As a malaria control staff member in Yunnan Province of China, I have been working on the China-Myanmar border for 27 years. I’ve heard many stories about malaria, experienced many malaria situations, and joined many intervention activities.
Understanding the high death rates
In November 2003, more than 100 deaths occurred in Kokang, Shan Special Region in Myanmar. At the time, local people and the authorities didn’t know the cause of these deaths. Chinese investigators suspected Acute Respiratory Syndrome (SARS) or plague to be the main cause of these deaths.
最终，云南寄生疾病研究所（YIPD）的专家确认这是疟疾。在1392年11月7日至11月19日之间，有13天的新疟疾病例和125例死亡，缅甸的Kokang的30个村庄被发现。
Intensive efforts with international and domestic financial support to control malaria have dramatically reduced malaria burden on China-Myanmar border over the past decade.
Intensive efforts with international and domestic financial support to control malaria have dramatically reduced malaria burden on China-Myanmar border over the past decade.
Especially with support from the 6th和10throunds of GFATM malaria control projects, and cooperation with Myanmar and Health Poverty Action (HPA), malaria control interventions was able to conduct in five special regions of Myanmar from 2007 to 2013.
妈laria prevalence
As a result of the interventions of GFATM projects, parasite prevalence rate had decreased from 13.6% in March 2008 to 1.5% in November 2013 in the five special regions of Myanmar. Annual parasite incidence had reduced from 19.6 per 10, 000 person-years in 2006 to 0.9 per 10, 000 person-years in 2013 across 19 Chinese counties.
在缅甸的Shan Special地区II（本地称为WA州）中，我们的年度评估指标调查未在2013年11月检测到任何疟疾寄生虫。
2014年6月19日，HPA报告了P. falciparum疟疾爆发在靠近边界的私人橡胶种植园中。在爆发疫情的时候，有122名居民，其中24个家庭是拉哈少数民族的14个家庭，2004年从中国兰开邦移民。
西澳少数民族有十个家庭，于2005年从缅甸山特别地区的其他村庄移民。我们意识到，当我们到达爆发现场时，我们的GFATM项目没有涵盖特殊社区。
What does our research suggest?
我们的调查结果表明进口P. falciparum从萨尔河河谷（Salween River Valley）引起了爆发，并且在爆发期间，儿童患疟疾感染的风险更高。
我们的调查结果表明进口P. falciparum从萨尔河河谷（Salween River Valley）引起了爆发，并且在爆发期间，儿童患疟疾感染的风险更高。
Seeking inappropriate treatment from a private healer who just administered a single artemether injection for treatment of malaria and lack of protection of bed nets were the causes of the outbreak.
The majority of the China-Myanmar border is just a political border where immigration control is only available at those important border crossing points. Illegal immigrants, internally displaced people, refugees and ethnic minorities exist along the mountainous and forested border. However they have limited access to the public health service.
Inappropriate diagnoses and treatments with sub-therapeutic-dosage and/or mono-therapies still exist in the private sector along the international border.
We cannot deny that inappropriate treatments in the private sector have helped to save lives, however, they contribute to maintain malaria transmission and are thus harmful to patient prognosis, public health and also a cause of drug resistance.
在这种情况下，我们的疟疾控制和消除计划应特别注意这些被忽视的人群。为了提高公共卫生设施的覆盖范围和服务，并加强与私营部门的合作以进行适当的疟疾病例管理，中国山脉边界沿线的疟疾控制需要进一步的多边合作。
Refugees, migrants both internal and external and group of people who moves along and cross border are vulnerable to malaria and receive less attention from the main stream national malaria control. It was good that YIPD has noticed and brought up this importance issue.