In Burma, the USAID | PMI Control and Prevention of Malaria Project (CAP-Malaria) is currently working where there is high malaria burden and drug resistance to reduce malaria morbidity and mortality and to contribute toward the containment of artemisinin-resistant malaria. Thandwe, in Southern Rakhine State, is one of the townships where CAP-Malaria is currently implementing control and prevention activities. Rakhine State is one of the high malaria transmission areas in Burma and, while some areas have experienced a reduction in malaria burden, other remote and hard to reach areas maintain a high malaria prevalence. In Thandwe, CAP-Malaria carries out malaria prevention and control activities in 45 villages and, through the use of strategic information, CAP-Malaria maintains close coordination with and support for the National Malaria Control Program (NMCP) and the Ministry of Health.
In January 2015, CAP-Malaria initiated intensified case finding (ICF) activities in collaboration with the NMCP and basic health services (BHS) staff in five remote villages. A team was assembled that included two NMCP staff, two BHS staff, and two CAP-Malaria staff. The team went to each of the five villages and performed blood tests and case management according to the National Malaria Treatment guideline. In addition, they provided health education sessions on malaria transmission, prevention, early diagnosis and effective treatment. The team tested 904 people out of the approximate 2,230 in the five villages with rapid diagnostic tests (RDTs). Among those tested, 61 patients were malaria positive (MPR-6.7%).
After analysis of the data collected from the previous visit, the CAPMalaria team returned to the three highest burden villages in March 2015. The team not only performed active case finding but also distributed long-lasting insecticide nets (LLINs) in order to prevent transmission. Early diagnosis and effective treatment is not enough to fully prevent transmission, therefore, it is essential to carry out vector control activities. The total population of 1,817 was provided 931 LLINs, covering 100% of households. In the three villages, 900 people were screened with 62 positive cases (MPR-6.8%). During LLIN distribution, Daw Than Myint, a villager from Pu Yitt Village, stated the he “now knows malaria is caused by the biting of mosquitos and, to prevent this, personal protection and use of LLINs are essential.” “Ma Yin Yin Aye, a CAP-Malaria village malaria worker told me how people get malaria, but I wasn’t able to afford a bed net. When I heard LLINs were going to be distributed by CAP-Malaria, I felt happy and grateful. I promised that my family would always sleep under the LLINs and I am going to encourage other villagers to use bed nets properly.”
Additionally, when the CAP-Malaria team arrived in Sin Man Village, they noticed that a woman was very excited to get the results of her families blood test. This is because her son, Aung Ye’ Lin a three year old boy, fell ill with malaria. She said “For a long time, my son felt sick off and on. I used local medicine
to treat him, but it did not work. Now I am very pleased to get malaria treatment for my son and really grateful to the CAPMalaria team for coming to such a far village.”
After 18 months of implementation in Thandwe, effective communication between the government and CAP-Malaria has been well established and the government is appreciative for the collaboration. The CAP-Malaria team is now able to explore new areas and, in the near future, CAP-Malaria will carry out ICF in the highest burden areas to reduce malaria morbidity and mortality and to monitor LLIN coverage and usage in areas where nets were distributed.