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Hong H, Eom TH, Trinh TTT, Tuan BD, Park H, Yeo SJ. Identification of breeding habitats and kdr mutations in Anopheles spp. in South Korea. Malar J 2023; 22:381. [PMID: 38104158 PMCID: PMC10724954 DOI: 10.1186/s12936-023-04821-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Malaria is still endemic in South Korea. However, limited information is available on the current Anopheles breeding sites and the occurrence of insecticide resistance-associated genetic mutations and their distribution needed to control the malaria vector efficiently. METHODS This study explored breeding sites of Anopheline adults in Gimpo-si, near the demilitarized zone (DMZ) in Gyeonggi-do province, South Korea, from 2022 to 2023. Genetic diversity was investigated based on the internal transcribed spacer (ITS2), cytochrome c oxidase subunit I (COI), and knockdown resistance (kdr) genes of Anopheles mosquitoes. A natural environment associated with the seasonal abundance of Anopheles larvae was characterized. RESULTS Two breeding sites of Anopheles larvae and adults were found at a stream margin or shallow freshwater near the forest in Wolgot-myeon in Gimpo-si without cattle shed within 1 km and in Naega-myeon in Ganghwa-gun with cow shed within 100 m in 2022 and 2023, respectively. Both sites were located between the newly cultivated lands and the forest. Besides, both breeding sites were in the valley at a slight elevation of 60-70 m from ground lands and maintained the shadow all day. Overall, the Wolgot-myeon breeding site showed various Anopheles spp. larvae, including Anopheles sinensis. Naega-myeon, an additional breeding site found in 2023, had Anopheles sineroides larvae, and approximately 59.7% (89/149) of An. sinensis adults inhabited within a 100-m distance. The total collection, including larvae and adults, revealed that An. sinensis, Anopheles pullus, Anopheles kleini, An. sineroides, Anopheles belenrae, and Anopheles lindesayi accounted for 44.2% (118/267), 0.7% (2/267), 0.7% (2/267), 22.1% (59/267), 1.9% (5/267), and 30.3% (81/267), respectively. Furthermore, various kdr mutant genotypes (F/F, C/C, L/F, L/C and F/C) in An. sinensis, and the first kdr allele mutant (L/F1014) in An. belenrae were identified in South Korea. CONCLUSIONS Two breeding sites of Anopheles larvae were studied in Wolgot-myeon and Naega-myeon. Various Anopheles spp. larvae were detected in both habitats, but overall, An. sinensis was the most prevalent adults in both study sites. The occurrence of kdr allele mutant of An. belenrae in South Korea was reported. Rigorous larvae monitoring of Anopheles spp., continuously updating information on Anopheles breeding sites, and understanding the environmental conditions of Anopheles habitats are required to develop an effective malaria control programme in South Korea.
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Affiliation(s)
- Hyelee Hong
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, 03080, Republic of Korea
| | - Tae-Hui Eom
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, 03080, Republic of Korea
| | - Thuy-Tien Thi Trinh
- Department of Tropical Medicine and Parasitology, Medical Research Center, Institute of Endemic Diseases, Seoul National University, Seoul, 03080, Republic of Korea
| | - Bao Duong Tuan
- Zoonosis Research Center, Department of Infection Biology, School of Medicine, Wonkwang University, 460 Iksan-Daero, Iksan, 54538, Republic of Korea
| | - Hyun Park
- Zoonosis Research Center, Department of Infection Biology, School of Medicine, Wonkwang University, 460 Iksan-Daero, Iksan, 54538, Republic of Korea
| | - Seon-Ju Yeo
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, 03080, Republic of Korea.
- Department of Tropical Medicine and Parasitology, Medical Research Center, Institute of Endemic Diseases, Seoul National University, Seoul, 03080, Republic of Korea.
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Goel V, Mathew S, Gudi N, Jacob A, John O. A scoping review on laboratory surveillance in the WHO Southeast Asia Region: Past, present and the future. J Glob Health 2023; 13:04028. [PMID: 37083001 PMCID: PMC10119808 DOI: 10.7189/jogh.13.04028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Background The South-East Asia (SEA) region bears a significant proportion of the world's communicable disease burden. The onset of the COVID-19 pandemic has further affected the situation. A well-established laboratory-based surveillance (LBS) can reduce the burden of infectious diseases. In light of this, the review collated the existing literature on LBS system in the region and the modifications adopted by the surveillance systems during the pandemic. Methodology We followed the guidelines for scoping review as prescribed by Arskey and O'Malley. We comprehensively searched three databases (PubMed, Scopus and CINAHL) and supplemented it with grey literature search. The screening of the articles was conducted at the title and abstract followed by full-text screening. This was followed by data extraction using a pre-tested data extraction tool by two independent reviewers. The results were presented narratively. Results Including 75 relevant articles and documents, we compiled a list of surveillance systems. A shift from paper to dual (paper and electronic) modalities was identified across the countries. This largely low- and middle-income countries (LMIC) area face challenges in reporting, resources, and collaboration-related issues. While some countries have well-established National Reference Laboratories; others have more private than public-owned laboratories. Given the COVID-19 pandemic, modifications to the existing laboratory capacities to enable real-time surveillance was identified. Laboratory capacity complemented with genomic surveillance can indubitably aid in disease detection and control. Limitations due to inaccessible government portals, and language barriers are acknowledged. This review identified a comprehensive list of surveillance systems in the region, challenges faced in using these surveillance systems and inform the decision makers about the benefits of integrating fragmented surveillance systems. Conclusion Regionally and nationally integrated genomic and laboratory surveillance systems justify capital investments, as their payoffs rationalise such costs owing to economies of scale over time. Further, as data flows are harmonized and standardized, algorithm- and computing-based pattern recognition methods allow for targeted and accurate disease prediction when integrated with, potentially, climate and weather systems data. Trained human resources are a sine qua non to optimize such investments, but in the medium to long run, such investments will buttress initiatives in other arenas at the regional level.
