年安徽省18个监测点的中华按蚊密度数据及同期气象参数（温度、湿度、降雨量）、归一化植被指数（NDVI）等遥感数据，通过多波段合成、影像拼接与地表反射率定标等预处理构建时空数据库。采用广义加性模型（GAM），基于2019-2022年监测数据进行模型训练，并对2023年蚊媒密度开展预测验证。在单变量GAM分析中，温度、滞后温度（temperature_1）、湿度、滞后湿度（humidity_1）、降雨量、滞后降雨（rainfall_1）、NDVI、滞后NDVI （NDVI_1）均呈现显著非线性效应。其中，NDVI（0.34–0.81）、气温（10.55℃–30.68℃）、湿度（46.82%–97.61%）、降雨量（9.67mm–440.52mm）与中华按蚊密度呈正相关。经参数优化，多变量GAM最终纳入humidity_1、NDVI_1、rainfall_1和temperature_1等滞后变量，模型决定系数为0.76，均方误差为0.19，平均绝对误差为0.28。NDVI、温度、湿度和降雨量构成安徽省中华按蚊密度变化的核心环境驱动因子，基于GAM构建的预测模型可为区域蚊媒动态监测及防控资源配置提供量化决策支持。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.101

Echinococcus Infection and Metacestode Fertility in Yaks and Sheep — Four Provincial-Level Administrative Divisions, Northwestern China, 2023

Qiufeng Lan^1,&; Zhuoma Bianba^2,&; Xiaojin Mo¹; Guirong Zheng³; Bolor Bold⁴; Gengcheng He¹; Haijun Gao⁵; Wei Hu³; Ting Zhang^1,2,3,#; Xiaonong Zhou^1,4,#

1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Shanghai, China;

2. National Health Commission Key Laboratory of Echinococcosis Prevention and Control, Xizang Center for Disease Control and Prevention, Lhasa City, Xizang Autonomous Region, China;

3. State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot City, Inner Mongolia Autonomous Region, China;

4. School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University of Medicine, Shanghai, China;

5. Chengdu Fifth People's Hospital, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine/The Second Clinical Medical College, Chengdu City, Sichuan Province, China.

^& Joint first authors.

^# Corresponding author: Ting Zhang, zhangting@nipd.chinacdc.cn; Xiaonong Zhou, zhouxn@nipd.chinacdc.cn .

Echinococcosis is a zoonotic parasitic disease caused by the larval stage of Echinococcus, prevalent in northwestern China. It poses a serious threat to human health and causes significant economic losses in the livestock industry. This study aims to investigate the infection and development of Echinococcus in livestock in northwestern China, providing scientific basis for precise prevention and control of echinococcosis. This study utilized a combination of slaughterhouse and household investigations. Liver and lungs from slaughtered livestock in Sichuan Province, Qinghai Province, Xizang Autonomous Region, and Xinjiang Uygur Autonomous Region were examined through visual inspection and palpation, and Echinococcus cysts were collected. The cyst fertility was analyzed via microscopic examination. Metacestode DNA was extracted for PCR amplification of the mitochondrial Cox1 gene. Sequence alignment with the GenBank database was conducted to identify the genotypes of Echinococcus. Phylogenetic tree was constructed using MEGA 7.0 software. Haplotypes were analyzed using DnaSP 6, and a haplotype network was constructed using PopART 1.7. Data analysis was performed using SAS 9.4, and P<0.05 indicates statistical significance. Between October and December 2023, 400 yaks and 808 sheep were surveyed in Qinghai, Xizang, and Xinjiang. The infection rate of Echinococcus in yaks was 16.5%, significantly higher than that in sheep (9.41%, χ² = 12.9802, P<0.001). The fertility rate of Echinococcus cysts in sheep was 71.79%, significantly higher than that in yaks (15.57%, χ² = 64.1670, P<0.0001). The cysts were mainly parasitizes in the liver of sheep (82.89%) and the lungs of yaks (63.89%). A total of 169 Cox1 sequences were successfully amplified, of which 98.82% (167/169) corresponded to E. granulosus sensu stricto G1/G3, while one sequence was identified as E. canadensis G6, and one from E. multilocularis. A total of 48 haplotypes were detected, with H3 being the predominant haplotype. In the four survey provinces of China, the infection rate in yaks (16.5%) was significantly higher than in sheep (9.41%). Echinococcus was found preferably infect sheep liver and yak lungs, with a higher cyst fertility rate in sheep compared to yaks. Livestock infections are mainly caused by E. granulosus G1/G3, and this study for the first time identified E. multilocularis infection in yaks from Xizang. The findings provide a crucial foundation for further research into the molecular epidemiology, genetic evolution, and the development of precise prevention and control strategies for Echinococcus in the regions.

