Surveillance and response strategy in the malaria post-elimination stage: case study of Fujian province

Malaria used to be a serious health problem in Fujian province in the past, but no local malaria transmission has been found since 2000. In order to eliminate the potential residual cases and prevent re-introduction of malaria so as to achieve the final goal of malaria elimination in Fujian province, various strategy and intervention approaches were tailored to the local settings. For instance, the monitoring of febrile patients by blood smear examinations and vector surveillance and control were strengthened in addition to the routine intervention in the mountainous area of Fujian province, where malaria was highly endemic and the mosquito Anopheles anthropophagus distributed with a high vectorial capacity. There were two local cases who got infected due to imported cases found in the building site of an expressway in 2004 and 2005, respective. All other imported malaria cases were detected during post-elimination stage through surveillance system. Based on results from post-transmission surveillance, malaria transmission has been interrupted in Fujian province for 13 years. Therefore, post-transmission surveillance and response is an important intervention to maintain the malaria elimination achievements in Fujian province.