1
|
Sikaala CH, Dlamini B, Lungu A, Fakudze P, Chisenga M, Siame CL, Mwendera N, Shaba D, Chimumbwa JM, Kleinschmidt I. Malaria elimination and the need for intensive inter-country cooperation. a critical evaluation of regional technical co-operation in Southern Africa. Malar J 2024; 23:62. [PMID: 38419105 PMCID: PMC10903059 DOI: 10.1186/s12936-024-04891-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Malaria elimination requires closely co-ordinated action between neighbouring countries. In Southern Africa several countries have reduced malaria to low levels, but the goal of elimination has eluded them thus far. The Southern Africa Development Community (SADC) Malaria Elimination Eight (E8) initiative was established in 2009 between Angola, Botswana, Eswatini, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe to coordinate malaria interventions aiming to eliminate malaria by 2030. Cross-border coordination is important in malaria elimination settings as it strengthens surveillance, joint planning and implementation, knowledge exchange and optimal use of resources. This paper describes how this collaboration is realized in practice, its achievements and challenges, and its significance for malaria elimination prospects. METHODS The ministers of health of the E8 countries oversee an intergovernmental technical committee supported by specialist working groups consisting of technical personnel from member countries and partner institutions. These technical working groups are responsible for malaria elimination initiatives in key focus areas such as surveillance, vector control, diagnosis, case management, behaviour change and applied research. The technical working groups have initiated and guided several collaborative projects which lay essential groundwork for malaria elimination. RESULTS The E8 collaboration has yielded achievements in the following key areas. (1) Establishment and evaluation of malaria border health posts to improve malaria services in border areas and reduce malaria among resident and, mobile and migrant populations. (2) The development of a regional malaria microscopy slide bank providing materials for diagnostic training and proficiency testing. (3) A facility for regional external competency assessment and training of malaria microscopy trainers in collaboration with the World Health Organization. (4) Entomology fellowships that improved capacity in entomological surveillance; an indoor residual spraying (IRS) training of trainers' scheme to enhance the quality of this core intervention in the region. (5) Capacity development for regional malaria parasite genomic surveillance. (6) A mechanism for early detection of malaria outbreak through near real time reporting and a quarterly bulletins of malaria incidence in border districts. CONCLUSIONS The E8 technical working groups system embodies inter-country collaboration of malaria control and elimination activities. It facilitates sustained interaction between countries through a regional approach. The groundwork for elimination has been laid, but the challenge will be to maintain funding for collaboration at this level whilst reducing reliance on international donors and to build capacities necessary to prepare for malaria elimination.
Collapse
Affiliation(s)
| | - Bongani Dlamini
- SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia
| | - Alphart Lungu
- SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia
| | - Phelele Fakudze
- SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia
| | | | | | - Nyasha Mwendera
- SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia
| | - Dumisani Shaba
- SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia
| | | | - Immo Kleinschmidt
- SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
2
|
Li X, Snow RW, Lindblade K, Noor AM, Steketee R, Rabinovich R, Gopinath D, Gasimov E, Alonso PL. Border malaria: defining the problem to address the challenge of malaria elimination. Malar J 2023; 22:239. [PMID: 37605226 PMCID: PMC10440889 DOI: 10.1186/s12936-023-04675-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/13/2023] [Indexed: 08/23/2023] Open
Abstract
Border malaria is frequently cited as an obstacle to malaria elimination and sometimes used as a justification for the failure of elimination. Numerous border or cross-border meetings and elimination initiatives have been convened to address this bottleneck to elimination. In this Perspective, border malaria is defined as malaria transmission, or the potential for transmission, across or along shared land borders between countries where at least one of them has ongoing malaria transmission. Border malaria is distinct from malaria importation, which can occur anywhere and in any country. The authors' analysis shows that the remaining transmission foci of malaria-eliminating countries tend to occur in the vicinity of international land borders that they share with neighbouring endemic countries. The reasons why international land borders often represent the last mile in malaria elimination are complex. The authors argue that the often higher intrinsic transmission potential, the neglect of investment and development, the constant risk of malaria importation due to cross-border movement, the challenges of implementing interventions in complex environments and uncoordinated action in a cross-border shared transmission focus all contribute to the difficulties of malaria elimination in border areas. Border malaria reflects the limitations of the current tools and interventions for malaria elimination and implies the need for social cohesion, basic health services, community economic conditions, and policy dialogue and coordination to achieve the expected impact of malaria interventions. Given the uniqueness of each border and the complex and multifaceted nature of border malaria, a situation analysis to define and characterize the determinants of transmission is essential to inform a problem-solving mindset and develop appropriate strategies to eliminate malaria in these areas.
