Epidemiological Characteristics, Risk Factors, and Countermeasures of Imported Malaria - China, 2017-2024

This study aimed to analyze the epidemiological characteristics of imported malaria in China, identify transmission risks from the global malaria burden and China's international population exchanges, and propose a two-stage prevention and control strategy for overseas and post-entry periods of outbound personnel.

A descriptive epidemiological analysis was performed on the National Infectious Disease Surveillance Information System, including the number of patients with imported malaria, Plasmodium species distribution, spatiotemporal patterns, demographic characteristics, and countries of infection origin.

Between 2017 and 2024, 16,571 patients with imported malaria, including 75 deaths, were reported, with a U-shaped temporal trend. The annual number of patients with imported malaria remained stable at 2,600-2,800 from 2017 to 2019, dropped to 798 in 2021, and rebounded to 3,155 in 2024. Plasmodium falciparum (10,593 patients) and Plasmodium vivax (3,288 patients) were the dominant species. P. falciparum was imported from Africa, whereas P. vivax was from Myanmar. Patients with imported malaria were distributed across China, with Yunnan, Guangdong, and Guangxi emerging as the top three provincial-level adminsitrative divisions (PLADs). The high-risk population was male overseas laborers aged 30-59. Severe illness and fatality rates among individuals with imported malaria remained low with no upward trend.

The global malaria epidemic and China's international exchanges have increased the pressure on malaria importation. Strengthening multisectoral collaboration in health services for outbound personnel and improving targeted surveillance and treatment capacity in key post-entry areas are crucial to prevent severe illness, deaths, and secondary transmission and to consolidate China's malaria elimination achievements.