牦牛与绵羊的棘球蚴感染及可育性调查 — 西北地区四省，中国，2023年

蓝秋凤^1,&，边巴卓玛^2,&，莫筱瑾¹， 郑贵荣³，Bolor Bold⁴，贺耿城¹，高海军⁵，胡薇³，张颋^1,2,3,#，周晓农^1,4,#

1.寄生虫病预防控制所（国家热带病研究中心），中国疾病预防控制中心；国家卫生健康委员会寄生虫病原与媒介生物学重点实验室；世界卫生组织热带病合作中心；科技部国家级热带病国际联合研究中心，传染病溯源预警与智能决策全国重点实验室，上海，中国；

2. 西藏自治区疾病预防控制中心，国家卫生健康委包虫病防治研究重点实验室，拉萨市，西藏自治区，中国；

3. 草原家畜生殖调控与繁育国家重点实验室，生命科学学院，内蒙古大学，呼和浩特市，内蒙古自治区，中国；

4. 全球健康学院，国家热带病研究中心，上海交通大学医学院，上海，中国；

5. 成都市第五人民医院,成都中医药大学附属第五医院/第二临床医学院，成都市，四川省，中国。

^& 共同第一作者。

^# 通讯作者: 张颋 zhangting@nipd.chinacdc.cn；周晓农 zhouxn@nipd.chinacdc.cn。

棘球蚴病是由棘球绦虫幼虫寄生在宿主体内引起的人兽共患寄生虫病，主要在我国西北地区高度流行。该病不仅严重危害人类健康，还给畜牧业带来巨大的经济损失。本研究旨在调查我国西北地区家畜中棘球绦虫的感染和发育情况，为棘球蚴病的精准防治提供科学依据。本研究采用屠宰场调查结合入户调查的方式，对四川省、青海省、西藏自治区和新疆维吾尔自治区的部分地区屠宰家畜的肝肺进行视诊和触诊，收集棘球蚴包囊；通过显微镜镜检分析包囊的可育性；提取棘球蚴的DNA，采用PCR扩增线粒体Cox1基因并与Genbank数据库中的序列进行比对，以鉴定棘球绦虫的基因型；使用MEGA7.0软件构建系统发育树；DnaSP 6 分析单倍型，PopArt 1.7绘制单倍型网络图。数据分析使用SAS 9.4，P<0.05表示差异有统计学意义。2023年10–12月间，在青海、西藏和新疆共调查400头牦牛和808头绵羊，牦牛棘球蚴的感染率为16.5%，显著高于绵羊（9.41%，χ²=12.9802, P<0.001）。绵羊体内棘球蚴的可育率为 71.79%，显著高于牦牛的可育率（15.57%, χ²=64.1670, P<0.0001）。棘球蚴主要寄生于绵羊肝脏（82.89%）和牦牛的肺脏（63.89%）；成功扩增了169条Cox1序列，其中，98.82%（167/169）的序列为细粒棘球绦虫狭义种G1/G3型，一条为加拿大棘球绦虫G6基因型，一条是多房棘球绦虫。共发现48个单倍型，以H3为主。我国西北四个省份家畜中牦牛感染率（16.5%）显著高于绵羊（9.41%）。棘球蚴更易于寄生在绵羊的肝脏和牦牛的肺脏；且绵羊棘球蚴的可育性高于牦牛。家畜感染主要以细粒棘球绦虫狭义种G1/G3 型为主，且首次在西藏牦牛中鉴定到多房棘球绦虫的感染。本研究结果为进一步研究当地棘球绦虫的分子流行病学、遗传进化，制定精准防控策略提供了重要基础。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.102