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Affiliation(s)
- Vidushi Goel
- The George Institute for Global Health, New Delhi, India
| | - Silvy Mathew
- The George Institute for Global Health, New Delhi, India
| | - Nachiket Gudi
- Public Health Evidence South Asia, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anil Jacob
- The George Institute Services, New Delhi, India
| | - Oommen John
- The George Institute for Global Health, New Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Sirimatayanant M, Hein PS, Anderson LF, Montoya LF, Potter R, Nghipumbwa M, Ranaweera P, Ngor P, Phetsouvanh R, Maude RJ. Gaps in research and capacity development for malaria surveillance and response in the Asia-Pacific: meeting report. Malar J 2023; 22:91. [PMID: 36899358 PMCID: PMC10000341 DOI: 10.1186/s12936-023-04459-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/14/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND This report is based on the 2021 annual meeting of the Asia-Pacific Malaria Elimination Network Surveillance and Response Working Group held online on November 1-3, 2021. In light of the 2030 regional malaria elimination goal, there is an urgency for Asia-Pacific countries to accelerate progress towards national elimination and prevent re-establishment. The Asia Pacific Malaria Elimination Network (APMEN) Surveillance Response Working Group (SRWG) supports elimination goals of national malaria control programmes (NMCPs) by expanding the knowledge base, guiding the region-specific operational research agenda and addressing evidence gaps to improve surveillance and response activities. METHODS An online annual meeting was hosted from 1 to 3 November 2021, to reflect on research needed to support malaria elimination in the region, challenges with malaria data quality and integration, current surveillance-related technical tools, and training needs of NMCPs to support surveillance and response activities. Facilitator-led breakout groups were held during meeting sessions to encourage discussion and share experience. A list of identified research priorities was voted on by attendees and non-attending NMCP APMEN contacts. FINDINGS 127 participants from 13 country partners and 44 partner institutions attended the meeting, identifying strategies to address malaria transmission amongst mobile and migrant populations as the top research priority, followed by cost effective surveillance strategies in low resource settings, and integration of malaria surveillance into broader health systems. Key challenges, solutions and best practices for improving data quality and integrating epidemiology and entomology data were identified, including technical solutions to improve surveillance activities, guiding priority themes for hosting informative webinars, training workshops and technical support initiatives. Inter-regional partnerships and SRWG-led training plans were developed in consultation with members to be launched from 2022 onwards. CONCLUSION The 2021 SRWG annual meeting provided an opportunity for regional stakeholders, both NMCPs and APMEN partner institutions, to highlight remaining challenges and barriers and identify research priorities pertaining to surveillance and response in the region, and advocate for strengthening capacity through training and supportive partnerships.
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Affiliation(s)
- Massaya Sirimatayanant
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Phone Si Hein
- Asia Pacific Malaria Elimination Network (APMEN), Singapore, Singapore
| | - Laura Fay Anderson
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Pengby Ngor
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,National Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | - Richard J Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. .,Harvard TH Chan School of Public Health, Harvard University, Boston, USA. .,The Open University, Milton Keynes, UK.
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Potter R, Tesfazghi K, Poyer S, Eliades MJ. Private Sector Contributions to National Malaria Surveillance Systems in Elimination Settings: Lessons Learned from Cambodia, Lao PDR, Myanmar, and Vietnam. Am J Trop Med Hyg 2023; 108:14-23. [PMID: 35914687 PMCID: PMC9904159 DOI: 10.4269/ajtmh.22-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023] Open
Abstract
Comprehensive malaria case surveillance is necessary to achieve and sustain malaria elimination. In the Greater Mekong Subregion (GMS), the private sector plays a substantial role in malaria treatment. Yet, none of the six GMS countries collects complete case data from private sector points-of-care. Between 2016 and 2019, the GMS Elimination of Malaria through Surveillance program supported national malaria programs in Cambodia, Lao PDR, Myanmar, and Vietnam to execute elimination strategies by engaging the private sector in malaria case management, generating private sector case data, and integrating these data into national surveillance systems. The project enrolled 21,903 private sector outlets, covering between 52% and 80% of the private sector in targeted geographies, which were trained and equipped to perform rapid diagnostic tests (RDTs) and report malaria case data. By 2019, the private providers enrolled in the program reported a total of 3,521,586 suspected cases and 96,400 confirmed malaria cases into national surveillance systems, representing 16% of the total reported caseload by these countries (Cambodia, 25%; Lao PDR, 5%; Myanmar, 12%; Vietnam, 8%). Results demonstrated that with comprehensive support, such as training, provision of free or subsidized RDTs, first-line treatments, and routine supportive supervision, private providers can provide quality malaria case management and achieve high reporting rates.
