Neglected Time Intervals Before "1-3-7" Approach About Imported Malaria Cases - China, 2014-2021
Zhiquan He1, Yuanjing Kou1, Dan Wang1
1Henan Provincial Center for Disease Control and Prevention, Zhengzhou City, Henan Province, China.
What Is Already Known About This Topic?:
China's "1-3-7" approach outlines specific targets to guide and monitor the processes of case reporting, investigation, and response. However, few studies have examined the time intervals preceding the initial step, and the timeline from the arrival of imported malaria cases in China to their diagnosis has been largely overlooked.
What Is Added By This Report?:
The study demonstrated that the median duration from arrival in China to the onset of symptoms for P. ovale was 78 days, with 71.59% of imported cases manifesting symptoms after more than one month. For P. vivax, the median interval was 42 days, with 55.91% exceeding one month. Additionally, the median time from symptom onset to malaria treatment in China between 2014 and 2021 was 2 days, with an interquartile range (IQR) of 1-4 days.
What Are The Implications For Public Health Practice?:
This study represents the initial effort to delineate the chronology of imported malaria cases, from their arrival in China to their subsequent treatment. The results underscore the importance of providing malaria health education to populations arriving from overseas. Furthermore, enhancing physician training is crucial for improving the diagnosis of malaria.
Insights
Imported malaria cases in China often show symptoms over a month after arrival. Early diagnosis and treatment are crucial, highlighting the need for improved health education and physician training to combat malaria spread.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- China's "1-3-7" approach guides malaria case management.
- Timelines from imported case arrival to diagnosis in China are understudied.
Purpose of the Study:
- To analyze the time intervals from arrival to symptom onset and diagnosis for imported malaria cases in China.
- To evaluate the time from symptom onset to treatment for imported malaria cases.
Main Methods:
- Retrospective analysis of imported malaria cases in China (2014-2021).
- Examination of time intervals: arrival to symptom onset, symptom onset to diagnosis, and symptom onset to treatment.
Main Results:
- Median time from arrival to symptom onset was 78 days for Plasmodium ovale and 42 days for P. vivax.
- Over 70% of P. ovale and 55% of P. vivax cases presented symptoms after one month.
- Median time from symptom onset to malaria treatment was 2 days (IQR: 1-4 days).
Conclusions:
- Significant delays exist between arrival and symptom onset for imported malaria, necessitating targeted health education for travelers.
- Enhanced physician training is vital for timely malaria diagnosis and effective public health response.
