Bangladesh in the era of malaria elimination

Haldar, Kasturi; Alam, Mohammad Shafiul; Koepfli, Cristian; Lobo, Neil F.; Phru, Ching Swe; Islam, Nazmul; Faiz, Abul; Khan, Wasif Ali; Haque, Rashidul

doi:10.1016/j.pt.2023.06.009

Cited by 4 publications

(3 citation statements)

References 73 publications

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“…The Bangladeshi context was initiated through a combination of published literature in Bangladesh, insights from informal conversations with malaria elimination experts from NMEP and BRAC, and focus group discussions with private healthcare Providers. [3][4][5][6][7]20 RESULTS.…”

Section: Methodsmentioning

confidence: 99%

“…LLINs also may not protect agricultural workers in tea gardens. 7 One important task for the malaria elimination program in Bangladesh is to better involve the forprofit private healthcare sector into malaria elimination efforts. So-called private sector engagement (PSE) has in recent years become a point of emphasis within both regional and global malaria elimination programs due to the large proportion of patients who seek care from private healthcare providers (PHPs).…”

Section: Introductionmentioning

confidence: 99%

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Bangladesh should engage the private sector for malaria elimination by 2030

McArdle,

Phru,

Hossain

et al. 2024

Preprint

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Bangladesh reduced malaria by 93% from 2008-2020 through the action of governmental and non-governmental organizations, yet ∼18 million people continue to live at risk of infection. For-profit private healthcare providers, catalytic for malaria elimination in many countries, have not yet been integrated into the national program. By imposing strict definitions on a large and complex literature surrounding private healthcare sector engagement, we distilled eight distinct strategies important in other developing settings: contracting, financing, subsidization, regulation, social franchising, demand-side interventions, infrastructure-building and training. We weighed these in the context of Bangladesh’s flourishing private health care sector—driven by patient demand, self-interest, and aspirations for public good—as well as the heterogeneity in provider capacity and malaria prevalence across districts. We developed a new model dependent on five strategies of subsidization, training, infrastructure building, demand-side intervention, and referral financing, to empower Bangladesh’s phased agenda of eliminating indigenous malaria transmission by 2030.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bangladesh should engage the private sector for malaria elimination by 2030

McArdle,

Phru,

Hossain

et al. 2024

Preprint

Self Cite

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“…The study areas were selected based on recommendations from NMEP. Bandarban has the highest malaria incidences in Bangladesh, accounting for roughly 56% of the country's overall incidence in 2019 [31], which has increased to 76% in 2022 (NMEP unpublished data). Therefore, three sub-districts (Alikadam, Thanchi, and Lama) from Bandarban with the highest annual parasitological index (API) and Chakaria from Cox's Bazar with low API were selected for this study.…”

Section: Study Setting and Populationmentioning

confidence: 99%

Adherence to Anti-Malarial Treatment in Malaria Endemic Areas of Bangladesh

Hossain,

Matin,

Ferdous

et al. 2023

Pathogens

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Ensuring adherence to antimalarial treatment is crucial for achieving a radical cure and elimination of malaria, especially in hard-to-reach areas. We conducted this study to assess the current scenario of drug adherence in four endemic sub-districts of Bangladesh. Among 110 enrolled participants, 70% were mono-infected with Plasmodium falciparum and the remaining 30% with P. vivax. The overall treatment adherence frequency was 92.7% (95% CI: 83.0–96.3%). A total of eight participants were found to be nonadherent to treatment and all of them were from Bandarban. Level of nonadherence was equally observed in two age groups: 11–17 and 18+ years. However, male participants (n = 6) were found to be more nonadherent than females (n = 2). Among 7.3% with nonadherence to treatment, a single participant with P. falciparum mono-infection refused to take medication and became nonadherent. Remaining participants stated that they were feeling well and going to work, thus leaving treatment course uncompleted. Although overall compliance with malaria medication seems good, a gradual increase in noncompliance to P. vivax malaria treatment suggests that the National Malaria Elimination Program must be enhanced and monitored to fulfil the projected malaria elimination goal before 2030 from Bangladesh.

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Assessing the role of the for-profit private healthcare sector in malaria elimination efforts in Bangladesh: a cross-sectional study of challenges and opportunities

Alam,

Hossain

et al. 2024

BMC Public Health

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Background Among 13 endemic districts, the Chittagong Hill Tracts bear more than 90% of Bangladesh’s malaria burden. Despite the private sector’s prominence in rural healthcare, its role in malaria management remains underutilized. This study aimed to strategize leveraging the for-profit private sector, such as diagnostic and treatment centers, to bolster national malaria surveillance and control, advancing Bangladesh toward malaria elimination by 2030. Methods This mixed-method study commenced with a questionnaire-based cross-sectional survey followed by selected focused group discussions (FGDs) among the participants. Three FGDs were held with the for-profit service providers so that further insights and qualitative viewpoints of them can be utilized in situation analysis. Based on the endemicity and strategic priorities, a comprehensive mapping of private for-profit facilities from the regions comprising 15 sub-districts across 8 chosen districts (7 malaria endemic districts and the rest non-endemic districts) was created. For the non-endemic zone, the sub-districts were selected based on their proximity to an area with high malaria transmission. Results Among the 104 representative participants, majority were male ( n = 92, 88.5%), had a diploma in their respective fields ( n = 53, 51%) and were involved either in laboratory work ( n = 49, 47.1%) or as owners/managers of health centers ( n = 41, 39.4%). The selected health facilities were close to the corresponding Upazila Health Complexes (mean distance 2.8 km), but were distantly located from the designated district hospitals (mean distance 48.9 km). The main sources of RDT kits (62.3%) and anti-malarial drugs (63.2%) were local wholesale markets. A large share of the corresponding facilities neither provided malaria treatment services (81.7%) nor worked with the NMEP (93.3%). Conclusions This study highlights challenges and recommendations for engaging private for-profit health facilities in Bangladesh’s malaria elimination efforts. The identified challenges include low-quality RDTs, staff shortages, and inadequate capacity building. Recommendations emphasize effective training, stakeholder interaction, and enhanced oversight for successful malaria control efforts. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-024-20448-2.

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Bangladesh in the era of malaria elimination

Cited by 4 publications

References 73 publications

Bangladesh should engage the private sector for malaria elimination by 2030

Bangladesh should engage the private sector for malaria elimination by 2030

Adherence to Anti-Malarial Treatment in Malaria Endemic Areas of Bangladesh

Assessing the role of the for-profit private healthcare sector in malaria elimination efforts in Bangladesh: a cross-sectional study of challenges and opportunities

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