Collapse
Affiliation(s)
- Xiaohong Li
- Global Malaria Programme, World Health Organization, Geneva, Switzerland.
| | - Robert W Snow
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Kim Lindblade
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Abdisalan M Noor
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Deyer Gopinath
- World Health Organization Country Office, Bangkok, Thailand
| | - Elkhan Gasimov
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Pedro L Alonso
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
3
|
Abdalal SA, Yukich J, Andrinopoulos K, Alghanmi M, Wakid MH, Zawawi A, Harakeh S, Altwaim SA, Gattan H, Baakdah F, Gaddoury MA, Niyazi HA, Mokhtar JA, Alruhaili MH, Alsaady I, Alhabbab R, Alfaleh M, Hashem AM, Alahmadey ZZ, Keating J. Livelihood activities, human mobility, and risk of malaria infection in elimination settings: a case-control study. Malar J 2023; 22:53. [PMID: 36782234 PMCID: PMC9926773 DOI: 10.1186/s12936-023-04470-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Livelihood activities and human movements participate in the epidemiology of vector-borne diseases and influence malaria risk in elimination settings. In Saudi Arabia, where malaria transmission intensity varies geographically, it is vital to understand the components driving transmission within specific areas. In addition, shared social, behavioural, and occupational characteristics within communities may provoke the risk of malaria infection. This study aims to understand the relationship between human mobility, livelihood activities, and the risk of malaria infection in the border region of Jazan to facilitate further strategic malaria interventions. In addition, the study will complement and reinforce the existing efforts to eliminate malaria on the Saudi and Yemen border by providing a deeper understanding of human movement and livelihood activities. METHODS An unmatched case-control study was conducted. A total of 261 participants were recruited for the study, including 81 cases of confirmed malaria through rapid diagnostic tests (RDTs) and microscopy and 180 controls in the Baish Governorate in Jazan Provinces, Saudi Arabia. Individuals who received malaria tests were interviewed regarding their livelihood activities and recent movement (travel history). A questionnaire was administered, and the data was captured electronically. STATA software version 16 was used to analyse the data. Bivariate and multivariate analyses were conducted to determine if engaging in agricultural activities such as farming and animal husbandry, recent travel history outside of the home village within the last 30 days and participating in spiritual gatherings were related to malaria infection status. RESULTS A logistical regression model was used to investigate components associated with malaria infection. After adjusting several confounding factors, individuals who reported travelling away from their home village in the last 30 days OR 11.5 (95% CI 4.43-29.9), and those who attended a seasonal night spiritual gathering OR 3.04 (95% CI 1.10-8.42), involved in animal husbandry OR 2.52 (95% CI 1.10-5.82), and identified as male OR 4.57 (95% CI 1.43-14.7), were more likely to test positive for malaria infection. CONCLUSION Human movement and livelihood activities, especially at nighttime, should be considered malaria risk factors in malaria elimination settings, mainly when the targeted area is limited to a confined borderland area.