Global Assistance and the Cascade of Malaria Prevention and Control — Sub-Saharan Africa, 2011–2022

Junyi Shi¹; Minmin Wang¹; Adelard Kakunze²; Hawa Catherine Margai³; Huang Hu⁴; Yikai Feng¹; Daniel Okaka⁵; Muhammad Abdullahi Idris⁶; Yinzi Jin^1#; Minghui Ren¹

1. Department of Global Health, School of Public Health, Peking University, Beijing, China;

2. African Centers for Disease Control and Prevention, Addis Ababa, Ethiopia;

3. Levuma Community Health Centre, Kenema District, Sierra Leone;

4. Department of Sociology, Tsinghua University, Beijing, China;

5. Medical Teams International, Kampala, Uganda;

6. Zamfara State University, Zamfara State, Nigeria.

^# Corresponding authors: Yinzi Jin, yzjin@bjmu.edu.cn.

Approximately 70% of funding for malaria prevention and control (P&C) in Sub-Saharan Africa comes from global assistance, yet progress has stagnated over the past decade. We constructed a cascade of malaria P&C services and analyzed its coverage and quality across 26 African countries from 2011–2022. Panel analysis was conducted to examine the effectiveness of four major donors [the United States of America (USA), the United Kingdom (UK), the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF), and United Nations International Children's Emergency Fund (UNICEF)], which account for 90% of global funding, in implementing the cascade. Recommended practice coverage doubled during 2011–2016 but decreased by 10% by 2022. Unrecommended practices followed the same pattern. Total funding from 2011–2020 reached 7.15 billion USA Dollar (USD), with the USA and GF steadily contributing 94.65%, while the UK and UNICEF demonstrated notable funding reductions. Overall, the funding showed limited correlation with the cascade coverage and quality, promoting directly only the upstream measures. Our findings highlight four key challenges: retrogression of cascade coverage since the late 2010s, persistent gaps between recommended and unrecommended practices, funding constraints, and limited direct effects of donor funding. Strengthening health system capacity at the farthest end of the cascade may provide a solution to this dilemma.

疟疾防控服务覆盖与全球援助有效性分析 — 撒哈拉以南非洲，2011–2022年

石珺怡¹；王敏敏¹；Adelard Kakunze²；Hawa Catherine Margai³；胡煌⁴；冯羿凯¹；Daniel Okaka⁵；Muhammad Abdullahi Idris⁶；金音子^1,#；任明辉¹

1. 全球卫生学系，公共卫生学院，北京大学,北京，中国；

2. 非洲疾病预防与控制中心，亚的斯亚贝巴，埃塞俄比亚；

3. Levuma社区卫生中心，Kenema区，塞拉利昂；

4. 社会学系，清华大学，北京，中国；

5. 国际医疗队，坎帕拉，乌干达；

6. 尼日利亚Zamfara州立大学，Zamfara州，尼日利亚。

^# 通信作者：金音子，yzjin@bjmu.edu.cn。

撒哈拉以南非洲国家的疟疾防控资金中有约70%来自全球援助，而在过去十年中，防控进展出现迟滞。构建疟疾防控服务链，分析2011–2022年间26个非洲国家的服务覆盖率及质量。使用面板回归，检验4个主要援助方（美国、英国、全球基金与联合国儿基会，合计提供了90%的抗疟援助资金）促进服务落实的效果。各项服务中，合规服务覆盖率在2011–2016年间翻倍增长，但到2022年则下降了10%。不合规服务覆盖率呈现同步变化趋势。2011–2020年间，援助资金累计超过71亿美元，美国和全球基金较为稳定地贡献了其中的94.65%，而英国和联合国儿基会则出现了明显的供资紧缩。援助资金与服务链覆盖率及质量的相关性较为有限，仅直接促进了位于服务链上游的服务覆盖水平。过去10年中，疟疾防控服务链覆盖率出现了退步，合规服务始终不能完全取代不合规服务，部分援助方供资下降，同时援助资金的直接效果较为有限。为解决此困境，未来应更加重视服务链远端相关的卫生系统能力建设。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.103