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Affiliation(s)
| | - Kemi Tesfazghi
- Population Services International, Vientiane, Laos;,Address correspondence to Kemi Tesfazghi, 1120 19th St. NW #600, Washington, DC 20036. E-mail:
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Brown M, Bouanchaud P, Tesfazghi K, Phanalasy S, Thet MM, Nguyen H, Wheeler J. Motivation to test, treat, and report malaria cases: a quantitative assessment among private sector providers in the Greater Mekong Subregion. Malar J 2022; 21:82. [PMID: 35264168 PMCID: PMC8905864 DOI: 10.1186/s12936-022-04108-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/27/2022] [Indexed: 11/26/2022] Open
Abstract
Background Accurately testing, treating, and tracking all malaria cases is critical to achieving elimination. Ensuring health providers are able and motivated to test, treat, and report cases is a necessary component of elimination programmes, and particularly challenging in low endemic settings where providers may not encounter a large volume of cases. This study aimed to understand provider motivations to test, treat, and report malaria cases to better optimize programme design, adjust incentive schemes, and ultimately improve reporting rates while growing the evidence base around private providers in the Greater Mekong Subregion (GMS). Methods With funding from the Bill & Melinda Gates Foundation, this study aimed to identify and validate distinctive subtypes of motivation among private sector providers enrolled in the Greater Mekong Subregion Elimination of Malaria through Surveillance (GEMS) programme, implemented by Population Services International. Quantitative questionnaires were administered electronically in person by trained enumerators to various provider groups in Myanmar, Lao PDR, and Vietnam. A three-stage confirmatory factor analysis was then conducted in STATA. Results Following this analysis, a two-factor solution that describes motivation in this population of providers was identified, and providers were scored on the two dimensions of motivation. The correlation between the two rotated factors was 0.3889, and the Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy was 0.93, indicating an excellent level of suitability. These providers, who are often assumed to only be financially motivated, engaged in malaria elimination activities because of both internal and external motivational factors that are independent of remuneration or financial gain. For all three countries’ data, significant covariances between the two latent variables for internal and external motivation were found. The models were found to be of adequate to good fit for the data across all three countries. It was determined that private sector providers, who were previously believed to be primarily financially motivated, were also motivated by personal factors. Motivation was also associated with key outcomes of importance to malaria elimination, such as reporting and stocking of tests and treatments. Conclusion Maintaining or increasing provider motivation to test and treat is essential in the fight to eliminate malaria from the GMS, as it helps to ensure that providers continue to pursue this goal, even in a low incidence environment where cases may be rare and in which providers face financial pressure to focus on areas of health service provision. Establishing mechanisms to better motivate providers through intrinsic factors is likely to have a substantive impact on the sustainability of malaria case management activities.
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Affiliation(s)
| | - Paul Bouanchaud
- Population Services International, 1120 19th St NW, Suite 600, Washington, DC, 20036, USA
| | - Kemi Tesfazghi
- Population Services International, 1120 19th St NW, Suite 600, Washington, DC, 20036, USA.
| | - Saysana Phanalasy
- Population Services International Laos, T4 Road, Unit 16, Donkoi Village, Sisattanak District, Vientiane Capital, Lao People's Democratic Republic
| | - May Me Thet
- Population Services International Myanmar, No.16 Shwe Gon Taing Street 4, Yangon, Myanmar
| | - Hoa Nguyen
- Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Phạm Đình Hổ, Hai Bà Trưng, Hanoi, Vietnam
| | - Jennifer Wheeler
- Population Services International, 1120 19th St NW, Suite 600, Washington, DC, 20036, USA
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Sung J, Cheong HK, Lim AY, Kim JH. A small window into the status of malaria in North Korea: estimation of imported malaria incidence among visitors from South Korea. Epidemiol Health 2020; 42:e2020068. [PMID: 33227181 PMCID: PMC8137370 DOI: 10.4178/epih.e2020068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/21/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES This study aimed to develop hypotheses on trends in malaria incidence in North Korea using malaria incidence among South Korean visitors to North Korea. METHODS The number of South Korean tourists who visited Mount Kumgang from 2000 to 2008 and the number of South Korean employees at the Kaesong Industrial Complex from 2005 to 2015 were obtained from the Korean Statistical Information Service. The number of malaria cases among South Koreans who visited North Korea was obtained from a previous report. The incidence of malaria per 100,000 person-years was calculated using these data and compared with the malaria incidence in North Korea derived from published articles. RESULTS A high incidence of malaria in 2001 and a sharp decline in the following years were observed in both South and North Korean data. Since then, North Korean data showed a relatively low and stable incidence, but the incidence among South Koreans visiting North Korea increased in 2006. Considering the trends in mass primaquine preventive treatment, floods, and economic growth rate, the incidence of malaria may have increased in North Korea in 2006. Since 2009, the incidence of malaria decreased gradually according to both South and North Korean data. CONCLUSIONS The trends of malaria incidence in North Korea could be reflected through its incidence among South Koreans who visited North Korea. For future inter-Korean collaboration aiming to eradicate malaria, we propose that a North Korean malaria monitoring system be established applying this method.