Collapse
Affiliation(s)
- Shaymaa A. Abdalal
- grid.412125.10000 0001 0619 1117Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Joshua Yukich
- grid.265219.b0000 0001 2217 8588School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| | - Katherine Andrinopoulos
- grid.265219.b0000 0001 2217 8588School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| | - Maimonah Alghanmi
- grid.412125.10000 0001 0619 1117Vaccines and Immunotherapy Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Majed H. Wakid
- grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayat Zawawi
- grid.412125.10000 0001 0619 1117Vaccines and Immunotherapy Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Steve Harakeh
- grid.412125.10000 0001 0619 1117King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah A. Altwaim
- grid.412125.10000 0001 0619 1117Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hattan Gattan
- grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fadi Baakdah
- grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mahmoud A. Gaddoury
- grid.412125.10000 0001 0619 1117Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hatoon A. Niyazi
- grid.412125.10000 0001 0619 1117Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jawahir A. Mokhtar
- grid.412125.10000 0001 0619 1117Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed H. Alruhaili
- grid.412125.10000 0001 0619 1117Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Isra Alsaady
- grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Special Infectious Agents Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rowa Alhabbab
- grid.412125.10000 0001 0619 1117Vaccines and Immunotherapy Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed Alfaleh
- grid.412125.10000 0001 0619 1117Vaccines and Immunotherapy Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Anwar M. Hashem
- grid.412125.10000 0001 0619 1117Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.412125.10000 0001 0619 1117Vaccines and Immunotherapy Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ziab Zakey Alahmadey
- grid.415696.90000 0004 0573 9824Microbiology and Serology Departments, Al-Ansar Hospital, Ministry of Health, Medina, Saudi Arabia
| | - Joseph Keating
- grid.265219.b0000 0001 2217 8588School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| |
Collapse
|
4
|
Abdalal SA, Yukich J, Andrinoplous K, Harakeh S, Altwaim SA, Gattan H, Carter B, Shammaky M, Niyazi HA, Alruhaili MH, Keating J. An insight to better understanding cross border malaria in Saudi Arabia. Malar J 2023; 22:37. [PMID: 36732819 PMCID: PMC9893606 DOI: 10.1186/s12936-023-04467-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 01/23/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Border malaria is a major obstacle for the malaria elimination in Saudi Arabia. Today, the southern border of Saudi Arabia is a region where malaria cases are resurging, and malaria control is dwindling mainly due to the humanitarian crisis and the conflict in Yemen. This study analyses the current border malaria epidemiology along the southern border of Saudi Arabia from 2015 to 2018. METHODS All reported cases maintained by the malaria elimination centres in Aledabi and Baish, Jazan Province, Saudi Arabia, from 2015 to 2018 were analysed to examine the epidemiological changes over time. Pearson's Chi-Square test of differences was utilized to assess differences between the characteristics of imported and local causes and between border cases. A logistic regression model was used to predict imported status was related to living along side of the border area. RESULTS A total of 3210 malaria cases were reported in Baish and Aledabi malaria centres between 2015 and 2018, of which 170 were classified as local cases and 3040 were classified as imported cases. Reported malaria cases were mainly among males, within the imported cases 61.5% (1868/3039) were residents of the border areas. CONCLUSIONS Given the complexity of cross-border malaria, creating a malaria buffer zone that covers a certain margin from both sides of the border would allow for a joint force, cross-border malaria elimination programme. To initiate a malaria elimination activity and cases reported as belonging to this zone, rather than being pushed from one country to the other, would allow malaria elimination staff to work collaboratively with local borderland residents and other stakeholders to come up with innovative solutions to combat malaria and reach malaria-free borders.
