Shaosen Zhang

Temporal correlation analysis between malaria and meteorological factors in Motuo County, Tibet

BackgroundMalaria has been endemic in Linzhi Prefecture in the Tibet Autonomous Region (TAR) over the past 20 years, especially in Motou County with a highest incidence in the country in recent years. Meteorological factors, such as rainfall, temperature and relative humidity in Motou County were unique compared to other areas in Tibet as well as other parts of China, thus the objective of this work was to analyse the temporal correlation between malaria incidence and meteorological factors in Motou County, in order to seek the particular interventions for malaria control.MethodsThe meteorological and malaria data during 1986-2009 in Motuo County were studied to analyse the statistical relationship between meteorological data time series and malaria incidence data series. Temporal correlation between malaria incidence and meteorological factors were analyzed using several statistical methods. Spearman correlation analysis was conducted to examine the association between monthly malaria incidence and meteorological variables. Cross-correlation analysis of monthly malaria incidence series and monthly meteorological data time series revealed the time lag(s) of meteorological factors preceding malaria at which the series showed strongest correlation. Multiplicative seasonal auto-regressive integrated moving average (SARIMA) models were used in the cross-correlation analysis with pre-whitening which remove seasonality and auto-correlation of meteorological data series. Differenced data analysis which called inter-annual analysis was carried out to find underlying relationship between malaria data series and meteorological data series.ResultsIt has been revealed that meteorological variables, such as temperature, relative humidity and rainfall were the important environmental factors in the transmission of malaria. Spearman correlation analysis demonstrated relative humidity was greatest relative to malaria incidence and the correlation coefficient was 0.543(P < 0.01). Strong positive correlations were found for malaria incidence time series lagging one to three months behind rainfall (r > 0.4) and lagging zero to two months behind temperature and relative humidity (r > 0.5) by the cross-correlation. Correlations were weaker with pre-whitening than without. The cross-correlograms between malaria incidence and various meteorological variables were entirely different. It was fluctuated randomly for temperature but with trend for the other two factors, which showed positive correlated to malaria when lag was from 0 to 5 months and negative from 6 to 12 months. Besides, the inter-annual analysis showed strong correlation between differenced annual malaria incidence and differenced meteorological variables (annual average maximum temperature, annual average relative humidity and annual average rainfall). The correlations coefficients were -0.668 (P < 0.01), 0.451(P < 0.05) and 0.432(P < 0.05), respectively.ConclusionMeteorological variables play important environmental roles in malaria transmission in Motou County. Relative humidity was the greatest influence factors, which affected the mosquito survival directly. The relationship between malaria incidence and rainfall was complex and it was not directly and linearly. The lags of temperature and relative humidity were similar and smaller than that of rainfall. Since the lags of meteorological variables affecting malaria transmission were short, it was difficult to do accurate long-term malaria incidence prediction using meteorological variables.

Spatial correlation between malaria cases and water-bodies in Anopheles sinensis dominated areas of Huang-Huai plain, China

BackgroundMalaria re-emerged in the Huang-Huai Plain of central China during 2006–2008, dominated with Anopheles sinensis as a vector. However, there is no information on strategies based on multi-factor analysis to effectively control the re-emergence of malaria in these areas. Previous experience indicates some relationship between the distribution of water bodies and malaria cases, but more detailed data are not available and in-depth studies have not been conducted up to now. The objective of this study was to identify the relationship between the distribution of water bodies and presentation of malaria cases using spatial analysis tools in order to provide guidance to help formulate effective strategies for use in controlling the sources of malaria infection, based on the identification of risk areas and population.MethodsThe geographic information of malaria cases and their surrounding water bodies were collected from Suixi, Guoyang, Guzhen, Yingshang, Fengyang and Yongqiao County in Anhui province, Yongcheng and Tongbai County in Henan province. All malaria cases distributed in 113 villages in these 8 counties were collected from the China Information System for Disease Control and Prevention and confirmed by household investigation. Data on GIS and malaria cases were mapped and analyzed with the software of ArcGIS 9.2 to identify the spatial correlation between malaria cases and water bodies. The distance from households with malaria cases to the nearest water bodies was used to calculate the OR value by Chi-square test. The risk area was identified through the comparison of OR values in different distances.Results357 malaria cases and their GPS data as well as surrounding water bodies were collected and analyzed. 74% of malaria cases were located within the extent of 60 m proximity to the water bodies. The risk rate of people living there and presenting with malaria was significantly higher than others (OR = 1.6,95%CI (1.042, 2.463),P < 0.05).ConclusionsThe results revealed that distribution of water bodies is an important factor influencing the occurrence and distribution of malaria cases in the An.sinensis areas, and implies that the scope and population within 60 m around water bodies are at risk and could be a targeted population for case management of malaria.

