Presentation

Malaria surveillance for displaced population and migrants: Thai-Myanmar border, 1995-2006
Presented in Kanchanaburi, May 2007
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Background

There are more than 100,000 refugees and many more migrant workers living along the Thai-Burmese border (See the Map). This area is endemic for malaria which results in symptomatic infection in all age groups. In 1992 in Shoklo (formerly one of the camps), the attack rate was 0.4 per year for the potentially fatal P.falciparum parasite (which accounted for approximately 70% of infections). P.vivax accounted for 20% of cases, the remaining being mixed PF/PV. The most important medical problem confronting the border communities is the increasing anti-malarial drug resistance. The main consequence of the deterioration of treatment efficacy is anaemia. Children are particularly susceptible to malaria induced anaemia. In 1992 mortality from malaria accounted for 15% of all deaths in the refugee camps. To confront this complex situation five international medical NGOs (MSF-F, IRC, AMI, ARC and MHD) are providing health care to the refugees. The migrant workers living in the region receive no assistance and represent a burden for the Thai Public Health structures.

In 1986, two years after the arrival of the first refugees an operational research programme was started to tackle malaria in the camps. The Shoklo Malaria Research Unit is attached to the Thai University of Mahidol (Bangkok) and is part of the Wellcome-Mahidol University-Oxford Tropical Medicine Research Programme supported by the Wellcome Trust of Great Britain.