Collapse
Affiliation(s)
- Shaymaa A. Abdalal
- grid.412126.20000 0004 0607 9688Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Joshua Yukich
- grid.265219.b0000 0001 2217 8588Tulane University School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Katherine Andrinoplous
- grid.265219.b0000 0001 2217 8588Tulane University School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Steve Harakeh
- Saudi Arabia Ministry of Health, Jazan, Saudi Arabia
| | - Sarah A. Altwaim
- grid.412126.20000 0004 0607 9688Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Hattan Gattan
- grid.412125.10000 0001 0619 1117Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Brendan Carter
- grid.265219.b0000 0001 2217 8588Tulane University School of Public Health and Tropical Medicine, New Orleans, LA USA
| | | | - Hatoon A. Niyazi
- grid.412126.20000 0004 0607 9688Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mohammed H. Alruhaili
- grid.412126.20000 0004 0607 9688Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Joseph Keating
- grid.265219.b0000 0001 2217 8588Tulane University School of Public Health and Tropical Medicine, New Orleans, LA USA
| |
Collapse
|
5
|
Galindo MS, Lambert Y, Mutricy L, Garancher L, Bordalo Miller J, Gomes JH, Sanna A, Peterka C, Hilderal H, Cairo H, Hiwat H, Nacher M, Suárez-Mutis MC, Vreden S, Douine M. Setting-up a cross-border action-research project to control malaria in remote areas of the Amazon: describing the birth and milestones of a complex international project (Malakit). Malar J 2021; 20:216. [PMID: 33975624 PMCID: PMC8111981 DOI: 10.1186/s12936-021-03748-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/28/2021] [Indexed: 11/27/2022] Open
Abstract
Background In French Guiana, gold miners working illegally represents a major reservoir of malaria. This mobile population, mainly of Brazilian descent, enters the French Guianese forest from neighbouring countries, Suriname and Brazil. A complex and innovative intervention was piloted as a cooperation with the three involved countries involved to control malaria in this specific population. The principle was that health workers called “facilitators” provide the participants with a self-diagnosis and self-treatment kit along with adequate training and material to rapidly manage an episode of malaria symptoms on their own, when they find themselves isolated from health care services. Methods This paper describes the design, development, content of the intervention and players’ organization of this multi-country project, the opportunities and constraints encountered, and the lessons learnt at this stage. Results The choice not to implement the usual “Test and Treat” approach within the community is mainly driven by regulatory reasons. The content of medical messages tends to balance the tension between thoroughness, accuracy and efficacy. The wide range of tools developed through a participatory approach was intended to cope with the challenges of the literacy level of the target population. Despite the difficulties encountered due to language, regulation differences and distance between partners, cooperation was fruitful, due to the complementary of stakeholders, their involvement at all important stages and regular face-to-face meetings. Discussion and conclusion This experience shows the feasibility of an ambitious project of action-research in a border malaria context, involving several countries and with a mobile and undocumented population. It reveals some factors of success which may be transferable in analogous settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03748-5.
Collapse
Affiliation(s)
- Muriel Suzanne Galindo
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana.
| | - Yann Lambert
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | - Louise Mutricy
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | | | | | | | - Alice Sanna
- Agence Régionale de Santé de la Guyane, Cayenne, French Guiana
| | - Cassio Peterka
- National Malaria Control Programme, Ministry of Health of Brazil, Brasilia, Brazil
| | - Hélène Hilderal
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | - Hedley Cairo
- National Malaria Control Programme, Ministry of Health of Suriname, Paramaribo, Suriname
| | - Helene Hiwat
- National Malaria Control Programme, Ministry of Health of Suriname, Paramaribo, Suriname
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | | | - Stephen Vreden
- Foundation for the Advancement of Scientific Research in Suriname, Paramaribo, Suriname
| | - Maylis Douine
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| |
Collapse
|
6
|
Li XH, Zhou HN, Xu JW, Lin ZR, Sun XD, Li JY, Lin XX, Xie Y, Alonso P, Yang HL. Seven decades towards malaria elimination in Yunnan, China. Malar J 2021; 20:147. [PMID: 33711990 PMCID: PMC7953382 DOI: 10.1186/s12936-021-03672-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Yunnan Province was considered the most difficult place in China for malaria elimination because of its complex malaria epidemiology, heterogeneous ecological features, relatively modest economic development, and long, porous border with three malaria endemic countries: Lao People's Democratic Republic, Myanmar, and Viet Nam. METHODS Academic publications and grey literature relevant to malaria elimination in Yunnan covering the period from 1950 until 2020 inclusive were considered. The following academic indexes were searched: China Science Periodical Database, China National Knowledge Infrastructure Database, and MEDLINE. Grey literature sources were mainly available from the National Institute of Parasitic Diseases (NIPD), the Chinese Center for Diseases Control and Prevention, and the Yunnan Institute of Parasitic Diseases (YIPD). RESULTS A malaria elimination campaign in the 1950-1960s, based mainly on mass administration of antimalarial drugs and large-scale vector control, reduced morbidity and mortality from malaria and interrupted transmission in some areas, although elimination was not achieved. Similar strategies were used to contain outbreaks and a resurgence of disease during the 1970s, when malaria services were discontinued. From the 1980s, malaria incidence declined, despite the challenges of large numbers of mobile and migrant populations and an unstable primary health care system in rural areas following economic transformation. Launch of the national malaria elimination programme in 2010 led to adoption of the '1-3-7' surveillance and response strategy specifying timely detection of and response for every case, supported by the establishment of a real-time web-based disease surveillance system and a new primary health care system in rural areas. Border malaria was addressed in Yunnan by strengthening the surveillance system down to the lowest level, cross-border collaboration with neighbouring countries and non-governmental organizations, and the involvement of other sectors. CONCLUSIONS Seven decades of work to eliminate malaria in Yunnan have shown the importance of political commitment, technically sound strategies with high quality implementation, a robust surveillance and response system at all levels, community participation and effective management of border malaria. The experiences and lessons learned from elimination remain important for prevention re-establishment of malaria transmission in the Province.