Impact of Implementation Interruptions of 1,7-Malaria Reactive Community-Based Testing and Response Approach on Malaria Control Efforts — Southern Tanzania

Yuejin Li^1,&; Jinxin Zheng^2,&; Yeromin P Mlacha^3,&; Shenning Lu²; Salim Abdulla³; Qin Li²; Ge Yan¹; Xiaonong Zhou^2,4; Ning Xiao²; Victoria Githu³; Tegemeo Gavana³; Prosper Chaki³; Peng Bi⁵; Yuan Sui⁶; Yongbin Wang^1,#; Duoquan Wang^2,4,#

1. Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining City, Shandong Province, China;

2. NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); Shanghai, China;

3. Ifakara Health Institute, Environmental Health and Ecological Science, Dar es Salaam, United Republic of Tanzania;

4. School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

5. School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia;

6. Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Fred Hutchinson Cancer Center, Seattle, WA, USA.

^& Joint first authors.

^# Corresponding authors: Duoquan Wang, wangdq@nipd.chinacdc.cn; Yongbin Wang, aveo226@163.com.

Surveys from the China-Tanzania Malaria Control Project demonstrated that the 1,7-malaria Reactive Community-Based Testing and Response (1,7-mRCTR) approach significantly reduced malaria incidence rates. However, implementation was disrupted by security concerns, infectious disease outbreaks, and supply shortages. This study evaluates how these interruptions affected intervention effectiveness to inform future malaria control strategies. The study employed a two-phased design: Phase I (2016–2018) and Phase II (2019–2021). Weekly malaria incidence rates per 100 people were calculated from cases reported by local health facilities in the intervention areas during both phases. Seasonal and trend decomposition using loess (STL) and interrupted time series modeling with piecewise linear regression were used to evaluate the impact of disruptions on 1,7-mRCTR implementation effectiveness. In Tanzania's 1,7-mRCTR areas, malaria incidence peaked during November-December and June-July. Phase I's 8-month interruption reversed the weekly trend from a 0.17% decline to a 0.58% increase (P=0.001). After resumption, incidence dropped 8.96% (P=0.039) and maintained a 0.39% long-term decline (P=0.003). Even with seasonal adjustment, the interruption slowed the weekly decline from 0.08% to 0.07% (P=0.003). Phase II showed a similar pattern: a one-week interruption caused a 0.70% drop (P=0.007) but shifted the trend from a 0.02% decline to a 0.08% increase (P=0.001). After resumption, interventions stabilized the decline at 0.11% weekly (P=0.001). This research demonstrates that Tanzania's malaria incidence is closely linked to seasonal patterns and consistent intervention efforts. Phase I's 8-month security-related interruption reduced 1,7-mRCTR effectiveness by 12.5%, while Phase II's 3-month pandemic-induced interruption caused only short-term fluctuations with minimal long-term impact. Rapid resumption of interventions after disruptions allowed for prompt recovery, highlighting the importance of adaptive strategies to maintain progress toward malaria control goals.

