A successful control programme for falciparum malaria in Xinyang, China

This paper describes a large scale control programme for falciparum malaria in Xinyang prefecture, China, from the early 1980s to 1992. Falciparum malaria, transmitted mainly by Anopheles anthropophagus, was epidemic in Gusi, Huangchuan, Shangcheng and Huaibin counties in the prefecture in the early 1980s, 2922 cases being reported in 1984. From 1985 to 1992, DDT residual spraying and the use of bed nets impregnated with pyrethroid insecticide were introduced for 2 consecutive years in areas at higher risk of P. falciparum infection, and then gradually extended to cover all the endemic areas over a period of 8 years. Malaria control was also carried out through the primary health care system in 4 counties, as had been done since the 1970s. As a result, no falciparum malaria case has been found since 1988 in spite of extensive surveillance, and vivax malaria has also decreased greatly. Repeated cross-sectional surveys showed that A. anthropophagus could not be found in most sites after 2 consecutive years of the vector control programme. Vector control was a major factor in the successful elimination of falciparum malaria and decreasing the incidence of P. vivax in the 4 counties.