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Poverty and malaria in the Yunnan province, China.

ABSTRACT: Poverty and malaria appear to have an intertwined link. This paper aims to define the relationship between poverty and malaria in Yunnan, China, and to make recommendations for future research in this important area. Data on malaria prevalence and the population's income in each county between 2005 and 2010 were obtained from the Yunnan Center for Disease Control and Prevention and the Yunnan Bureau of Statistics, respectively. Geographic mapping shows an apparent spatial convergence of poverty and the incidence of malaria at a county level, and suggests that poverty may be one of the drivers of malaria transmission in Yunnan. Future research should focus on: 1. measuring and quantifying the relationship between poverty and the malaria burden at the individual, community, county and regional level in Yunnan; and 2. developing the GIS-based spatial decision support system (SDSS) framework in malaria endemic areas, particularly along the border areas in Yunnan.

SUBMITTER: Bi Y

PROVIDER: S-EPMC4161269 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Poverty and malaria in the Yunnan province, China.

Bi Yan Y Tong Shilu S

Infectious diseases of poverty 20140901

Poverty and malaria appear to have an intertwined link. This paper aims to define the relationship between poverty and malaria in Yunnan, China, and to make recommendations for future research in this important area. Data on malaria prevalence and the population's income in each county between 2005 and 2010 were obtained from the Yunnan Center for Disease Control and Prevention and the Yunnan Bureau of Statistics, respectively. Geographic mapping shows an apparent spatial convergence of poverty ...[more]

PMID: 25215187

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Project description:Yunnan Province, China is thought to be the original source of biovar Orientalis of Yersinia pestis, the causative agent of the third plague pandemic that has spread globally since the end of the 19th century. Although encompassing a large area of natural plague foci, Y. pestis strains have rarely been found in live rodents during surveillance in Yunnan, and most isolates are from rodent corpses and their fleas. In 2017, 10 Y. pestis strains were isolated from seven live rodents and three fleas in Heqing County (HQ) of Yunnan. These strains were supposed to have low virulence to local rodents Eothenomys miletus and Apodemus chevrieri because the rodents were healthy and no dead animals were found in surrounding areas, as had occurred in previous epizootic disease. We performed microscopic and biochemical examinations of the isolates,and compared their whole-genome sequences and transcriptome with those of 10 high virulence Y. pestis strains that were isolated from the adjacent city (Lijiang). We analyzed the phenotypic, genomic, and transcriptomic characteristics of live rodent isolates. The isolates formed a previously undefined monophyletic branch of Y. pestis that was named 1.IN5. Six SNPs, two indels, and one copy number variation were detected between live rodent isolates and the high virulence neighbors. No obvious functional consequence of these variations was found according to the known annotation information. Among the genes that were differentially expressed between the live rodent isolates and their high virulence neighbors, we detected five iron transfer-related genes that were significantly up-regulated in live rodent isolates compared with high virulence isolates (|log2 (FC) | >1, p.adjust <0.05), indicating these genes may be related to the low-virulence phenotype. The novel genotype of Y. pestis reported here provides further insights into the evolution and spread of plague as well as clues that may help to decipher the virulence mechanism of this notorious pathogen.

Project description:BackgroundYunnan Province was considered the most difficult place in China for malaria elimination because of its complex malaria epidemiology, heterogeneous ecological features, relatively modest economic development, and long, porous border with three malaria endemic countries: Lao People's Democratic Republic, Myanmar, and Viet Nam.MethodsAcademic publications and grey literature relevant to malaria elimination in Yunnan covering the period from 1950 until 2020 inclusive were considered. The following academic indexes were searched: China Science Periodical Database, China National Knowledge Infrastructure Database, and MEDLINE. Grey literature sources were mainly available from the National Institute of Parasitic Diseases (NIPD), the Chinese Center for Diseases Control and Prevention, and the Yunnan Institute of Parasitic Diseases (YIPD).ResultsA malaria elimination campaign in the 1950-1960s, based mainly on mass administration of antimalarial drugs and large-scale vector control, reduced morbidity and mortality from malaria and interrupted transmission in some areas, although elimination was not achieved. Similar strategies were used to contain outbreaks and a resurgence of disease during the 1970s, when malaria services were discontinued. From the 1980s, malaria incidence declined, despite the challenges of large numbers of mobile and migrant populations and an unstable primary health care system in rural areas following economic transformation. Launch of the national malaria elimination programme in 2010 led to adoption of the '1-3-7' surveillance and response strategy specifying timely detection of and response for every case, supported by the establishment of a real-time web-based disease surveillance system and a new primary health care system in rural areas. Border malaria was addressed in Yunnan by strengthening the surveillance system down to the lowest level, cross-border collaboration with neighbouring countries and non-governmental organizations, and the involvement of other sectors.ConclusionsSeven decades of work to eliminate malaria in Yunnan have shown the importance of political commitment, technically sound strategies with high quality implementation, a robust surveillance and response system at all levels, community participation and effective management of border malaria. The experiences and lessons learned from elimination remain important for prevention re-establishment of malaria transmission in the Province.

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Poverty and malaria in the Yunnan province, China.

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Poverty and malaria in the Yunnan province, China.

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