BackgroundAs Myanmar progresses towards lymphatic filariasis (LF) elimination, it is important to know how well the anti-filarial activities have performed. The present study was conducted to study the implementation of the key anti-filarial activities and their impact on key indicators of LF transmission.MethodsA secondary analysis of aggregate program data on the anti-filarial activities was conducted in four endemic state/regions of Myanmar receiving at least six mass drug administration (MDA) rounds during 2001–2016.ResultsMDA coverage has been expanded to cover all the endemic implementation units (IUs), i.e., 45 by 2015 and 6 IUs out of them have already stopped MDA. The reported coverage of MDA ranges from 87 to 100% whereas surveyed coverage ranges from 78 to 100% among the eligible population. The prevalence of microfilaria has significantly declined especially in Magway from 4.7 to 0.2% and Sagaing region from 7.9 to 1.3% during 2001–2016. Around 2.5% of estimated cases of hydrocele were reported to the program during 2009–2014.ConclusionMyanmar has achieved significant success in interrupting LF transmission through several MDA rounds with high coverage. However, morbidity reporting and management, being in its initial phase requires an active surveillance system for identifying and managing people with LF-associated morbidities under the program.

Background To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown. Methods A mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the following areas were investigated: data quality and completeness, data access and usage, capacity for timely reporting, the acceptability, functionality, and ease of use of the application and facilitators and barriers to its use, and the relative cost of MCBR compared to the PBR system. Results Compared to PBR, MCBR enabled more accurate and complete data to be reported in a much timelier manner, with 63% of MCBR users reporting they transmit rapid diagnostic test outcomes within 24 h, compared to 0% of PBR users. MCBR was favoured by integrated community malaria volunteers and their supervisors because of its efficiency. However, several technical and operational challenges associated with internet coverage, data transmission, and e-literacy were identified and stakeholders reported not being confident to rely solely on MCBR data for programmatic decision-making. Conclusions Implementation of MCBR provided timely and accurate data for malaria surveillance. Findings from this evaluation study will enable the optimization of an application-based reporting system for malaria monitoring and surveillance in the Greater Mekong Subregion and advance systems to track progress towards, and certify, the achievement of malaria elimination targets.

Background Due to the effectiveness of insecticide-treated nets (ITNs), most malaria-endemic countries resort to free distributions in the population with particular attention to pregnant women, a more vulnerable group. However, the mere issuance of ITNs does not usually translate to proper utilization. This study aimed to examine the utilization of ITNs and its associated factors among pregnant women in Myanmar. Methods The data analyzed in this cross-sectional study were extracted from available survey datasets of the 2015–16 Myanmar Demographic Health Survey. The secondary data were presented using a chart, descriptive statistics and inferential statistics including simple and multiple logistic regression models. All analyses were performed using STATA, Version 15. A p-value <0.05 was considered statistically significant. Results Of 466 currently pregnant women, the majority (96%) possessed bed nets for sleeping. Among them, 15.9% slept without a bed net the night before the survey, while 65.7% slept with untreated nets. Only about 1 in 5 (18.4%) slept under ITNs. In the multivariate logistic regression analysis, pregnant women residing in delta and lowland regions [adjusted odds ratio (aOR) = 7.70, 95% confidence interval (CI): 3.62, 16.38], plains (aOR = 7.09, 95%CI: 3.09, 16.25) or hilly areas (aOR = 4.26, 95%CI: 1.91, 9.52) were more likely to report non-utilization of ITNs than those residing in coastal regions. Conclusion Relatively poor ITN utilization was observed among pregnant women in Myanmar. Health promotion activities for ITN utilization should be implemented especially for pregnant women residing in the delta, lowland, plain and hilly regions. Other social-behavioral factors including perceived susceptibility to malaria, knowledge of ITNs, and attitude towards ITN that might favor the non-utilization of ITNs need to be further explored.

Background: Myanmar has targeted Plasmodium falciparum malaria elimination by 2025 and all human malaria elimination by 2030. Coronavirus Disease-2019 (COVID-19) pandemic could jeopardize the current gains. The objective of the study is to assess the impact of COVID-19 on epidemiology and malaria services in Myanmar. Methods: This is cross sectional study using retrospective routine programme data reported by Ministry of Health and Sports (for COVID-19) and National Malaria Control Programme (NMCP) (for malaria) during January – September 2019 and 2020. Results: Myanmar implemented whole of society COVID-19 response since its first 2 cases were detected on 23 March 2020. NMCP mobilized US$ 7 mil to support, protect and mitigate COVID-19 impact on malaria through implementation of tailored guidelines, job aids and risk communication materials starting April 2020. Front line health workers were protected through supplies of surgical masks, hand sanitizer, aprons, gloves, non-contact digital thermometers among others. During January-September 2020, reported malaria cases, severe cases and deaths declined by 11%, 34% and 27%, respectively in the same period in 2019. Total P. falciparum cases declined by 55% with minimal increase in tests (0.14%). 80% of cases and 98% of foci were investigated in 2020 in comparison to 68% and 54% in 2019, respectively (p<0.05). In 2020, NMCP distributed 72% of the targeted long-lasting insecticidal nets (vs 49% in 2019) (p<0.05). Integrated Community Malaria Volunteers (ICMVs) trained in 2020 was 49% in comparison to 94% in 2019 (P<0.05), while number of functional ICMVs remained at 91% (vs 94% in 2019). Overall monthly reports from all reporting units received slightly dropped by 5%. In 2020, NMCP was able to conduct 59% supervision visits at various levels, which was higher than 2019 (56%). Conclusions: Malaria cases, severe cases and deaths continued to decline amid COVID-19 in Myanmar with 55% decline in P. falciparum . Programme need to continue essential malaria services during the upsurge of COVID-19 and simultaneously plan proactively to ensure uninterrupted supply of essential malaria commodities for 2021 to ensure P. falciparum elimination by 2025.