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Abstract
Background: Malaria Clinics (MCs) have served communities in Thailand since 1965 and are still playing a critical role in providing early diagnosis and effective treatment of malaria. Methods: We reviewed six decades of published manuscripts, articles, strategies, and plans regarding MC operations in Thailand;,and analyzed national program surveillance data in both malaria control and malaria elimination phases. Results: MCs accounted for 39.8% of malaria tests and 54.8% of positive cases by the end of the 1980s. The highest number of MCs established was 544 in 1997. MCs contributed to 6.7% of all tests and 30% of all positive cases over the 2015–2017 period. Between 2017 and June 2019, during the malaria elimination phase, MCs continued to test an average of 67% of all persons tested for malaria, and confirmed 38.3% of all positive cases detected in the country. Conclusions: Testing and positive rates of MCs are on a gradual decline as the overall burden of malaria declines annually, which may reflect decreasing transmission intensity. Although the number of MCs in the last three years has been stable (n = 240), the attrition of MC staff poses a real challenge to the longevity of MCs in the absence of a human resource plan to support the elimination phase. It is necessary to identify and support capacity gaps and needs as MCs are absorbed into an integrated and decentralized program, while ensuring that the Division of Vector Borne Diseases (DVBD) maintains its necessary technical and advisory role.
Highlights
The Malaria Control Program (MCP) adopted, evaluated, and revised various malaria control strategies from existing vector control methods, such as the countrywide spraying of DDT, along with anti-malaria drug distribution to at-risk populations concentrated in forested areas [4]
The first documented Malaria Clinics (MCs) was established in Pakchong District, Nakorn Ratchasima province in 1959, the precise number of MCs that were subsequently established was undocumented until 1975, when 14 MCs that were established at Malaria Sector Offices were documented
In 1975, a formal 8-week training course for malaria HVs stationed at MCs was introduced to include the basic principles of malaria transmission, English terminologies, and training on microscope usage for the examination of blood films
Summary
The MCP adopted, evaluated, and revised various malaria control strategies from existing vector control methods, such as the countrywide spraying of DDT, along with anti-malaria drug distribution to at-risk populations concentrated in forested areas [4]. In addition to these strategies, malaria clinics (MCs) established since the 1960s onwards have played a critical role for the MCP in providing early diagnosis and treatment for malaria. Methods: We reviewed six decades of published manuscripts, articles, strategies, and plans regarding MC operations in Thailand;,and analyzed national program surveillance data in both malaria control and malaria elimination phases. It is necessary to identify and support capacity gaps and needs as MCs are absorbed into an integrated and decentralized program, while ensuring that the Division of Vector Borne Diseases (DVBD) maintains its necessary technical and advisory role
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