Malaria Elimination Task Force
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Scope of the Project
The overall goal of the project is to decrease the prevalence of clinical and sub-clinical P. falciparum infections in a defined area where artemisinin resistance has been documented (control activities) and then to proceed with elimination of the parasite reservoirs (elimination activities). This is achieved using the key strategies identified in the Global Fund’s Regional Artemisinin Initiative Inter Countries Component (RAI-ICC) Call for Proposals and will demonstrate their effectiveness for deployment elsewhere in Myanmar where artemisinin resistance is confirmed.
From a pilot held during 2 years in a selection of villages in Kayin State, a strategy has been developed, and is scaled up to 4 entire townships in Eastern Kayin State (Myawaddy, Hlaing Bwe, Hpapun and Kawkareik).
This strategy relies on several pillars:
- Dynamic mapping of the whole area: all villages’ GPS coordinated recorded, and basic information on demography, accessibility… recorded;
- establishment of a Malaria Post in all villages of the 4 townships, and set up a system allowing a basic set of weekly data to be reported in near real time;
- evaluation of the submicroscopic malaria parasites reservoir through random qPCR surveys throughout the whole intervention area;
- treatment of the places where a high P. Falciparum prevalence has been identified through Targeted Masss Treatment (TMT, after villagers acceptance has been obtained through Community Engagement meetings and activities) (this part having been granted permission by Myanmar Department of Medical research Ethics Committee (DMR EC);
- follow up of resistance to ACT molecular markers and follow up of the vector population and behavior, in order to test and evaluate adapted vector control complementary strategies
Management of the Program
This program is the result of a co-funding of
- The Global Fund to fight Malaria, Aids and Tuberculosis
- The Bill and Melinda Gates Foundation
- The Wellcome Trust.
It is directed by an Executive Committee, where all concerned local CBOs are sitting. This ExCom is composed of a member of each of the following organisations: Kaw Htoo Lay Department of Health and Welfare (KDHW, present Chair), Burma Medical Association (BMA, present secretariat), Karen Border Guard Force (KBGF), Karen Peace Council (KPC), Mae Tao Clinic (MTC), Back Pack Health Workers Team (BPHWT), Klohtoobaw Karen Organization (KKO) and Shoklo Malaria Research Unit (SMRU).
All strategic decisions are endorsed by this ExCom, which members are essential to help accompany the set-up of the program up to the most remote places in the field.
Achieved so far (31 December 2016)
- Mapping: 1,314 villages have been mapped and are part of the GIS helping to pilot the program.
- Malaria posts deployment: 1,221 Malaria Posts have been opened so far
- TMT: 51 Hotspots detected out of the 270 qPCR surveys randomly performed on the 4 townships
Decreasing Pf incidence and increased malaria post coverage in Eastern Kayin State, Myanmar (June 2014 – December 2016)
Left panel: A map of village tracts within the target area (Eastern Kayin State), with dark gray indicating no reported data and the intensity of Pf incidence indicated by darker red colours.
Top right panel: Smoothed monthly Pf incidence (cases per 1000 per month) over the project period
Bottom right panel: Number of malaria posts opened and functioning in the target area by month