Collapse
Affiliation(s)
- Xiao-Hong Li
- Global Malaria Programme, World Health Organization, Geneva, Switzerland.
| | - Hong-Ning Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Jian-Wei Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Zu-Rui Lin
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Xiao-Dong Sun
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| | - Jia-Yin Li
- Yunnan Representative Office, Health Poverty Action (UK), Kunming, China
| | - Xian-Xian Lin
- Yunnan Representative Office, Health Poverty Action (UK), Kunming, China
| | - Yan Xie
- School of Public Health, Peking University, Beijing, China
| | - Pedro Alonso
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Heng-Lin Yang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Pu'er City, China
| |
Collapse
|
7
|
Noisang C, Prosser C, Meyer W, Chemoh W, Ellis J, Sawangjaroen N, Lee R. Molecular detection of drug resistant malaria in Southern Thailand. Malar J 2019; 18:275. [PMID: 31416468 PMCID: PMC6694568 DOI: 10.1186/s12936-019-2903-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Drug resistance within the major malaria parasites Plasmodium vivax and Plasmodium falciparum threatens malaria control and elimination in Southeast Asia. Plasmodium vivax first-line treatment drug is chloroquine together with primaquine, and the first-line treatment for P. falciparum malaria is artemisinin in combination with a partner drug. Plasmodium vivax and P. falciparum parasites resistant to their respective first-line therapies are now found within Southeast Asia. The resistance perimeters may include high transmission regions of Southern Thailand which are underrepresented in surveillance efforts. METHODS This study investigated blood samples from malaria centres in Southern Thailand. Genetic loci associated with drug resistance were amplified and sequenced. Drug resistance associated genes Pvmdr1, Pvcrt-o, Pvdhfr, and Pvdhps were characterized for 145 cases of P. vivax malaria, as well as the artemisinin resistance-associated Pfkelch13 gene from 91 cases of P. falciparum malaria. RESULTS Plasmodium vivax samples from Southern Thai provinces showed numerous chloroquine and antifolate resistance-associated mutations, including SNP and Pvcrt-o K10-insertion combinations suggestive of chloroquine resistant P. vivax phenotypes. A high proportion of the C580Y coding mutation (conferring artemisinin resistance) was detected in P. falciparum samples originating from Ranong and Yala (where the mutation was previously unreported). CONCLUSIONS The results demonstrate a risk of chloroquine and antifolate resistant P. vivax phenotypes in Southern Thailand, and artemisinin resistant P. falciparum observed as far south as the Thai-Malaysian border region. Ongoing surveillance of antimalarial drug resistance markers is called for in Southern Thailand to inform case management.
Collapse
Affiliation(s)
- Chaturong Noisang
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.,Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Christiane Prosser
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.,Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia.,Westmead Institute for Medical Research, Westmead, NSW, Australia.,Westmead Hospital (Research and Education Network), Westmead, NSW, Australia
| | - Waenurama Chemoh
- Department of Microbiology, Faculty of Medicine, Princess of Naradhiwas University, Narathiwat, Thailand
| | - John Ellis
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Nongyao Sawangjaroen
- Department of Microbiology, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Rogan Lee
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, Westmead, NSW, Australia.
