Border malaria in China: knowledge and use of personal protection by minority populations and implications for malaria control: a questionnaire-based survey

Liu

The American Society of Tropical Medicine and Hygiene

et al. 2016

Abstract. The surveillance and response system remains one of the biggest challenges to malaria elimination along the China-Myanmar border. In China, "1-3-7" approach was developed to guide elimination activities according to the National Malaria Elimination Program, which is a simplified set of targets that delineates responsibilities and actions. The time frame of the approach has been incorporated into the nationwide web-based disease reporting system: 1, case reporting within 1 day after diagnosis; 3, case investigation within 3 days; and 7, focus investigation and action within 7 days. Herein, the data on malaria cases in 2005-2014 and after the "1-3-7" implementation in 2013-2014 of the 18 counties at the China-Myanmar border are reviewed and analyzed. Results showed that the total cases decreased while the proportion of imported cases rose. The "1-3-7" was well executed, except for the "3" indicator, which was 96.3% accomplished on average in the 18 border counties, but needs to be further strengthened. More efforts are highlighted for timely and accurate case detection as well as proactive mapping of disease transmission hot spots to facilitate the elimination of border malaria.

Section: Discussionsupporting

confidence: 79%

Towards Malaria Elimination: Monitoring and Evaluation of the “1-3-7” Approach at the China–Myanmar Border

Liu

The American Society of Tropical Medicine and Hygiene

et al. 2016

“…Our finding indicated that the majority of the respondents preferred volunteers (>75%) to strengthen prevention and control measures against malaria and over 50% preferred to channel information, education and communication (IEC) messages through collaboration in the locality. Findings from our study and others highlighted the need to improve the mechanisms of communication and coordination among multiple partners engaged in artemisinin resistance [8,9]. Potential strategies to maximize accessibility to malaria interventions may include the following: 1) tracking of foci of infections in mobile populations and mapping of the extent and distribution of malaria infections [19]; 2) real-time frequent sharing of information on drug resistant malaria; 3) frequent update of counterfeit and sub-standard antimalarial drug use; 4) setting up contact screening points for improved availability and use of RDTs and optimal use of quality antimalarial drugs.…”

Section: Discussionmentioning

confidence: 93%

“…Although the majority of the migrant populations understood Myanmar language, limited education level may impede their understanding of the message [11]. As shown in other studies conducted in similar circumstances [8,14-16], these physical, social and language barriers in the study population likely increase the potential risk in malaria transmission and spread of artemisinin resistance. Effective communication in this diverse high-risk group is critical and may be better reached by the use of simple language, inclusion of common ethnic languages in addition to Myanmar, and/or well-trained motivated interpreters.…”

Section: Discussionmentioning

confidence: 99%

Spatial distribution, work patterns, and perception towards malaria interventions among temporary mobile/migrant workers in artemisinin resistance containment zone

Wai

Kyaw

et al. 2014

BMC Public Health

BackgroundMobile populations are at a high risk of malaria infection and suspected to carry and spread resistant parasites. The Myanmar National Malaria Control Programme focuses on preventive interventions and vector control measures for the temporary mobile/migrant workers in Myanmar Artemisinin Resistance Containment Zones.MethodsA prospective cross-sectional study was conducted in 2012 in Kawthaung and Bokepyin townships of Tanintharyi Region, Myanmar, covering 192 mobile/migrant aggregates. The objectives were to identify the spatial distribution of the mobile/migrant populations, and to assess knowledge, attitudes, perceptions, and practices concerning malaria prevention and control, and their preferred methods of interventions. The structure of the192 migrant aggregates was investigated using a migrant mapping tool. Individual and household information was collected by structured interviews of 408 respondents from 39 aggregates, supplemented by 12 in-depth interviews of health care providers, authorities, volunteers, and employers. Data were analyzed by triangulating quantitative and qualitative data.ResultsThe primary reasons for the limitation in access to formal health services for suspected malaria within 24 hours were identified to be scattered distribution of migrant aggregates, variable working hours and the lack of transportation. Only 19.6% of respondents reported working at night from dusk to dawn. Among study populations, 73% reported a perceived risk of contracting malaria and 60% reported to know how to confirm a suspected case of malaria. Moreover, only 15% was able to cite correct antimalarial drugs, and less than 10% believed that non-compliance with antimalarial treatment may be related to the risk of drug resistance. About 50% of study population reported to seeking health care from the public sector, and to sleep under ITNs/LLINs the night before the survey. There was a gap in willingness to buy ITNs/LLINs and affordability (88.5% vs. 60.2%) which may affect their sustained and consistent use. Only 32.4% across all aggregates realized the importance of community participation in effective malaria prevention and control.ConclusionsCommunity-based innovative approaches through strong collaboration and coordination of multi-stakeholders are desirable for relaying information on ITNs/LLINs, rapid diagnostic test, and artemisinin combination therapy and drug resistance successfully across the social and economic diversity of mobile/migrant aggregates in Myanmar.

“…However, other evidence shows lack of significant association between travel to Myanmar and transmission of P. vivax along the China–Myanmar border [53]. Residents in this area have a relatively low educational level, limited knowledge of malaria transmission and utilization of personal protection, especially during outdoor activities [61, 62], and exhibit poor treatment-seeking behaviour [62]. These factors could contribute to sustained malaria transmission in this area [17].…”

Section: Discussionmentioning

confidence: 99%

Spatial and space–time distribution of Plasmodium vivax and Plasmodium falciparum malaria in China, 2005–2014

Hundessa

Williams

et al. 2016

Malar J

BackgroundDespite the declining burden of malaria in China, the disease remains a significant public health problem with periodic outbreaks and spatial variation across the country. A better understanding of the spatial and temporal characteristics of malaria is essential for consolidating the disease control and elimination programme. This study aims to understand the spatial and spatiotemporal distribution of Plasmodium vivax and Plasmodium falciparum malaria in China during 2005–2009.MethodsGlobal Moran’s I statistics was used to detect a spatial distribution of local P. falciparum and P. vivax malaria at the county level. Spatial and space–time scan statistics were applied to detect spatial and spatiotemporal clusters, respectively.ResultsBoth P. vivax and P. falciparum malaria showed spatial autocorrelation. The most likely spatial cluster of P. vivax was detected in northern Anhui province between 2005 and 2009, and western Yunnan province between 2010 and 2014. For P. falciparum, the clusters included several counties of western Yunnan province from 2005 to 2011, Guangxi from 2012 to 2013, and Anhui in 2014. The most likely space–time clusters of P. vivax malaria and P. falciparum malaria were detected in northern Anhui province and western Yunnan province, respectively, during 2005–2009.ConclusionThe spatial and space–time cluster analysis identified high-risk areas and periods for both P. vivax and P. falciparum malaria. Both malaria types showed significant spatial and spatiotemporal variations. Contrary to P. vivax, the high-risk areas for P. falciparum malaria shifted from the west to the east of China. Further studies are required to examine the spatial changes in risk of malaria transmission and identify the underlying causes of elevated risk in the high-risk areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1646-2) contains supplementary material, which is available to authorized users.