CAP-Malaria reduces malaria-positive cases in Burma

The USAID |PMI Control and Prevention of Malaria Project (CAP-Malaria) works to control, treat, and prevent malaria and artemisinin-resistant malaria in the Greater Mekong Subregion. In Burma, CAP-Malaria combines behavior change communication (BCC) tactics, health systems strengthening for early diagnosis and appropriate treatment, and cost-effective vector-control interventions to reduce malaria transmission and support effective case management for hard-to-reach and vulnerable populations.

CAP-Malaria scaled up successful interventions, including the distribution of long-lasting insecticidal nets (LLINs) with supporting BCC activities to promote proper use. The project trains and supports village malaria workers to distribute bed nets and provide awareness through BCC materials and interpersonal counseling on malaria and proper use of LLINs, and monitors subsequent net use to ensure full coverage.

BCC provided by village malaria workers also highlights the importance of early diagnosis and appropriate treatment of malaria, encouraging villagers and migrant workers to seek treatment within 24 hours of fever onset. Providing the first line of care for hard-to-reach populations, VMWs diagnose malaria through the use of rapid diagnostic tests and immediately provide artemisinin-based combination therapy (ACT) to positive cases. Malaria treatment requires three consecutive days of medication to ensure that the parasite is cleared from the system. Failure to complete the three-day treatment can lead to the development, and spread, of drug-resistant malaria. To ensure effective outcomes and reduce the chance of resistance through compliance with the treatment course, VMWs visit the patient in their home to provide directly observed therapy (DOT) daily.

To monitor effectiveness of treatment and detect artemisinin-resistant malaria, CAP-Malaria introduced Day-3 surveillance, which is now carried out in key areas with known resistance. Through Day-3 surveillance, rapid diagnostic tests are conducted on both the initial day of diagnosis and the third day of ACT treatment. After proper treatment, a patient should no longer test positive for malaria. However, due to the presence of drug-resistant malaria, the parasite may still be present. Detecting Day-3 positive cases allows for better targeting of malaria interventions and ensures proper treatment for all detected malaria cases.

Migrants and mobile populations represent a high-risk and vulnerable group. As these workers are often employed by private companies in hard-to-reach areas, CAP-Malaria works with the private sector to educate employers about the prevention and treatment of artemisinin-resistant malaria, the role of the private sector in malaria prevention and control activities, and the use of LLINs to prevent malaria. The project has distributed over 33,000 nets at work sites and trained over 125 private providers to deliver malaria services to employees.

CAP-Malaria conducts regular monitoring visits to supervise activities and conduct regular on-the-job training on quality malaria diagnosis, case management, and data management to ensure quality of malaria diagnosis and treatment.

In Burma, CAP-Malaria has reduced the overall malaria positive rate (positive cases out of those tested) by 87% in target areas, from 2012 through 2015.

Date 
April 22, 2016
Authors 
Taylor Price, Senior Programs Officer
Regions/ Countries