基于中断时间序列分析评估1,7-mRCTR策略对疟疾防控效果的影响 — 南坦桑尼亚地区

李曰进^1,&；郑金鑫^2,&；Yeromin P Mlacha^3,&；陆申宁²；Salim Abdulla³；李琴²；闫歌¹；周晓农^2,4；肖宁²；Victoria Githu ³；Tegemeo Gavana³, Prosper Chaki³；毕鹏⁵；Yuan Sui⁶；王用斌^1,#；王多全^2,4,#

1. 山东第一医科大学（山东省医学科学院），山东省寄生虫病防治研究所，济宁市，山东省，中国；

2. 国家卫生健康委员会寄生虫病原与媒介生物学重点实验室，中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心），上海，中国；

3. Ifakara卫生研究所, 环境健康与生态科学, 达累斯萨拉姆, 坦桑尼亚联合共和国；

4. 全球健康学院（国家热带病研究中心）,上海交通大学医学院，上海，中国；

5. 公共卫生学院, 阿德莱德大学, 阿德莱德, 南澳大利亚州, 澳大利亚；

6. 性病艾滋病研究和预防统计中心（SCHARP），福瑞德·哈金森癌症研究中心，西雅图，华盛顿州，美国。

^& 共同第一作者。

^# 通信作者：王多全，wangdq@nipd.chinacdc.cn; 王用斌, aveo226@163.com。

中国-坦桑尼亚疟疾防控项目调查显示，基于社区的1,7-疟疾主动检测与响应（1,7-mRCTR）方法显著降低了疟疾发病率。然而，该干预措施的实施因安全问题、传染病疫情及物资短缺多次中断。本研究旨在评估这些中断对干预效果的影响，为优化未来疟疾防控策略提供依据。通过局部加权回归散点平滑法（STL）进行季节性和趋势分解，并使用分段线性回归构建中断时间序列模型，评估实施中断对1,7-mRCTR干预效果的影响。在坦桑尼亚1,7-mRCTR干预区，疟疾发病率在11–12月和6–7月达到高峰。第一阶段8个月的中断使每周发病率趋势从下降0.17%逆转为上升0.58%（P=0.001）；恢复干预后，发病率周降幅达8.96%（P=0.039），并维持0.39%的长期下降趋势（P=0.003）。即使经过季节性调整，中断仍使周降幅从0.08%放缓至0.07%（P=0.003）。第二阶段呈现相似模式：1周的中断导致发病率短暂下降0.70%（P=0.007），但趋势从下降0.02%转为上升0.08%（P=0.001）；恢复干预后，发病率以每周0.11%的降幅稳定下降（P=0.001）。研究表明，坦桑尼亚疟疾发病率与季节性模式及持续干预措施密切相关。第一阶段因安全问题导致的8个月中断使1,7-mRCTR效果降低12.5%，而第二阶段因传染病大流行引发的3个月中断仅造成短期波动。中断后迅速恢复干预措施使效果得以快速回升，凸显了采用适应性策略以维持疟疾防控目标进展的重要性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.104

China's Malaria R&D Innovations: A Scoping Review from 2013-2023

Shuxun Wang¹; Wei Ding^1,2; Shenning Lu¹; Linjia Li³; Furong Qian³; Canhui Chen³; Longsheng Liu¹; Yongtong Cai⁴; Xian Liu¹; Sandra Perez²; Roger Frutos^5,6,7; Hangping Yao⁸; Yuhang Zhou⁸; Chunsheng Ye⁹; Danna Wu⁹; Shizhu Li^1,10; Xiaoxiao Jiang Kwete¹¹; Yuan Sui¹²; Duoquan Wang^1,10,#

1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China;

2. Université Côte d'Azur, ESPACE UMR 7300, Nice, France;

3. Shanghai University of Medicine & Health Sciences, Shanghai, China;

4. The University of Hong Kong, Hong Kong Special Administrative Region, China;

5. Intertryp, UMR 17, CIRAD, Montpellier, France;

6. Faculty of Medicine-Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;

7. Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia;

8. Zhejiang University, Hangzhou City, Zhejiang Province, China;

9. Hangzhou Biotest Biotech Co., Ltd., Hangzhou City, Zhejiang Province, China;

10. School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

11. Global Health Research and Consulting, Yangzhou City, Jiangsu Province, China;

12. Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Fred Hutchinson Cancer Center, Seattle, WA, USA.

^# Corresponding authors: Duoquan Wang, wangdq@nipd.chinacdc.cn.