Meteorological Factors–Based Spatio-Temporal Mapping and Predicting Malaria in Central China

Despite significant reductions in the overall burden of malaria in the 20th century, this disease still represents a significant public health problem in China, especially in central areas. Understanding the spatio-temporal distribution of malaria is essential in the planning and implementing of effective control measures. In this study, normalized meteorological factors were incorporated in spatio-temporal models. Seven models were established in WinBUGS software by using Bayesian hierarchical models and Markov Chain Monte Carlo methods. M₁, M₂, and M₃ modeled separate meteorological factors, and M₃, which modeled rainfall performed better than M₁ and M₂, which modeled average temperature and relative humidity, respectively. M₇ was the best fitting models on the basis of based on deviance information criterion and predicting errors. The results showed that the way rainfall influencing malaria incidence was different from other factors, which could be interpreted as rainfall having a greater influence than other factors.

Spatio-temporal analysis of malaria vectors in national malaria surveillance sites in China

BackgroundTo reveal the spatio-temporal distribution of malaria vectors in the national malaria surveillance sites from 2005 to 2010 and provide reference for the current National Malaria Elimination Programme (NMEP) in China.MethodsA 6-year longitudinal surveillance on density of malaria vectors was carried out in the 62 national malaria surveillance sites. The spatial and temporal analyses of the four primary vectors distribution were conducted by the methods of kernel k-means and the cluster distribution of the most widely distribution vector of An.sinensis was identified using the empirical mode decomposition (EMD).ResultsTotally 4 species of Anopheles mosquitoes including An.sinensis, An.lesteri, An.dirus and An.minimus were captured with significant difference of distribution as well as density. An. sinensis was the most widely distributed, accounting for 96.25% of all collections, and its distribution was divided into three different clusters with a significant increase of density observed in the second cluster which located mostly in the central parts of China.ConclusionThis study first described the spatio-temporal distribution of malaria vectors based on the nationwide surveillance during 2005–2010, which served as a baseline for the ongoing national malaria elimination program.

Preparation of Malaria Resurgence in China: Case Study of Vivax Malaria Re-emergence and Outbreak in Huang-Huai Plain in 2006

This chapter reviews the patterns of malaria re-emergence and outbreak that occurred in the Huang-Huai Plain of China in 2006, and the way of quick response to curtail the outbreak by mass drug administration and case management. The contribution of the each intervention in quick response is discussed. Particularly due to the special ecological characteristics in the Huang-Huai Plain, the intervention of vector control is not implemented. Finally, the challenges in the elimination of malaria in this region are highlighted.

Anopheles Vectors in Mainland China While Approaching Malaria Elimination

China is approaching malaria elimination; however, well-documented information on malaria vectors is still missing, which could hinder the development of appropriate surveillance strategies and WHO certification. This review summarizes the nationwide distribution of malaria vectors, their bionomic characteristics, control measures, and related studies. After several years of effort, the area of distribution of the principal malaria vectors was reduced, in particular for Anopheles lesteri (synonym: An. anthropophagus) and Anopheles dirus s.l., which nearly disappeared from their former endemic regions. Anopheles sinensis is becoming the predominant species in southwestern China. The bionomic characteristics of these species have changed, and resistance to insecticides was reported. There is a need to update surveillance tools and investigate the role of secondary vectors in malaria transmission.

