Abstract:

Objective To understand the current status of malaria prevention and control capacity in Shanghai after malaria elimination for reference for sustaining the elimination achievements. Methods By field interviews and questionnaire responses, we conducted a survey on the status of malaria practitioners in center for disease control and prevention (CDC) in Shanghai, as well as the awareness and knowledge towards malaria prevention and treatment among the employees in health institutions. The data related to malaria surveillance, prevention and control from 2017 to 2025 in Shanghai were collected to analyze the competence of the practitioners in case reporting, diagnosis and treatment, and emergency response capability of the institutions. Results In total, there were 81 malaria control professionals at the CDC in urban Shanghai, most of whom were part-time staff (n=59; 72.84%), and 40 (49.38%) had fewer than 5 years of experience in malaria prevention and control. A total of 840 malaria control?related personnel from 84 general hospitals at or above the second level were surveyed, with 835 valid questionnaires recovered and 8 350 questions answered. The overall awareness rate of malaria control knowledge was 94.07% (7 855/8 350). The awareness rates for epidemiology, clinical diagnosis and treatment, prevention and control, and laboratory testing were 93.85% (2 351/2 505), 95.33% (2 388/2 505), 92.34% (2 313/2 505) and 96.17% (803/835), respectively. The difference was statistically significant (χ²=27.442, P<0.05). From 2017 to 2025, a total of 371 malaria cases were reported. The majority of the cases were associated with Plasmodium falciparum malaria (302 cases, 81.40%). Critical, severe and mild cases accounted for 5.93% (22/371), 69.27% (257/371), and 24.80% (92/371), respectively. The correct rate of initial diagnosis was 71.16% (264/371), in which 79.53% (136/171) occurred at the municipal-level institutions, 74.10% (103/139) at the district-level institutions, and 40.98% (25/61) at institutions of other levels. The time from symptom onset to confirmed diagnosis ranged from 0 to 52 days, with a median of 1 (0, 3) day, and the rate of diagnosis within one day was 60.65% (225/371). The cure rate of reported cases was 99.19% (368/371). The timeliness rates for case reporting, case review, and epidemic response were all 100.00%. The rate of timely individual case investigation and reporting within 2 days was 99.19% (368/371), and the rate of timely investigation and response at the epidemic focus within 3 days was 96.79% (241/249). All reported cases were imported from overseas, and no secondary transmission occurred. Conclusion Shanghai has built an effective capacity system for malaria prevention and control, and continues to maintain its malaria-elimination status. Nevertheless, further efforts are needed to deepen the integration of medical treatment and disease prevention, strengthen personnel training, and optimize the guarantee mechanism for diagnosis and treatment of patients.

Key words: Malaria, Prevention and control capacity, Shanghai Municipality