| |
Collapse
|
8
|
Pongvongsa T, Culleton R, Ha H, Thanh L, Phongmany P, Marchand RP, Kawai S, Moji K, Nakazawa S, Maeno Y. Human infection with Plasmodium knowlesi on the Laos-Vietnam border. Trop Med Health 2018; 46:33. [PMID: 30250398 PMCID: PMC6145087 DOI: 10.1186/s41182-018-0116-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 09/10/2018] [Indexed: 09/03/2023] Open
Abstract
Background Border malaria in the Greater Mekong region of Southeast Asia poses a serious threat to the health of the ethnic minority populations of the region. Traditionally thought to be caused primarily by the malaria parasites Plasmodium falciparum and Plasmodium vivax, recently a zoonotic parasite, Plasmodium knowlesi, has been identified in some countries of the region. The presence of this parasite poses a challenge to malaria control programmes, as it is maintained in a zoonotic reservoir of forest-dwelling macaque monkeys. Methods A cross-sectional malaria parasite species prevalence survey was conducted along the Laos-Vietnam border in the central part of the two countries. Human blood samples were collected from Savannakhet in Laos and Quang Tri in Vietnam between August and October 2010 and assayed for the presence of human malaria parasite species and P. knowlesi. A PCR targeting the 18S small subunit ribosomal RNA gene and circumsporozoite protein gene was used for Plasmodium species identification. Results Nine cases of P. knowlesi were detected by PCR in blood samples from the Laos side and three from the Vietnam side. All P. knowlesi infections were found in co-infection with P. vivax, with some triple infections of P. knowlesi, P. vivax and P. falciparum detected in Laos. Phylogenetic analysis of these parasites suggests that P. knowlesi is circulating in the Laos-Vietnam border region. Conclusion This report shows that P. knowlesi is transmited on both sides of the Vietnam-Laos border. Continued monitoring of the range and prevalence of P. knowlesi on both the sides of Laos-Vietnam border is of importance to the National Malaria Control Programmes of both countries. Electronic supplementary material The online version of this article (10.1186/s41182-018-0116-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Richard Culleton
- 2Malaria Unit, Department of Pathology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Nagasaki Japan
| | - Hoang Ha
- Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Le Thanh
- Malaria-Parasitology and Entomology Department, Preventive Medicine Center of Quang Tri province, Quang Tri province, Vietnam
| | | | - Ron P Marchand
- Khanh Phu Malaria Research Unit, Medical Committee Netherlands-Viet Nam, Nha Trang, Khanh Hoa Province Vietnam
| | - Satoru Kawai
- 6Laboratory of Tropical Medicine and Parasitology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Kazuhiko Moji
- 7Graduate School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Nagasaki Japan
| | - Shusuke Nakazawa
- 8Department of Protozoology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Nagasaki Japan
| | - Yoshimasa Maeno
- 9Department of Virology and Parasitology, Fujita Health University School of Medicine, 1-98 Kutsukake, Toyoake, Aichi 470-1192 Japan
| |
Collapse
|
9
|
Sriwichai P, Karl S, Samung Y, Kiattibutr K, Sirichaisinthop J, Mueller I, Cui L, Sattabongkot J. Imported Plasmodium falciparum and locally transmitted Plasmodium vivax: cross- border malaria transmission scenario in northwestern Thailand. Malar J 2017. [PMID: 28637467 PMCID: PMC5480133 DOI: 10.1186/s12936-017-1900-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cross-border malaria transmission is an important problem for national malaria control programmes. The epidemiology of cross-border malaria is further complicated in areas where Plasmodium falciparum and Plasmodium vivax are both endemic. By combining passive case detection data with entomological data, a transmission scenario on the northwestern Thai-Myanmar border where P. falciparum is likely driven by importation was described, whereas P. vivax is also locally transmitted. This study highlights the differences in the level of control required to eliminate P. falciparum and P. vivax from the same region. METHODS Malaria case data were collected from malaria clinics in Suan Oi village, Tak Province, Thailand between 2011 and 2014. Infections were diagnosed by light microscopy. Demographic data, including migrant status, were correlated with concomitantly collected entomology data from 1330 mosquito trap nights using logistic regression. Malaria infection in the captured mosquitoes was detected by ELISA. RESULTS Recent migrants were almost four times more likely to be infected with P. falciparum compared with Thai patients (OR 3.84, p < 0.001) and cases were significantly associated with seasonal migration. However, P. falciparum infection was not associated with the Anopheles mosquito capture rates, suggesting predominantly imported infections. In contrast, recent migrants were equally likely to present with P. vivax as mid-term migrants. Both migrant groups were twice as likely to be infected with P. vivax in comparison to the resident Thai population (OR 1.96, p < 0.001 and OR 1.94, p < 0.001, respectively). Plasmodium vivax cases were strongly correlated with age and local capture rates of two major vector species Anopheles minimus and Anopheles maculatus (OR 1.23, p = 0.020 and OR 1.33, p = 0.046, respectively), suggesting that a high level of local transmission might be causing these infections. CONCLUSIONS On the Thai-Myanmar border, P. falciparum infections occur mostly in the recent migrant population with a seasonality reflecting that of agricultural activity, rather than that of the local mosquito population. This suggests that P. falciparum was mostly imported. In contrast, P. vivax cases were significantly associated with mosquito capture rates and less with migrant status, indicating local transmission. This highlights the different timelines and requirements for P. falciparum and P. vivax elimination in the same region and underlines the importance of multinational, cross-border malaria control.