Biology, Bionomics and Molecular Biology of Anopheles sinensis Wiedemann 1828 (Diptera: Culicidae), Main Malaria Vector in China

China has set a goal to eliminate all malaria in the country by 2020, but it is unclear if current understanding of malaria vectors and transmission is sufficient to achieve this objective. Anopheles sinensis is the most widespread malaria vector specie in China, which is also responsible for vivax malaria outbreak in central China. We reviewed literature from 1954 to 2016 on An. sinensis with emphasis on biology, bionomics, and molecular biology. A total of 538 references were relevant and included. An. sienesis occurs in 29 Chinese provinces. Temperature can affect most life-history parameters. Most An. sinensis are zoophilic, but sometimes they are facultatively anthropophilic. Sporozoite analysis demonstrated An. sinensis efficacy on Plasmodium vivax transmission. An. sinensis was not stringently refractory to P. falciparum under experimental conditions, however, sporozoite was not found in salivary glands of field collected An. sinensis. The literature on An. sienesis biology and bionomics was abundant, but molecular studies, such as gene functions and mechanisms, were limited. Only 12 molecules (genes, proteins or enzymes) have been studied. In addition, there were considerable untapped omics resources for potential vector control tools. Existing information on An. sienesis could serve as a baseline for advanced research on biology, bionomics and genetics relevant to vector control strategies.

Monitoring of malaria vectors at the China-Myanmar border while approaching malaria elimination

BackgroundTengchong County was one of the counties located at the China-Myanmar border with high malaria incidence in the previous decades. As the pilot county for malaria elimination at the border area, Tengchong County is aiming to be the first county to achieve malaria elimination goal. A cross-sectional entomological survey was carried out to evaluate the feasibility of elimination approach and assess the receptivity of malaria reintroduction.MethodsLight traps associated with live baits were used to investigate the abundance of adult mosquitoes in nine villages in Tengchong County. Light traps were set to collect adult mosquitoes in both human houses and cowsheds from dusk till dawn in each site.ResultsA total of 4948 adult Anopheles mosquitoes were collected from May to December in two villages. Of the mosquitoes were captured, 24.2% were in human houses and 75.8% in cowsheds. The peak of abundance occurred in July for An. sinensis and in September-October for An. minimus (s.l.) Ten Anopheles species were collected, the most prevalent being An. sinensis (50.3%), An. peditaeniatus (31.6%) and An. minimus (s.l.) (15.8%), contributing to 97.6% of the sample. Potential breeding sites were also investigated and a total of 407 larvae were collected, with An. sinensis (50.1%) and An. minimus (s.l.) (46.2%) as predominant species. Ponds and rice fields were the two preferred breeding sites for Anopheles mosquitoes; however, the difference between the number of adults and larvae captured suggest other breeding sites might exist. Both An. sinensis and An. minimus (s.l.) were found zoophilic with human blood index as 0.21 and 0.26, respectively. No Plasmodium positive Anopheles specimens were found by PCR among 4,000 trapped mosquitoes.ConclusionsAlthough no indigenous malaria cases have been reported in Tengchong County since 2013, there is still a risk from the presence of vectors in the context of human population movements from neighboring malaria endemic areas. The presence of An. sinensis, associated to rice fields, is particularly worrying. Sustained entomological surveillance is strongly suggested even after malaria elimination certification.

Mobile population dynamics and malaria vulnerability: a modelling study in the China-Myanmar border region of Yunnan Province, China

BackgroundThe China-Myanmar border region presents a great challenge in malaria elimination in China, and it is essential to understand the relationship between malaria vulnerability and population mobility in this region.MethodsA community-based, cross-sectional survey was performed in five villages of Yingjiang county during September 2016. Finger-prick blood samples were obtained to identify asymptomatic infections, and imported cases were identified in each village (between January 2013 and September 2016). A stochastic simulation model (SSM) was used to test the relationship between population mobility and malaria vulnerability, according to the mechanisms of malaria importation.ResultsThirty-two imported cases were identified in the five villages, with a 4-year average of 1 case/year (range: 0–5 cases/year). No parasites were detected in the 353 blood samples from 2016. The median density of malaria vulnerability was 0.012 (range: 0.000–0.033). The average proportion of mobile members of the study population was 32.56% (range: 28.38–71.95%). Most mobile individuals lived indoors at night with mosquito protection. The SSM model fit the investigated data (χ2 = 0.487, P = 0.485). The average probability of infection in the members of the population that moved to Myanmar was 0.011 (range: 0.0048–0.1585). The values for simulated vulnerability increased with greater population mobility in each village.ConclusionsA high proportion of population mobility was associated with greater malaria vulnerability in the China-Myanmar border region. Mobile population-specific measures should be used to decrease the risk of malaria re-establishment in China.