Malaria incidence in Myanmar 2005–2014: steady but fragile progress towards eliminationReport as inadecuate




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Malaria Journal

, 15:503

First Online: 18 October 2016Received: 21 August 2016Accepted: 07 October 2016DOI: 10.1186-s12936-016-1567-0

Cite this article as: Mu, T.T., Sein, A.A., Kyi, T.T. et al. Malar J 2016 15: 503. doi:10.1186-s12936-016-1567-0

Abstract

BackgroundThere has been an impressive recent reduction in the global incidence of malaria, but the development of artemisinin resistance in the Greater Mekong Region threatens this progress. Increasing artemisinin resistance is particularly important in Myanmar, as it is the country in the Greater Mekong Region with the greatest malaria burden. If malaria is to be eliminated in the region, it is essential to define the spatial and temporal epidemiology of the disease in Myanmar to inform control strategies optimally.

ResultsBetween the years 2005 and 2014 there was an 81.1 % decline in the reported annual incidence of malaria in Myanmar 1341.8 cases per 100,000 population to 253.3 cases per 100,000 population. In the same period, there was a 93.5 % decline in reported annual mortality from malaria 3.79 deaths per 100,000 population to 0.25 deaths per 100,000 population and a 87.2 % decline in the proportion of hospitalizations due to malaria 7.8 to 1.0 %. Chin State had the highest reported malaria incidence and mortality at the end of the study period, although socio-economic and geographical factors appear a more likely explanation for this finding than artemisinin resistance. The reduced malaria burden coincided with significant upscaling of disease control measures by the national government with support from international partners. These programmes included the training and deployment of over 40,000 community health care workers, the coverage of over 60 % of the at-risk population with insecticide-treated bed nets and significant efforts to improve access to artemesinin-based combination treatment. Beyond these malaria-specific programmes, increased general investment in the health sector, changing population demographics and deforestation are also likely to have contributed to the decline in malaria incidence seen over this time.

ConclusionsThere has been a dramatic fall in the burden of malaria in Myanmar since 2005. However, with the rise of artemisinin resistance, continued political, financial and scientific commitment is required if the ambitious goal of malaria elimination in the country is to be realized.

KeywordsMalaria Myanmar Artemisinin resistance Epidemiology Public health Greater Mekong Region AbbreviationsACTartemisinin-based combination therapy

HMISHealth Management Information System

HRECHuman Research Ethics Committee

IRSindoor residual spraying

ITNinsecticide treated net

MAS33-day regimen of mefloquine and artesunate

TACTtriple artemisinin-based combination therapy

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Author: Thet Thet Mu - Aye Aye Sein - Tint Tint Kyi - Myo Min - Ne Myo Aung - Nicholas M. Anstey - Myat Phone Kyaw - Chit So

Source: https://link.springer.com/







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