Collapse
Affiliation(s)
- Patchara Sriwichai
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Stephan Karl
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Yudthana Samung
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kirakorn Kiattibutr
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Ivo Mueller
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, University Park, PA, USA
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
10
|
Xu JW, Li Y, Yang HL, Zhang J, Zhang ZX, Yang YM, Zhou HN, Havumaki J, Li HX, Liu H, Zhou H, Xie XY, Dong JX, Zhang Y, Sun XY, Li B, Li JY, Tian YH, Wang PY, Li BF. Malaria control along China-Myanmar Border during 2007-2013: an integrated impact evaluation. Infect Dis Poverty 2016; 5:75. [PMID: 27507163 PMCID: PMC4979141 DOI: 10.1186/s40249-016-0171-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 07/11/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Implementing effective interventions remain a lot of difficulties along all border regions. The emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great concern. China has effectively controlled cross-border transmission of malaria and artemisinin resistance of P. falciparum along the China-Myanmar border. METHODS A combined quantitative and qualitative study was used to collect data, and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during 2007-2013. RESULTS The parasite prevalence rate (PPR) in the five special regions of Myanmar was decreased from 13.6 % in March 2008 to 1.5 % in November 2013. Compared with the baseline (PPR in March 2008), the risk ratio was only 0.11 [95 % confidence interval (CI), 0.09-0. 14) in November 2013, which is equal to an 89 % reduction in the malaria burden. Annual parasite incidence (API) across 19 Chinese border counties was reduced from 19.6 per 10 000 person-years in 2006 to 0.9 per 10 000 person-years in 2013. Compared with the baseline (API in 2006), the API rate ratio was only 0.05(95 % CI, 0.04-0.05) in 2013, which equates to a reduction of the malaria burden by 95.0 %. Meanwhile, the health service system was strengthened and health inequity of marginalized populations reduced along the international border. CONCLUSION The effective collaboration between China, Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified processes. The integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.
Collapse
Affiliation(s)
- Jian-Wei Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China.
| | - Yong Li
- Yunnan Provincial Health and Family Planning Commission, Kunming, 650200, People's Republic of China
| | - Heng-Lin Yang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| | - Jun Zhang
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Zai-Xing Zhang
- World Health Organization Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines
| | - Ya-Ming Yang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| | - Hong-Ning Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| | - Joshua Havumaki
- Foundation for Innovative New Diagnostics, 1216, Cointrin, Geneva, Switzerland
| | - Hua-Xian Li
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| | - Hui Liu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| | - Hua Zhou
- Yunnan Provincial Health and Family Planning Commission, Kunming, 650200, People's Republic of China
| | - Xin-Yu Xie
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Jia-Xiang Dong
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Yue Zhang
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Xiao-Ying Sun
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Bo Li
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Jia-Yin Li
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Yang-Hui Tian
- Yunnan Office of Health Poverty Action, Kunming, 650041, People's Republic of China
| | - Pi-Yu Wang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| | - Ben-Fu Li
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China
| |
Collapse
|