Evaluation on vulnerability of malaria control system in China based on TOPSIS method

Objective To assess the vulnerability of malaria control system in China and to provide suggestions for malaria risk management.Methods Using stratified random sampling and typical sampling,we selected 8 counties in Hubei,Anhui and Guangxi provinces for a survey between July 2015 and September 2016.Representative indicators for epidemic and control of malaria were established by using literature research,brainstorming,expert consultation,and questionnaire survey.The vulnerability of malaria control system in the selected areas was evaluated with technique for order-preference by similarity to ideal solution (TOPSIS) method.Results A total of 19 indicators referring to 5 domains of the malaria control system (economic vulnerability,social vulnerability,political vulnerability,health system vulnerability and sensitivity) were identified and the weight coefficients of the indicators ranged between 0.009 2 and 0.103 7,with the two higher values for the weight coefficient for the number of mobile population (0.100 6) and government attention to malaria risk (0.103 7).The overall vulnerability of malaria control system in the surveyed areas was not at a high level and the vulnerability scores from high to low for the 8 areas were 0.652 42 (Qianjiang municipality of Hubei province),0.578 39 (Tianjia'an district of Huainan municipality of Anhui province),0.509 58 (Feixi county of Anhui province),0.459 92 (Guangshui municipality of Hubei province),0.40582 (Du'an county of Guangxi Zhuang Autonomous Region),0.578 39 (Xiejia district of Huainan municipality of Anhui province),0.234 74 (Tian'e county of Guangxi Zhuang Autonomous Region),and 0.181 66 (Nandan county of Guangxi Zhuang Autonomous Region),respectively.Conclusion The overall vulnerability of malaria control system in China was not high and is mostly influenced by the number of mobile population in epidemic areas and the government attention to malaria risk.