Table 2.

Themes of challenges and lessons learned of Chinese malaria 1-3-7 surveillance strategy

	Challenges	Lessons learned
Case reporting within 1 day	• Inadequate surveillance capacity of primary health staff • Delay of presence of malaria patients in clinics • Inadequate diagnostic tools • Village clinics are not covered under the reporting system	• Continues capacity building at primary health clinics • A well-functioning surveillance infrastructure • Technical flexibility of suspected cases reporting
Case investigation within 3 days	• Respecting the 3 days timeline • Difficulties of species identification • Subjective and technical aspects of case classification • Limited quality control of case investigation	• The importance of information technology (IT) support • New research findings
Foci Investigation within 7 days	• Complexity and difficulties during evaluation of local transmission risk • Respecting the 7 days timeline • IRS and RACD in potential active/active foci • Acceptance of actions by population • Limited quality control of focus investigation	• Logistical aspects • Community acceptability • Methods of quality control • Active screening of migrant workers and their peers upon return to China
Overall aspects of the 1-3-7 surveillance strategy	• Declining motivation of primary health staff • Increasing returning migrant workers from malaria endemic countries • The complexity to establish multi-sectorial collaboration	• High government commitment • Aspects on better targeting and management of returning migrant workers • Financial incentives • Health campaigns, education and training programs