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Affiliation(s)
- Jisun Sung
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Ah-Young Lim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
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7
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Diptyanusa A, Zablon KN. Addressing budget reduction and reallocation on health-related resources during COVID-19 pandemic in malaria-endemic countries. Malar J 2020; 19:411. [PMID: 33198747 PMCID: PMC7668022 DOI: 10.1186/s12936-020-03488-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/09/2020] [Indexed: 12/31/2022] Open
Abstract
The global COVID-19 pandemic has been affecting the maintenance of various disease control programmes, including malaria. In some malaria-endemic countries, funding and personnel reallocations were executed from malaria control programmes to support COVID-19 response efforts, resulting mainly in interruptions of disease control activities and reduced capabilities of health system. While it is principal to drive national budget rearrangements during the pandemic, the long-standing malaria control programmes should not be left behind in order to sustain the achievements from the previous years. With different levels of intensity, many countries have been struggling to improve the health system resilience and to mitigate the unavoidable stagnation of malaria control programmes. Current opinion emphasized the impacts of budget reprioritization on malaria-related resources during COVID-19 pandemic in malaria endemic countries in Africa and Southeast Asia, and feasible attempts that can be taken to lessen these impacts.
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Affiliation(s)
- Ajib Diptyanusa
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia.
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Ondigo BN, Hamre KES, Frosch AEP, Ayodo G, White MT, John CC. Antibody Profiles to P. falciparum Antigens Over Time Characterize Acute and Long-Term Malaria Exposure in an Area of Low and Unstable Transmission. Am J Trop Med Hyg 2020; 103:2189-2197. [PMID: 33124539 DOI: 10.4269/ajtmh.19-0480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Prevalence and levels of antibodies to multiple Plasmodium falciparum antigens show promise as tools for estimating malaria exposure. In a highland area of Kenya with unstable transmission, we assessed the presence and levels of antibodies to 12 pre-erythrocytic and blood-stage P. falciparum antigens by multiplex cytometric bead assay or ELISA in 604 individuals in August 2007, with follow-up testing in this cohort in April 2008, April 2009, and May 2010. Four hundred individuals were tested at all four time points. During this period, the only substantial malaria incidence occurred from April to August 2009. Antibody prevalence in adults was high at all time points (> 70%) for apical membrane antigen 1, erythrocyte-binding antigen 175, erythrocyte-binding protein-2, glutamate rich protein (GLURP)-R2, merozoite surface protein (MSP) 1 (19), MSP-1 (42), and liver-stage antigen-1; moderate (30-70%) for GLURP-R0, MSP-3, and thrombospondin-related adhesive protein; and low (< 30%) for SE and circumsporozoite protein (CSP). Changes in community-wide malaria exposure were best reflected in decreasing antibody levels overtime for highly immunogenic antigens, and in antibody seroprevalence overtime for the less-immunogenic antigens. Over the 3 years, antibody levels to all antigens except CSP and schizont extract (SE) decreased in an age-dependent manner. Prevalence and levels of antibodies to all antigens except CSP and SE increased with age. Increases in antibody prevalence and levels to CSP and SE coincided with increases in community-wide malaria incidence. Antibody levels to multiple P. falciparum antigens decrease in the absence of consistent transmission. Multiplex assays that assess both the presence and level of antibodies to multiple pre-erythrocytic and blood-stage P. falciparum antigens may provide the most useful estimates of past and recent malaria transmission in areas of unstable transmission and could be useful tools in malaria control and elimination campaigns.
