Results from a malaria indicator survey highlight the importance of routine data capture in high-risk forest and farm transmission sites in Vietnam to tailor location-specific malaria elimination interventions

Abstract

In-line with the World Health Organization’s (WHO) Global Technical Strategy for Malaria (2016–2030), Vietnam is striving to eliminate malaria by 2030. Targeting appropriate interventions in high-risk populations such as forest and forest-fringe communities is a critical component of malaria elimination efforts in Vietnam. In 2016, a household-level malaria indicator survey was conducted in Phu Yen Province, Vietnam with the aim of assessing the knowledge, behaviors and associated risks of malaria infection among priority mobile and migrant populations (MMPs) working and sleeping in forests and on farms. A total of 4211 people were included in the survey, comprised of 1074 heads of households and 3137 associated household members. Of the 1074 head-of-household respondents, 472 slept in a forest, 92 slept on a farm, 132 slept in both forests and farms, and 378 slept at their villages within the last 12 months. Age, literacy, and occupation were significantly different among those who slept in a forest versus on a farm. Of 301 respondents who answered questions about malaria risk factors at sleeping sites, 35% were somewhat aware of malaria prevention practices, but only 4% could recall at least four malaria prevention messages. Among the same group of 301 respondents, only 29% used nets and only 11% used treated nets. Ownership and use of nets among forest-goers was significantly lower than those who slept on a farm or in their village. Huts without walls were significantly prominent forest sleeping site locations (POR = 10.3; 95% CI 4.67–22.7). All respondents who slept in a forest requested standby malaria drugs and one-third of them self-treated without blood testing. Results from this study highlight the importance of capturing relevant location-specific data among priority populations such as remote forest and farm going mobile and migrant populations in Vietnam. Data regarding behavioral practices, knowledge, preventative measures, and intervention coverage at remote-area transmission sites must be routinely captured to effectively monitor progress and refine targeted intervention strategies accordingly.

Cross-sectional survey of asymptomatic malaria in Dak Nong province in the Central Highlands of Vietnam for the malaria elimination roadmap

“…The relatively low utilization of LLINs and regular retreatment or replacement of LLINs in all three communes needs to be addressed in order to further reduce both, symptomatic and asymptomatic malaria in the area. Furthermore, our results confirmed that only 1.7% of participants used a topical repellent in Quang Truc, with none reported by participants in the other two communes, which was also observed in other areas of Central Vietnam and GMS [ 38 , 53 ].…”

“…These findings further support the notion that forest goers are at the highest risk to malaria exposure and interventions need to be prioritized for this group, consistent with previous recommendations [ 49 ]. As no significant association risk factors could be identified in the low and moderate malaria risk areas, malaria exposure in those areas may be more heterogenic and focal, similar to findings in the neighbouring Phu Yen province in Central Vietnam [ 38 , 50 ].…”

“…Note that the data provided by NMCP may not capture all the malaria cases in the area as some patients from the communes may have been diagnosed with malaria and treated in another province. Additionally, patients may have self-medicated when they experienced malaria symptoms [ 38 ].…”