Objectives <p>Chinese-funded projects in Africa continue to grow in scale, and as a result Chinese expatriate workers face elevated health risks from tropical vector-borne diseases such as malaria, dengue, and schistosomiasis. Limited evidence is available on the infection risk profiles and unmet health service needs of Chinese workers while stationed abroad.</p> Methods <p>A cross-sectional online survey was conducted between September and October 2023 among Chinese employees working in African countries; and data was collected through a structured questionnaire informed by the Dahlgren-Whitehead model of health determinants. Descriptive statistics, χ² tests, and multivariate logistic regression were applied to identify factors associated with reported infections.</p> Results <p>Of 303 valid questionnaires, 33.7% respondents reported having contracted a tropical vector-borne disease, mainly malaria. Factors significantly associated with infection included older age (OR_{30 − 38}=2.884, 95%CI_{30 − 38}=1.288–6.462; OR_{39 − 60}=3.043, 95%CI_{39 − 60}=1.357–6.824), deployment over three years (OR = 4.199, 95%CI = 1.015–17.374), exposure to primates (OR = 2.428, 95%CI = 1.108–5.322), drinking tap water (OR = 2.418, 95%CI = 1.046–5.589), and lacking medical support (OR = 2.920, 95%CI = 1.231–6.927).</p> Conclusion <p>Chinese expatriate workers in Africa face multifaceted health challenges, underscoring the need to prioritize their health and well-being. Toward advancing universal health coverage, our findings highlight the importance of safeguarding mobile labor populations and fostering stronger collaboration between enterprises, public health systems, and host-country institutions.</p>