Malaria elimination has made remarkable progress in China and the country was certified as malaria free by the World Health Organization (WHO) in 2021. However, with increasing numbers of Chinese migrant workers and more business, tourism, and international exchanges in recent years, the number of imported malaria cases from other countries remains high [1]. A low degree of public knowledge about malaria has been observed in many studies conducted in China, with particularly weak knowledge on its prevention. Young people and residents living far from township hospitals tend to have poorer knowledge of malaria [2]. Malaria awareness among travellers from China remains lower than the national goal [3]. Students at elementary and high schools also have poor awareness of malaria [4]. Health education has long-term effects on disease control and is an indispensable component of malaria elimination [5].
The benefits of health education in the prevention of malaria had been demonstrated in Thailand [6]. The experience of schistosomiasis control in China has also shown that the implementation of a health education programme can improve people’s knowledge level and change their attitudes [7]. Traditional media (e.g. bulletin boards, newspapers, shopping bags, leaflets) have played an important role in influencing public awareness of malaria; however, one of the challenges is difficulty to achieve the expected effect [8]. Therefore, use of a variety of media and means to improve the effect of health education is necessary to meet the needs of various target populations.
Social media is becoming an important platform for information dissemination. This is believed to have direct implications for health education, prompting new opportunities to use social media to impact disease prevention. Social media attracts the largest proportion of Internet users and this is likely to continue to grow, making them an obvious target for maximizing the reach and impact of health education [9]. Social media may have the capacity to reach a wider audience than traditional media. A broad range of people including the general public, patients, and health professionals can use social media to communicate about health issues [10]. According to the 47th China Statistical Report on Internet Development (CNNIC), the number of Chinese “netizens” (citizens who use the Internet) has reached 989 million, mobile phone Internet users has reached 986 million, and the percentage of Internet users who surf the Internet via mobile phone is as high as 99.7%. Netizens aged 20–50 years are the main population age group, accounting got 57.1% of all users. Among the netizens in China, 59.6% have junior high school education or below and only 19.8% have a college degree or above [11]. This provides an opportunity to conduct health education through social media in China.
WeChat is a free mobile device application that was released in 2011 and has become one of the most popular social media platforms in China. It presents complex information by instant text, voice message, video, and graphics, providing an accessible way to spread health information to the public. WeChat public accounts, one of functions of WeChat, can be used by government, companies, and organizations to provide information. Health information through WeChat public accounts provided by professional institutions plays an important role in improving public health literacy. For example, it has been applied in health education for heart disease [12], cancer [13], and diabetes [14].
Low public participation is one of the biggest challenges for health education programs [15]. WeChat has created a featured incentive named “WeChat Red Packet” and through which people can receive a minor bonus (up to 2RMB). National Malaria Day on April 26, 2021 had the theme “Preventing re-establishment and consolidating the achievements of malaria elimination”.
This study explored the effect of malaria knowledge dissemination via a WeChat public account and whether the use of WeChat Red Packet as an incentive increased engagement with malaria health information during the National Malaria Day period in China.