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Affiliation(s)
- Bartholomew N Ondigo
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, Maryland.,Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,Department of Biochemistry and Molecular Biology, Egerton University, Nakuru, Kenya
| | - Karen E S Hamre
- CDC Foundation, Atlanta, Georgia.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.,Division of Global Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Anne E P Frosch
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota.,Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - George Ayodo
- School of Health Sciences, Jaramogi Oginga Odinga University of Science and Technology, Siaya, Kenya.,Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Michael T White
- Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Chandy C John
- Division of Global Pediatrics, University of Minnesota, Minneapolis, Minnesota.,Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, Indiana
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9
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Shretta R, Silal SP, Celhay OJ, Gran Mercado CE, Kyaw SS, Avancena A, Fox K, Zelman B, Baral R, White LJ, Maude RJ. Malaria elimination transmission and costing in the Asia-Pacific: Developing an investment case. Wellcome Open Res 2020. [PMID: 32025571 DOI: 10.12688/wellcomeopenres.14769.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: The Asia-Pacific region has made significant progress against malaria, reducing cases and deaths by over 50% between 2010 and 2015. These gains have been facilitated in part, by strong political and financial commitment of governments and donors. However, funding gaps and persistent health system challenges threaten further progress. Achieving the regional goal of malaria elimination by 2030 will require an intensification of efforts and a plan for sustainable financing. This article presents an investment case for malaria elimination to facilitate these efforts. Methods: A transmission model was developed to project rates of decline of Plasmodium falciparum and Plasmodium vivax malaria and the output was used to determine the cost of the interventions that would be needed for elimination by 2030. In total, 80 scenarios were modelled under various assumptions of resistance and intervention coverage. The mortality and morbidity averted were estimated and health benefits were monetized by calculating the averted cost to the health system, individual households, and society. The full-income approach was used to estimate the economic impact of lost productivity due to premature death and illness, and a return on investment was computed. Results: The study estimated that malaria elimination in the region by 2030 could be achieved at a cost of USD 29.02 billion (range: USD 23.65-36.23 billion) between 2017 and 2030. Elimination would save over 400,000 lives and avert 123 million malaria cases, translating to almost USD 90 billion in economic benefits. Discontinuing vector control interventions and reducing treatment coverage rates to 50% will result in an additional 845 million cases, 3.5 million deaths, and excess costs of USD 7 billion. Malaria elimination provides a 6:1 return on investment. Conclusion: This investment case provides compelling evidence for the benefits of continued prioritization of funding for malaria and can be used to develop an advocacy strategy.
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Affiliation(s)
- Rima Shretta
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA.,Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Sheetal Prakash Silal
- Modelling and Simulation Hub, Africa, Department of Statistical Sciences, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Cape Town, South Africa
| | - Olivier J Celhay
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chris Erwin Gran Mercado
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Shwe Sin Kyaw
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Anton Avancena
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Katie Fox
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Brittany Zelman
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Ranju Baral
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Lisa Jane White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Richard James Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Harvard TH Chan School of Public Health, Harvard University, Boston, USA
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10
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Kim JH, Lim AY, Cheong HK. Malaria Incidence of the Regions Adjacent to the Demilitarized Zone in the Democratic People's Republic of Korea, 2004-2016. J Korean Med Sci 2019; 34:e227. [PMID: 31538416 PMCID: PMC6753370 DOI: 10.3346/jkms.2019.34.e227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Vivax malaria reemerged in the Korean peninsula in 1990s beginning from the western border area and spread across both Koreas rapidly with its peak incidences reported on the early 2000s. There have been few reports on the malaria incidence in the Democratic People's Republic of Korea (North Korea) that provides detailed epidemiological features. The purpose of this study was to describe the time trends and spatial distribution of malaria in North Korea with comparison to those in South Korean regions across the border. METHODS The incidence of malaria in each province of North Korea from 2004 to 2016 was estimated based on data from domestic and international health authorities. Consistency of the data was evaluated by calculating the ratio of malaria cases in each province to the total cases each year. We also compared the changes in malaria incidence over time in South and North Korea adjacent to the demilitarized zone. RESULTS In North Korea, the incidence of malaria in the three provinces adjacent to the demilitarized zone was the highest (52.1-315.3 per 100,000), followed by Pyeonganbuk-do (14.7-113.5 per 100,000), where railways and road networks were connected to northern China. The incidence of malaria in each province of North Korea reported after 2011 was more consistent than when compared with previous annual data, and there was also a positive correlation between changes in incidence over time when compared with malaria incidence in South Korea (r = 0.855, r = 0.596). CONCLUSION The malaria report of North Korea was relatively consistent in its spatiotemporal tendency since 2011, suggesting improvement of the quality of the surveillance data. The strong correlation between North and South Korean malaria incidence at regional level suggests that collaboration between both sides are essential for the successful elimination of malaria in the Korean peninsula.
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Affiliation(s)
- Jong Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Ah Young Lim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Hae Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea.
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11
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Abstract
The technical genesis and practice of 8-aminoquinoline therapy of latent malaria offer singular scientific, clinical, and public health insights. The 8-aminoquinolines brought revolutionary scientific discoveries, dogmatic practices, benign neglect, and, finally, enduring promise against endemic malaria. The clinical use of plasmochin-the first rationally synthesized blood schizontocide and the first gametocytocide, tissue schizontocide, and hypnozoitocide of any kind-commenced in 1926. Plasmochin became known to sometimes provoke fatal hemolytic crises. World War II delivered a newer 8-aminoquinoline, primaquine, and the discovery of glucose-6-phosphate dehydrogenase (G6PD) deficiency as the basis of its hemolytic toxicity came in 1956. Primaquine nonetheless became the sole therapeutic option against latent malaria. After 40 years of fitful development, in 2018 the U.S. Food and Drug Administration registered the 8-aminoquinoline called tafenoquine for the prevention of all malarias and the treatment of those that relapse. Tafenoquine also cannot be used in G6PD-unknown or -deficient patients. The hemolytic toxicity of the 8-aminoquinolines impedes their great potential, but this problem has not been a research priority. This review explores the complex technical dimensions of the history of 8-aminoquinolines. The therapeutic principles thus examined may be leveraged in improved practice and in understanding the bright prospect of discovery of newer drugs that cannot harm G6PD-deficient patients.
