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Table 1 Strategies for malaria elimination in Yunnan (1950–1970s)

From: Seven decades towards malaria elimination in Yunnan, China

Strategy, interventions Malaria transmission stratuma Timing and frequency
Clearance of the infection source
 Case management High/medium/low: Clinical cases and laboratory-confirmed cases Any time
 Radical treatment High: Individuals with a history of recent malaria; entire population or targeted populationb Any time for individuals; MDA during non-transmission seasons. Usually, one round MDA during non-transmission seasons. In high-transmission areas, several rounds of MDA might be necessary, before and during transmission seasons
Medium/low: Individuals with a history of recent malaria; entire population living in active foci or targeted populationb
Chemoprevention
 Intermittent preventive treatmentc High: Entire population of villages and migrants Start 1 month before the transmission season starts. Depending on the drugs used, application covered the entire transmission season; usually at least eight times per year
Medium/low: Population in active foci, migrants
Vector control
 Indoor residual insecticide sprayingd High: Houses and animal sheds in whole villages During the transmission season. Depending on the duration of transmission seasons and the insecticide used, could be one, two or three rounds per year
Medium/low: Houses and animal sheds in active foci
 Treatment of larval breeding sites High: Use chemicals At the end of winter and the beginning of spring
Medium/low: Use whatever available (e.g. herbal)
  1. MDA, mass drug administration
  2. aHigh transmission stratum: > 30% population with a history of malaria; annual incidence > 20%; incidence in children and new arrivals higher than that in adults; transmission of P. vivax, P. falciparum and P. malariae, mixed infections. Medium-transmission stratum: annual incidence 5–20%; no difference in incidence by age; majority of infections P. vivax. Low-transmission stratum: annual incidence < 5%; nearly all infections P. vivax
  3. bTargeted population: people with a recent history of malaria and migrants from endemic areas, asymptomatic cases detected in surveys, people with enlarged spleens, people targeted for MDA but missed the treatment
  4. cIntermittent preventive treatment was used for healthy individuals, mostly migrants from non-endemic areas, as chemoprophylaxis. It was also regularly performed as MDA for the entire population in high transmission stratum, active foci, or during outbreaks. Sometimes, low-dose primaquine was added for therapeutic efficacy
  5. dSpraying with dichlorodiphenyltrichloroethane or hexachlorocyclohexane