Malaria in China: a longitudinal population-based surveillance study

Ding, Cheng; Huang, Chenyang; Zhou, Yuqing; Fu, Xiaofang; Liu, Xiaoxiao; Wu, Jie; Deng, Min; Li, Lanjuan; Yang, Shigui

Between 1950 and 2016, there were 227 668 374 cases of malaria reported in China, with an annualised average incidence of 337.024 (336.980−337.068) per 100 000 population (Supplementary Table S1 ). Overall, the incidence of malaria decreased with an AAPC of −11.4% (−16.6 to −6.0). The highest incidence occurred in 1970, which was 2905.704 per 100 000 (Fig. 1 ). Since the 1970s, the incidence of malaria has decreased rapidly with an APC of The annualised average incidence rates were more than 500 per 100 000 in provinces such as Henan, Anhui, Jiangsu and Hubei. The rates were under 1 per 100 000 in Chongqing, Neimenggu, Ningxia, Heilongjiang, Qinghai and Jilin ( Table 1) . Epidemics of malaria were disproportionate in different provinces and areas, and overall, districts in southern China suffered more disease burden than did other areas. The incidence rates in most provinces and areas decreased, and the AAPC values were significant (P < 0.05) ( Fig. 2 and Table 1 ). The annualised average mortality rate in Yunnan was the highest (3.466 per 1 000 000), and the rates in some districts, such as Guizhou, Zhejiang, Guangxi and Guangdong, were more than 1 per 1 000 000 (Table 1) . Mortality cases were concentrated in southern China in the 1950s. The mortality rates have been under 1 per 1 000 000 approximately since the 1970s across China ( Supplementary Fig. S1 ). Along with the incidence of malaria, the mortality rates decreased in most provinces and areas (Table 1 and Supplementary Fig. S1 ).