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Affiliation(s)
- J Kevin Baird
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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12
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Sun Y, Xiang D, Chen C, He S, Qi H, Wang C. Infected RBC flag/parameter provided by Mindray BC-6800 haematology analyzer aid the diagnosis of malaria. Malar J 2019; 18:262. [PMID: 31366365 PMCID: PMC6668162 DOI: 10.1186/s12936-019-2890-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 07/22/2019] [Indexed: 12/13/2022] Open
Abstract
Background The Mindray BC-6800 haematology analyzer (BC-6800) provides a dedicated flag ‘Infected RBC’ (InR) and the number of InR (InR#)/the permillage of InR (InR‰) in routine blood testing as a screening tool for malaria in endemic areas. This study sought to evaluate the effectiveness of the BC-6800 flag parameter for aiding the diagnosis of malaria. Methods A total of 181 samples were tested using the Mindray BC-6800 haematology analyzer, including 117 malaria-infected samples collected from Yunnan, China, and 64 samples from healthy controls. Microscopy examination was conducted as reference when stained thick blood film revealed the presence of malaria parasites identified as Plasmodium vivax and Plasmodium falciparum. The receiver operating characteristic (ROC) curve analysis was developed using Analyse-it v4.92.3. The Kappa value was determined to evaluate the agreement between BC-6800 and light microscopy. Results The sensitivity of InR‰ generated by BC-6800 for P. vivax and P. falciparum was 88.3 and 24.1%, respectively; specificity of InR‰ for malaria parasites was 84.3 and 84.3%, respectively; positive predictive value and negative predictive value was 89.4 and 82.7% for P. vivax, and 52.8 and 60.3% for P. falciparum. There was a strong correlation between ΔWBC and InR‰ (R2 = 0.9731 for P. vivax and R2 = 0.9757 for P. falciparum). There was also a significant correlation between parasitaemia and InR# in P. vivax-infected samples (R2 = 0.734). InR# was evaluated using ROC curve analysis, the area under the ROC curve is 0.95 with a 95% confidence interval of 0.926 to 0.974, and the cut-off value is 0.01 × 109/L for P. vivax. However, the ring stage and the early trophozoite stage of Plasmodium cannot be detected easily on BC-6800, possibly because of the small size and low nucleic acid content of these stages. Conclusions The findings suggest that the flag ‘InR’ and the parameters ‘InR#/InR‰’ provided by the BC-6800 haematology analyzer could be used to screen for malaria in a clinical setting.
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Affiliation(s)
- Yi Sun
- Department of Clinical Laboratory, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Daijun Xiang
- Department of Clinical Laboratory, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Chen Chen
- Department of Clinical Laboratory, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Shang He
- Department of Clinical Laboratory, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Huan Qi
- Algorithm and Clinical Research Department, Haematology, IVD, Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Shenzhen, 518057, China
| | - Chengbin Wang
- Department of Clinical Laboratory, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
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13
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Mercado CEG, Lawpoolsri S, Sudathip P, Kaewkungwal J, Khamsiriwatchara A, Pan-Ngum W, Yimsamran S, Lawawirojwong S, Ho K, Ekapirat N, Maude RR, Wiladphaingern J, Carrara VI, Day NPJ, Dondorp AM, Maude RJ. Spatiotemporal epidemiology, environmental correlates, and demography of malaria in Tak Province, Thailand (2012-2015). Malar J 2019; 18:240. [PMID: 31311606 PMCID: PMC6636027 DOI: 10.1186/s12936-019-2871-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 07/06/2019] [Indexed: 12/14/2022] Open
Abstract
Background Tak Province, at the Thai–Myanmar border, is one of three high malaria incidence areas in Thailand. This study aimed to describe and identify possible factors driving the spatiotemporal trends of disease incidence from 2012 to 2015. Methods Climate variables and forest cover were correlated with malaria incidence using Pearson’s r. Statistically significant clusters of high (hot spots) and low (cold spots) annual parasite incidence per 1000 population (API) were identified using Getis-Ord Gi* statistic. Results The total number of confirmed cases declined by 76% from 2012 to 2015 (Plasmodium falciparum by 81%, Plasmodium vivax by 73%). Incidence was highly seasonal with two main annual peaks. Most cases were male (62.75%), ≥ 15 years (56.07%), and of Myanmar (56.64%) or Thai (39.25%) nationality. Median temperature (1- and 2-month lags), average temperature (1- and 2-month lags) and average relative humidity (2- and 3-month lags) correlated positively with monthly total, P. falciparum and P. vivax API. Total rainfall in the same month correlated with API for total cases and P. vivax but not P. falciparum. At sub-district level, percentage forest cover had a low positive correlation with P. falciparum, P. vivax, and total API in most years. There was a decrease in API in most sub-districts for both P. falciparum and P. vivax. Sub-districts with the highest API were in the Tha Song Yang and Umphang Districts along the Thai–Myanmar border. Annual hot spots were mostly in the extreme north and south of the province. Conclusions There has been a large decline in reported clinical malaria from 2012 to 2015 in Tak Province. API was correlated with monthly climate and annual forest cover but these did not account for the trends over time. Ongoing elimination interventions on one or both sides of the border are more likely to have been the cause but it was not possible to assess this due to a lack of suitable data. Two main hot spot areas were identified that could be targeted for intensified elimination activities. Electronic supplementary material The online version of this article (10.1186/s12936-019-2871-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chris Erwin G Mercado
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Prayuth Sudathip
- Bureau of Vector-borne Diseases (BVBD), Department of Disease Control (DDC), Ministry of Public Health (MOPH), Nonthaburi, Thailand
| | - Jaranit Kaewkungwal
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Amnat Khamsiriwatchara
- Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wirichada Pan-Ngum
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Surapon Yimsamran
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Siam Lawawirojwong
- Geo-Informatics and Space Technology Development Agency (GISTDA), Bangkok, Thailand
| | - Kevin Ho
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nattwut Ekapirat
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rapeephan R Maude
