TY - JOUR
T1 - Challenges and prospects for malaria elimination in the Greater Mekong Subregion
AU - Cui, Liwang
AU - Yan, Guiyun
AU - Sattabongkot, Jetsumon
AU - Chen, Bin
AU - Cao, Yaming
AU - Fan, Qi
AU - Parker, Daniel
AU - Sirichaisinthop, Jeeraphat
AU - Su, Xin zhuan
AU - Yang, Henglin
AU - Yang, Zhaoqing
AU - Wang, Baomin
AU - Zhou, Guofa
N1 - Funding Information:
To facilitated malaria control and elimination in the GMS, an International Center of Excellence for Malaria Research (ICEMR) was recently created with financial support from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA. The three target countries of our ICEMR are entering the phases of malaria control (Myanmar), pre-elimination (Thailand) and elimination (China), respectively. This program is expected to contribute greatly to the fulfillment of the goals for each country. The overall goal of China is zero malaria-associated mortality by 2013 and, except in the border counties of Yunnan and Tibet, malaria elimination by the end of 2015 ( Ministry of Health of China, 2009 ). The main interventions are composed of early and accurate diagnosis; prompt, effective, and safe treatment in both public and private sectors; appropriate vector control measures (IRS and LLINs); and better outreach efforts to the populations at risk (such as residents of remote communities and migrant workers). Malaria in Thailand is endemic only in the remote, hilly, and forested regions near international borders (mostly with Myanmar and Cambodia). Therefore, the GFATM program aims at improving access to prevention measures, early diagnosis and treatment of malaria, increasing effective utilization of LLINs, and better outreach efforts to promote prompt treatment-seeking behaviors among fever cases. Since Thailand is at the epicenter of MDR falciparum parasites, close monitoring of drug resistance is essential to ensure effective treatment of malaria. With dramatic decline in malaria incidence in China and Thailand, both nations need to strengthen their malaria surveillance systems and to ensure adequate outbreak response capability through improved case detection and reporting as well as entomological and antimalarial resistance monitoring. The malaria burden in Myanmar is the heaviest among all GMS nations. The GFATM program provides malaria control support in highly endemic areas such as development project sites, resettlement areas, and epidemic prone areas. Major interventions include scaled-up use of LLINs and IRS for vector control, improved access to quality diagnosis and treatment for malaria, and efficient supply chain management. The technical feasibility of malaria elimination in Myanmar is very low and requires enhanced health education, supportive supervision, monitoring, and evaluation.
Funding Information:
This work was supported by National Institute of Allergy and Infectious Diseases, NIH ( U19 AI089672 ). X. Su is supported by the Division of Intramural Research, NIAID, NIH.
PY - 2012/3
Y1 - 2012/3
N2 - Despite significant improvement in the malaria situation of the Greater Mekong Subregion (GMS), malaria control for the region continues to face a multitude of challenges. The extremely patchy malaria distribution, especially along international borders, makes disease surveillance and targeted control difficult. The vector systems are also diverse with dramatic differences in habitat ecology, biting behavior, and vectorial capacity, and there is a lack of effective transmission surveillance and control tools. Finally, in an era of heavy deployment of artemisinin-based combination therapies, the region acts as an epicenter of drug resistance, with the emergence of artemisinin resistant Plasmodium falciparum posing a threat to both regional and global malaria elimination campaigns. This problem is further exacerbated by the circulation of counterfeit and substandard artemisinin drugs. Accordingly, this Southeast Asian Malaria Research Center, consisting of a consortium of US and regional research institutions, has proposed four interlinked projects to address these most urgent problems in malaria control. The aims of these projects will help to substantially improve our understanding of malaria epidemiology, vector systems and their roles in malaria transmission, as well as the mechanisms of drug resistance in parasites. Through the training of next-generation scientists in malaria research, this program will help build up and strengthen regional research infrastructure and capacities, which are essential for sustained malaria control in this region.
AB - Despite significant improvement in the malaria situation of the Greater Mekong Subregion (GMS), malaria control for the region continues to face a multitude of challenges. The extremely patchy malaria distribution, especially along international borders, makes disease surveillance and targeted control difficult. The vector systems are also diverse with dramatic differences in habitat ecology, biting behavior, and vectorial capacity, and there is a lack of effective transmission surveillance and control tools. Finally, in an era of heavy deployment of artemisinin-based combination therapies, the region acts as an epicenter of drug resistance, with the emergence of artemisinin resistant Plasmodium falciparum posing a threat to both regional and global malaria elimination campaigns. This problem is further exacerbated by the circulation of counterfeit and substandard artemisinin drugs. Accordingly, this Southeast Asian Malaria Research Center, consisting of a consortium of US and regional research institutions, has proposed four interlinked projects to address these most urgent problems in malaria control. The aims of these projects will help to substantially improve our understanding of malaria epidemiology, vector systems and their roles in malaria transmission, as well as the mechanisms of drug resistance in parasites. Through the training of next-generation scientists in malaria research, this program will help build up and strengthen regional research infrastructure and capacities, which are essential for sustained malaria control in this region.
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U2 - 10.1016/j.actatropica.2011.04.006
DO - 10.1016/j.actatropica.2011.04.006
M3 - Article
C2 - 21515238
AN - SCOPUS:84857648447
VL - 121
SP - 240
EP - 245
JO - Acta Tropica
JF - Acta Tropica
SN - 0001-706X
IS - 3
ER -