Abstract
BackgroundCountries of the greater Mekong subregion have made a transition from malaria control to an aim for falciparum and vivax malaria elimination. The elimination of falciparum malaria will have to be achieved against a background of increasing artemisinin and multi-drug resistance. This ambitious goal requires an operational research (OR) agenda that addresses the dynamic challenges encountered on the path to elimination, which will need to be flexible and developed in close relation with the cambodian national programme for parasitology, entomology and malaria control (CNM). In Cambodia, a number of meetings with stakeholders were convened by the CNM and emergency response to artemisinin resistance (ERAR) hub, producing an initial list of priority OR topics. The process and outcome of these meetings are described, which could serve as a template for other countries in the region.MethodsA landscaping exercise was conducted to gather all past, on-going and planned malaria focussed OR activities conducted by the cambodian research consortium in Cambodia and categorized according to research theme. The six themes included (1) malaria epidemiology, surveillance and response, (2) malaria case management, (3) malaria vector control, (4) malaria behavioural issues, (5) malaria clinical studies, and (6) other vector-borne diseases (dengue, neglected tropical diseases, soil-transmitted helminths). The different themes were discussed in small focus groups, which made an initial prioritization list which was then presented to a plenary group for further discussion. This produced a list of research questions ranked according to priority.ResultsOR priorities produced by the thematic groups were discussed in the plenary meeting and given a priority score by group voting. A list of 17 OR questions were developed, finalized and listed, which included questions on surveillance, active case detection and treatment efficacy.ConclusionThis paper describes ERAR’s work on supporting Cambodia’s transition to malaria elimination by identifying national operational research priorities. ERAR has initiated and currently plays a critical role in the development of country specific research agendas for malaria elimination. The first example of this has been the described exercise in Cambodia, which could serve a template for setting OR priorities in the wider region.
Highlights
Countries of the greater Mekong subregion have made a transition from malaria control to an aim for falciparum and vivax malaria elimination
Of particular use were the Planning Meeting for Operational Research on Malaria Elimination organized by the World Health Organization (WHO)/GMP and held in 17–18 October 2013 in Geneva, Switzerland [1], as well as the greater Mekong sub-region (GMS) regional meeting organized by SEARO and WPRO: ‘Informal consultation on operational research to support accelerating malaria elimination in the context of artemisinin resistant falciparum malaria in the Greater Mekong Sub region’ in December 2013, Bangkok, Thailand [26]
Rank ordering Based on the list generated in Step 1, a ranking exercise was conducted by all participants present
Summary
Countries of the greater Mekong subregion have made a transition from malaria control to an aim for falciparum and vivax malaria elimination. The elimination of falciparum malaria will have to be achieved against a background of increasing artemisinin and multi-drug resistance This ambitious goal requires an operational research (OR) agenda that addresses the dynamic challenges encountered on the path to elimination, which will need to be flexible and developed in close relation with the cambodian national programme for parasitology, entomology and malaria control (CNM). Cambodia is moving towards elimination, and aims to move towards pre-elimination of malaria with special efforts to (1) contain artemisinin-resistant P. falciparum malaria by 2015, (2) to achieve elimination of falciparum malaria (and malaria deaths) by 2020, and (3) to achieve a phased elimination of all forms of malaria in Cambodia by 2025 [6] To achieve these elimination targets, Cambodia must increase and accelerate operational research (OR) activities around malaria elimination
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