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Abstract
BackgroundThis study examined evolving malaria profiles from January, 2010 to December, 2014 to evaluate achievements and challenges of implementing measures to prevent and control spread of artemisinin resistance in Myanmar.MethodsUsing National Malaria Control Programme (NMCP) data, a cross-sectional descriptive study of 52 townships in artemisinin-resistant containment areas in Myanmar was conducted. Annual program data were analysed, and trends over time are graphically presented.ResultsIn the 52 study townships populated by 8.7 million inhabitants, malaria incidence showed a decreasing trend from 10.54 per 1 000 population in 2010 to 2.53 in 2014, and malaria mortalities also decreased from 1.83 per 100 000 population in 2010 to 0.17 in 2014. The proportion of confirmed to total tested malaria cases also decreased from 6 to 1%, while identification of cases improved. All cases from all parasites species, including Plasmodium falciparum, decreased. Coverage of LLIN (long-lasting insecticidal net)/ITN (insecticide-treated mosquito nets) and indoor residual spraying (IRS) was high in targeted areas with at-risk persons, even though the total population was not covered. In addition to passive case detection (PCD), active case detection (ACD) was conducted in hard-to-reach areas and worksites where mobile migrant populations were present. ACD improved in most areas from 2012 to 2014, but continues to need to be strengthened.ConclusionsThe findings provide useful data on the malaria situation in artemisinin-resistant initiative areas, which may be useful for the NMCP to meet its elimination goal. These profiles could contribute to better planning, implementation, and evaluation of intervention activities.
Highlights
This study examined evolving malaria profiles from January, 2010 to December, 2014 to evaluate achievements and challenges of implementing measures to prevent and control spread of artemisinin resistance in Myanmar
We report on 52 targeted areas with implementation of the key containment activities, and their impact on key malaria indicators from 2010 to 2014
From 2014 on, Myanmar became the main recipient of the Greater Mekong subregion (GMS) regional artemisinin resistance initiative (RAI) with The global fund to fight Aids (GFATM) and Bill and Melinda Gates Foundation (BMGF) funding, and Three Disease Fund will continue to fund Myanmar Artemisinin Resistance Containment (MARC), possibly until 2016 [5]
Summary
This study examined evolving malaria profiles from January, 2010 to December, 2014 to evaluate achievements and challenges of implementing measures to prevent and control spread of artemisinin resistance in Myanmar. As a response to these challenges, the Myanmar Artemisinin Resistance Containment (MARC) project was initiated in 2010–2011 and implemented in 2011 [4, 5]. Key activities in MARC areas included increasing access to early diagnosis and effective treatment, improving community case management through community and private sector approaches, banning artemisinin-based monotherapy, reintroducing indoor residual spraying (IRS) combined with long-lasting insecticidal net (LLIN)/insecticide-treated mosquito nets (ITN), increasing use of LLIN/ITN to target 100% population coverage (anticipating two persons per net), strengthening malaria prevention and treatment for migrants at their work-sites, and setting up malaria screening points, operational research, periodic surveys, and applying multi-sectoral approaches. The need for strengthening routine surveillance systems and operational research was emphasized [2]
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