Malaria imported from Ghana by returning gold miners to China
This report aims to describe the epidemiologic characteristics of a large outbreak of imported malaria among Chinese workers returning from overseas countries, in Shanglin County, Guangxi Zhuang Autonomous Region, in 2013.
The main goal is to facilitate formulation of more effective prevention and control measures for imported malaria at a time of rapidly increasing globalization.
In Shanglin County, since 2006, >10,000 inhabitants have traveled abroad to conduct gold mining work, most of them to Ghana. In late April 2013, the government of Ghana began to strictly regulate the gold mining industry, which forced many gold miners to return to China within a short time. In recent years, no locally acquired malaria cases had been reported in Shanglin County; only sporadic cases of imported malaria.
During May-August, 2013, 6,096 individuals from Shanglin County were tested for Plasmodium spp. infections. A malaria outbreak comprising 874 persons was detected among 4,052 persons returning from overseas. Ghana was the predominant destination country, and 92.3% of malarial infections occurred in gold miners.
Preventive measures should be enhanced for persons in high-risk occupations traveling to malaria-endemic countries.
Shanglin County conducted active malaria screening among three groups:
(1) persons with an overseas travel history during the previous year.
(2) febrile patients visiting hospitals who had no overseas travel history.
(3) asymptomatic local residents who had no overseas travel history but lived in the same household as persons who had malaria.
P. falciparum infections were treated with artemisinin-based combination therapy. Glucose-6-phosphate dehydrogenase deficient individuals infected with P. vivax or P. ovale were radically cured with chloroquine combined with primaquine. P. malariae infections were treated with chloroquine.