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jacher Wiladphaingern
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Verena I Carrara
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Shoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Nicholas P J Day
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Richard J Maude
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
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14
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Shretta R, Silal S, White LJ, Maude RJ. Predicting the cost of malaria elimination in the Asia-Pacific. Wellcome Open Res 2019; 4:73. [PMID: 31080895 PMCID: PMC6484453 DOI: 10.12688/wellcomeopenres.15166.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 11/21/2022] Open
Abstract
Over the past decade, the countries of the Asia-Pacific region have made significant progress towards the goal of malaria elimination by the year 2030. It is widely accepted that for the region to meet this goal, an intensification of efforts supported by sustained funding is required. However, robust estimates are needed for the optimal coverage and components of malaria elimination packages and the resources required to implement them. In this collection, a multispecies mathematical and economic modelling approach supported by the estimated burden of disease is used to make preliminary estimates for the cost of elimination and develop an evidence-based investment case for the region.
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Affiliation(s)
- Rima Shretta
- Global Health Group, University of California, San Francisco, San Francisco, CA 94158, USA
- Swiss Tropical and Public Health Institute, Basel 4002, Switzerland
- University of Basel, Basel 4001, Switzerland
| | - Sheetal Silal
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
- South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Cape Town, South Africa
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Lisa J. White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Bangkok 10400, Thailand
| | - Richard J. Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Bangkok 10400, Thailand
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
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15
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Maude RJ, Mercado CEG, Rowley J, Ekapirat N, Dondorp A. Estimating malaria disease burden in the Asia-Pacific. Wellcome Open Res 2019. [DOI: 10.12688/wellcomeopenres.15164.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The Asia-Pacific aims to eliminate malaria by 2030. Many of the 22 endemic countries have earlier targets. To track progress towards elimination and predict timelines and funding required it is essential to have an accurate picture of the true burden of malaria over time. Estimating this is a major challenge with most countries having incomplete data on numbers of cases and wide variation between health system access and performance. Regular estimates are published by the World Health Organization (WHO), but these are not split by species, can have a wide range of uncertainty, change over time and are not available for every year. Methods: For the Asia Pacific Leaders Malaria Alliance, the burden of malaria for the 22 malaria-endemic countries in the Asia-Pacific from 2000 to 2015 was estimated by combining data submitted by countries to WHO with a systematic review to estimate the proportion of cases recorded. Due to a lack of suitable data, it was only possible to apply this method to 2013-2015. A simplified method was then derived to estimate the annual burden of falciparum and vivax malaria as inputs to a mathematical model to predict the cost of elimination, which is described elsewhere. Results: The total number of estimated cases was around double the number of confirmed cases reported in the Asia Pacific with a broad range of uncertainty around these estimates due primarily to sparsity of data with which to estimate proportions of cases reported. The ranges of estimated burdens were mostly like those published for countries by WHO, with some exceptions. Conclusions: The accuracy and precision of malaria burden estimates could be greatly improved by having more regular large surveys on access to healthcare in malaria-endemic areas and making subnational data on malaria incidence and reporting completeness publicly available.
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16
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Shretta R, Silal SP, Celhay OJ, Gran Mercado CE, Kyaw SS, Avancena A, Fox K, Zelman B, Baral R, White LJ, Maude RJ. Malaria elimination transmission and costing in the Asia-Pacific: Developing an investment case. Wellcome Open Res 2019; 4:60. [PMID: 32025571 PMCID: PMC6974926 DOI: 10.12688/wellcomeopenres.14769.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The Asia-Pacific region has made significant progress against malaria, reducing cases and deaths by over 50% between 2010 and 2015. These gains have been facilitated in part, by strong political and financial commitment of governments and donors. However, funding gaps and persistent health system challenges threaten further progress. Achieving the regional goal of malaria elimination by 2030 will require an intensification of efforts and a plan for sustainable financing. This article presents an investment case for malaria elimination to facilitate these efforts. Methods: A transmission model was developed to project rates of decline of Plasmodium falciparum and Plasmodium vivax malaria and the output was used to determine the cost of the interventions that would be needed for elimination by 2030. In total, 80 scenarios were modelled under various assumptions of resistance and intervention coverage. The mortality and morbidity averted were estimated and health benefits were monetized by calculating the averted cost to the health system, individual households, and society. The full-income approach was used to estimate the economic impact of lost productivity due to premature death and illness, and a return on investment was computed. Results: The study estimated that malaria elimination in the region by 2030 could be achieved at a cost of USD 29.02 billion (range: USD 23.65-36.23 billion) between 2017 and 2030. Elimination would save over 400,000 lives and avert 123 million malaria cases, translating to almost USD 90 billion in economic benefits. Discontinuing vector control interventions and reducing treatment coverage rates to 50% will result in an additional 845 million cases, 3.5 million deaths, and excess costs of USD 7 billion. Malaria elimination provides a 6:1 return on investment. Conclusion: This investment case provides compelling evidence for the benefits of continued prioritization of funding for malaria and can be used to develop an advocacy strategy.
