Malaria Elimination Task Force

 

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 (as detailed in our Report):

  • 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
  • Follow the entomology indicators: vector species present, their habits and behaviour, through mosquito catchings performed in hotspot villages at baseline and 12 months after intervention. Mosquito control activities are also assessed as a complement to intervention (such as Outdoor Residual Spraying).

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 (March 2018):

  • Mapping: 1,500+ villages have been mapped and are part of the GIS helping to pilot the program.
  • Malaria posts deployment: 1,226 Malaria Posts have been opened so far, operated by a group of 1,600+ Malaria Post Workers, supervisors, Zone and Area Coordinators, supported by a transversal team (logistics, training, admin and community engagement.
  • TMT: 69 Hotspots detected out of the 272 qPCR surveys randomly performed on the 4 townships. Mass Drug Administration (MDA) have been administered in 61 of those villages.

Decreasing Pf incidence and increased malaria post coverage in Eastern Kayin State, Myanmar (June 2014 – March 2018)