Malaria in Hubei Province, China: approaching eradication

In the last six years, there has been a steady reduction of Plasmodium vivax malaria in Hubei Province with an API (annual parasite incidence) of 0.134 per thousand by 1992. This is especially so in the south, east, west and north-west parts of the province. Much of this reduction has been produced by a policy of repeated radical treatment in the non-malaria season. In the centre of Hubei, where Anopheles anthropophagus is the chief vector, malaria is still a problem. The key factors in destabilizing malaria are a sudden increase in the number of An. anthropophagus, introduction of non-immunes into the endemic area, and the village doctors' diminished interest in malaria surveillance activities. Impregnated bed nets are possibly the best strategy for reducing malaria, but where the prevalence is reduced to a sufficiently low level efficient case finding and detection are able to contain malaria and produce a continued reduction.