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Affiliation(s)
- Rima Shretta
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Sheetal Prakash Silal
- Modelling and Simulation Hub, Africa, Department of Statistical Sciences, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Cape Town, South Africa
| | - Olivier J. Celhay
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chris Erwin Gran Mercado
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Shwe Sin Kyaw
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Anton Avancena
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Katie Fox
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Brittany Zelman
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Ranju Baral
- Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA, 94158, USA
| | - Lisa Jane White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Richard James Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA
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17
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Al Zahrani MH, Omar AI, Abdoon AMO, Ibrahim AA, Alhogail A, Elmubarak M, Elamin YE, AlHelal MA, Alshahrani AM, Abdelgader TM, Saeed I, El Gamri TB, Alattas MS, Dahlan AA, Assiri AM, Maina J, Li XH, Snow RW. Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia. BMC Med 2018; 16:98. [PMID: 29940950 PMCID: PMC6019222 DOI: 10.1186/s12916-018-1081-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/21/2018] [Indexed: 11/17/2022] Open
Abstract
Malaria at international borders presents particular challenges with regards to elimination. International borders share common malaria ecologies, yet neighboring countries are often at different stages of the control-to-elimination pathway. Herein, we present a case study on malaria, and its control, at the border between Saudi Arabia and Yemen. Malaria program activity reports, case data, and ancillary information have been assembled from national health information systems, archives, and other related sources. Information was analyzed as a semi-quantitative time series, between 2000 and 2017, to provide a plausibility framework to understand the possible contributions of factors related to control activities, conflict, economic development, migration, and climate. The malaria recession in the Yemeni border regions of Saudi Arabia is a likely consequence of multiple, coincidental factors, including scaled elimination activities, cross-border vector control, periods of low rainfall, and economic development. The temporal alignment of many of these factors suggests that economic development may have changed the receptivity to the extent that it mitigated against surges in vulnerability posed by imported malaria from its endemic neighbor Yemen. In many border areas of the world, malaria is likely to be sustained through a complex congruence of factors, including poverty, conflict, and migration.
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Affiliation(s)
- Mohammed H. Al Zahrani
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Abdiasiis I. Omar
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Abdelmohsin M. O. Abdoon
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Ali Adam Ibrahim
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah Alhogail
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Elmubarak
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Yousif Eldirdiry Elamin
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed A. AlHelal
- National Malaria Elimination Programme, Public Health Agency, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Ali M. Alshahrani
- Malaria Elimination Programme, Aseer Health Affairs Directorate, Abha, Kingdom of Saudi Arabia
| | - Tarig M. Abdelgader
- Malaria Elimination Programme, Aseer Health Affairs Directorate, Abha, Kingdom of Saudi Arabia
| | - Ibrahim Saeed
- Malaria Elimination Programme, Aseer Health Affairs Directorate, Abha, Kingdom of Saudi Arabia
| | - Tageddin B. El Gamri
- Malaria Elimination Programme, Jazan Health Affairs Directorate, Jazan, Kingdom of Saudi Arabia
| | - Mohammed S. Alattas
- Malaria Elimination Programme, Jazan Health Affairs Directorate, Jazan, Kingdom of Saudi Arabia
| | - Abdu A. Dahlan
- Malaria Elimination Programme, Jazan Health Affairs Directorate, Jazan, Kingdom of Saudi Arabia
| | - Abdullah M. Assiri
- Directorate of Public Health, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Joseph Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Xiao Hong Li
- Malaria Elimination Unit, Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Robert W. Snow
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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18
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Park KS, Malik SK, Lee JH, Karim AM, Lee SH. Commentary: Malaria elimination in India and regional implications. Front Microbiol 2018; 9:992. [PMID: 29867890 PMCID: PMC5963121 DOI: 10.3389/fmicb.2018.00992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 04/27/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Kwang Seung Park
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University, Yongin, South Korea
| | - Sumera Kausar Malik
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University, Yongin, South Korea
| | - Jung Hee Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University, Yongin, South Korea
| | - Asad Mustafa Karim
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University, Yongin, South Korea.,Department of Bioinformatics, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Sang Hee Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University, Yongin, South Korea
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