Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved]
Background: Myanmar has one of the largest malaria burdens in Southeast Asia. Along the border with Thailand, Plasmodium falciparum parasites are increasingly showing reduced sensitivity to artemisinin combination therapies. Given that there are no current alternative treatment therapies, one propos...
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Wellcome
2017-10-01
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| Online Access: | https://wellcomeopenresearch.org/articles/2-98/v1 |
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| author | Daniel M. Parker Jordi Landier Aung Myint Thu Khin Maung Lwin Gilles Delmas François H. Nosten The Malaria Elimination Task Force Group |
| author_facet | Daniel M. Parker Jordi Landier Aung Myint Thu Khin Maung Lwin Gilles Delmas François H. Nosten The Malaria Elimination Task Force Group |
| author_sort | Daniel M. Parker |
| collection | DOAJ |
| description | Background: Myanmar has one of the largest malaria burdens in Southeast Asia. Along the border with Thailand, Plasmodium falciparum parasites are increasingly showing reduced sensitivity to artemisinin combination therapies. Given that there are no current alternative treatment therapies, one proposed solution to the threat of untreatable P. falciparum malaria is to eliminate the parasite from the region. Several small-scale elimination projects have been piloted along the Myanmar-Thailand border. Following their success, this operational research aimed to scale up the elimination to a broad area of Eastern Kayin State, Myanmar. Methods: The project relied on geographic reconnaissance and a geographic information system, community engagement, generalized access to community-based early diagnosis and treatment, near real-time epidemiological surveillance, cross sectional malaria prevalence surveys and targeted mass drug administration in villages with high prevalence of P. falciparum malaria. Molecular markers of drug resistance were also monitored in individuals with symptomatic and asymptomatic infections. Discussion: This project illustrates the establishment of an elimination project and operational research in a remote, rural area encompassing several armed groups, multiple political organizations and a near-absent health care infrastructure. The establishment of the project relied on a strong rapport with the target community, on-the-ground knowledge (through geographic surveys and community engagement), rapid decision making and an approach that was flexible enough to quickly adapt to a complex landscape. The elimination project is ongoing, now over three years in operation, and assessment of the impact of this operational research will follow. This project has relevance not only for other malaria elimination projects but also for operational research aimed at eliminating other diseases. |
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| institution | Directory Open Access Journal |
| issn | 2398-502X |
| language | English |
| last_indexed | 2024-12-16T15:48:24Z |
| publishDate | 2017-10-01 |
| publisher | Wellcome |
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| series | Wellcome Open Research |
| spelling | doaj.art-1dc4a10ccbc84e149f1c5d649f8629f52022-12-21T22:25:44ZengWellcomeWellcome Open Research2398-502X2017-10-01210.12688/wellcomeopenres.12741.113804Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved]Daniel M. Parker0Jordi Landier1Aung Myint Thu2Khin Maung Lwin3Gilles Delmas4François H. Nosten5The Malaria Elimination Task Force GroupShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, ThailandShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, ThailandShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, ThailandShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, ThailandShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, ThailandCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UKBackground: Myanmar has one of the largest malaria burdens in Southeast Asia. Along the border with Thailand, Plasmodium falciparum parasites are increasingly showing reduced sensitivity to artemisinin combination therapies. Given that there are no current alternative treatment therapies, one proposed solution to the threat of untreatable P. falciparum malaria is to eliminate the parasite from the region. Several small-scale elimination projects have been piloted along the Myanmar-Thailand border. Following their success, this operational research aimed to scale up the elimination to a broad area of Eastern Kayin State, Myanmar. Methods: The project relied on geographic reconnaissance and a geographic information system, community engagement, generalized access to community-based early diagnosis and treatment, near real-time epidemiological surveillance, cross sectional malaria prevalence surveys and targeted mass drug administration in villages with high prevalence of P. falciparum malaria. Molecular markers of drug resistance were also monitored in individuals with symptomatic and asymptomatic infections. Discussion: This project illustrates the establishment of an elimination project and operational research in a remote, rural area encompassing several armed groups, multiple political organizations and a near-absent health care infrastructure. The establishment of the project relied on a strong rapport with the target community, on-the-ground knowledge (through geographic surveys and community engagement), rapid decision making and an approach that was flexible enough to quickly adapt to a complex landscape. The elimination project is ongoing, now over three years in operation, and assessment of the impact of this operational research will follow. This project has relevance not only for other malaria elimination projects but also for operational research aimed at eliminating other diseases.https://wellcomeopenresearch.org/articles/2-98/v1EpidemiologyParasitology |
| spellingShingle | Daniel M. Parker Jordi Landier Aung Myint Thu Khin Maung Lwin Gilles Delmas François H. Nosten The Malaria Elimination Task Force Group Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved] Wellcome Open Research Epidemiology Parasitology |
| title | Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved] |
| title_full | Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved] |
| title_fullStr | Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved] |
| title_full_unstemmed | Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved] |
| title_short | Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved] |
| title_sort | scale up of a plasmodium falciparum elimination program and surveillance system in kayin state myanmar version 1 referees 2 approved |
| topic | Epidemiology Parasitology |
| url | https://wellcomeopenresearch.org/articles/2-98/v1 |
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