Abstract
BackgroundMyanmar, a malaria endemic country of Southeast Asia, adopted surveillance and response strategy similar to “1-3-7” Chinese strategy to achieve sub-national elimination in six low-endemic region/states of the country. Among these, Yangon, Bago-East, and Mon region/states have implemented this malaria surveillance and response strategy with modification in 2016. The current study was conducted to assess the case notification, investigation, classification, and response strategy (NICR) in these three states.MethodsThis was a retrospective cohort study using routine program data of all patients with malaria diagnosed and reported under the National Malaria Control Programme in 2016 from the above three states. As per the program, all malaria cases need to be notified within 1 day and investigated within 3 days of diagnosis and response to control (active case detection and control) should be taken for all indigenous malaria cases within 7 days of diagnosis.ResultsA total of 959 malaria cases were diagnosed from the study area in 2016. Of these, the case NICR details were available only for 312 (32.5%) malaria cases. Of 312 cases, the case notification, investigation, and classification were carried out within 3 days of malaria diagnosis in 95.5% cases (298/312). Of 208 indigenous malaria cases (66.7%, 208/312), response to control was taken in 96.6% (201/208) within 7 days of diagnosis.ConclusionThe timeline at each stage of the strategy namely case notification, investigation, classification, and response to control was followed, and response action was taken in nearly all indigenous malaria cases for the available case information. Strengthening of health information and monitoring system is needed to avoid missing information. Future research on feasibility of mobile/tablet-based surveillance system and providing response to all cases including imported malaria can be further studied.
Highlights
Myanmar, a malaria endemic country of Southeast Asia, adopted surveillance and response strategy similar to “1-3-7” Chinese strategy to achieve sub-national elimination in six low-endemic region/states of the country
National Malaria Control Programme (NMCP) is carrying out malaria control and elimination activities, and the services are provided free of charge to the population
The annual parasite index of malaria cases detected under NMCP in 2016 for Yangon, Bago-East, and Mon was 0.01 (52/7,510,139), 0.14 (414/2,952,897), and 0.24 (493/2,096,099), respectively
Summary
A malaria endemic country of Southeast Asia, adopted surveillance and response strategy similar to “1-3-7” Chinese strategy to achieve sub-national elimination in six low-endemic region/states of the country. Yangon, Bago-East, and Mon region/states have implemented this malaria surveillance and response strategy with modification in 2016. The current study was conducted to assess the case notification, investigation, classification, and response strategy (NICR) in these three states. The Global Technical Strategy for Malaria 2016–2030 (GTS) calls for elimination of malaria in 10 countries by 2020 and 35 countries by 2030 [2]. Among the 14 countries of Asia Pacific Malaria Elimination Network (APMEN), 13 countries reported the availability of such surveillance system in place. The member countries have reported about the malaria case investigations to all or part of cases notified depending on the burden and type of malaria cases (indigenous or imported malaria) [5]
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