Malaria remains a major global health challenge. Understanding the research progress of the potential innovative tools is important for malaria elimination. This scoping review aims to explore China's research and development (R&D) advances from 2013-2023 in addressing the current challenges and contributing to global malaria elimination. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), this review searched the English and Simplified Chinese data sources from five databases. A total of 11,112 English articles and 2,944 Chinese articles were retrieved. After screening, 44 English and 13 Chinese articles were included. Key advancements were identified in three domains: vector control, pathogen screening and diagnosis, and prevention and treatment. Innovations in vector control include studies such as the use of Serratia strains and symbiont-mediated RNAi approaches to block malaria transmission. Advances in pathogen screening and diagnosis feature biosensor development, AI monitoring technologies, and novel amplification gene and nucleic acid detection technologies. In prevention and treatment, artemisinin-based combination therapies (ACTs) remain a cornerstone, with additional progress in industrial pharmaceuticals and technologies already in field and semi-field-testing stages. This review underscores the importance of leveraging China's R&D capacity to meet global challenges. To maximize impact, we call for global attention to strengthening international collaboration with China in malaria R&D to accelerate the commercialization, regulatory approval, and large-scale deployment of innovations.

2013-2023年中国疟疾研发创新范围综述

王舒珣¹；丁玮^1,2；陆申宁¹；李林佳³；钱复融³；陈灿慧³；刘隆升¹；蔡咏同⁴；刘弦¹；Sandra Perez²； Roger Frutos^5,6,7；姚杭萍⁸；周宇航⁸；叶春生⁹；吴丹娜⁹；李石柱^1,10；蒋晓晓¹¹；睢园¹²；王多全^1,10,#

1中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心）；国家卫生健康委员会寄生虫病原与媒介生物学重点实验室；世界卫生组织热带病合作中心；科技部国家级热带病国际联合研究中心，上海，中国；

2法国蔚蓝海岸大学ESPACE UMR 7300，尼斯，法国；

3上海健康医学院，上海，中国；

4香港大学，香港特别行政区，中国；

5 法国农业国际合作研究发展中心（CIRAD）UMR 17 Intertryp，蒙彼利埃，法国；

6玛希隆大学医学院-拉玛吉博迪医院，曼谷，泰国；

7艾尔兰加大学职业学院，泗水，印度尼西亚；

8浙江大学，杭州市，浙江省，中国；

9杭州博拓生物科技股份有限公司，杭州市，浙江省，中国；

10全球健康学院，上海交通大学医学院-国家热带病研究中心，上海，中国；

11扬州尧智智能科技有限公司，扬州市，江苏省，中国；

12美国艾滋病研究与预防统计中心，弗雷德·哈钦森癌症中心，西雅图，华盛顿州，美国。

^# 通信作者：王多全，wangdq@nipd.chinacdc.cn。

疟疾至今仍是全球性的卫生难题。了解现有的潜在创新工具的研究进展对于疟疾消除具有重要意义。本范围综述的目的是了解中国在2013-2023年间在疟疾消除领域的相关研究和开发进展，以应对当前疟疾挑战并助力全球疟疾消除。本研究采用PRISMA范围评估检查表（PRISMA- scr），通过检索五个数据库的中英文文献，共获取英文文献11,112篇、中文文献2,944篇。筛选后共纳入英文文献44篇、中文文献13篇。研究发现，中国在疟疾防控三大关键领域取得显著进展：媒介控制、病原体筛查和诊断以及预防和治疗。媒介控制领域的创新包括对幼虫和成蚊干预的研究，如利用沙雷氏菌株和共生体介导的RNAi技术阻断疟疾传播。病原体筛查和诊断的进展包括生物传感器、人工智能监测技术和新开发的扩增基因和核酸检测技术。在预防和治疗领域，以青蒿素为基础的联合疗法仍是核心，众多工业药品和技术已进入现场和半现场试验阶段。本综述强调了中国的疟疾研发能力对应对全球挑战的重要性。为提升影响力，呼吁全球加强与中国在疟疾研发领域的国际合作，加快创新成果的商业转化和监管部门的审查，以实现大规模的推广应用。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.105