by Dr Samlane Phompida, Director Centre of … Dr Samlane Phompida, Director Centre of Malariology...
Transcript of by Dr Samlane Phompida, Director Centre of … Dr Samlane Phompida, Director Centre of Malariology...
P.phetsouvanh malaria situation update 2008
Malaria control in Lao PDR : Malaria control in Lao PDR : progress report update 2009progress report update 2009
Vientiane CapitalVientiane Capital1616--1818thth March 2008March 2008
by Dr Samlane Phompida, Director by Dr Samlane Phompida, Director Centre of Centre of MalariologyMalariology ParasitologyParasitology and and
EntomologyEntomology
P.phetsouvanh malaria situation update 2008
objectives• To reduce malaria mortality by 80%• To reduce malaria morbidity by 80%• To protect 3.6 Mio under ITN/LLN• To expand EDAT until the grass root
village level• Re-stratification of malaria control to adjust
malaria strategies and interventions
P.phetsouvanh malaria situation update 2008
Annual Parasite Incidence (API) per 1,000 population: Provincial trend : 2005-2007
0
5
10
15
20
25
30
35
40
45
VT.Capita
lPhongs
alyLuan
gnamtha
Oudomxa
yBoke
oLuan
gpraban
gHuap
hanh
Xayab
uryXieng
khuan
gVienti
ane
Borikham
xay
Khammouan
eSav
annak
hetsa
ravan
ese
kong
Champa
sack
Attapeu
API
/100
0
API 2005 API 2006 API 2007
P.phetsouvanh malaria situation update 2008
ACT+ADT 2005-2006
ACT+ADT 2004-2005
N
90 0 90 180 270 Kilometers
ACT/RDT coverage
P.phetsouvanh malaria situation update 2008
comparison between malaria suspected cases vs confirmed cases
0
50000
100000
150000
200000
250000
300000
350000
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
year
mal
aria
cas
es
malaria casesconfirmed malaria cases
P.phetsouvanh malaria situation update 2008
Villages under ITN in 2008
90 0 90 180 270 360 450 Kilometers
N
EW
S
%targetvillagecovered with IBN
%target_villages _covered
> 100%>80 %
Legend
P.phetsouvanh malaria situation update 2008
83
96
52
78
64
108
166
13155
105
96
10578
96
43
36
44
100 0 100 200 Kilometers
N
EW
S
IBN_treatment rate
IBN_treatment rate> 50 %80 % > 80 %
ITN treatment rate in 2008
P.phetsouvanh malaria situation update 2008
Number of IBN impregnated, population protected and person per net:
Trend: 2003-2008
8994
80
1 090
957
1386
241
1486
622
8135
39
9686
34
2353797 2443801 2360744 2599962
3292573 34075722.6
3.0
2.4 2.4 2.4 2.3
0500000
100000015000002000000
2500000300000035000004000000
2003 2004 2005 2006 2007 2008
Popu
latio
n pr
otec
ted
0
0.5
1
1.5
2
2.5
3
3.5
Pers
on p
er n
et
Net impregnated People protected Person/net
P.phetsouvanh malaria situation update 2008
Luangorabang Province2007: Artesunate + LumefantrineSS= 5, FU= 28, ACPR= 100%
Vientiane Province1999: Chloroquine SS= 39, TF= 46%, RII/RIII: 33%
Khammouane Province2005-2006: Artesunate + LumefantrineSS= 42, FU= 28, ACPR= 100%2007: Artesunate + LumefantrineSS= 18, FU= 28, ACPR= 94.4%
Attapeu province2001: Chloroquine SS= 65, FU= 14, TF= 45-55%2002: FansidarSS= 33, FU= 14, TF: 15%Chloroquine + Fansidar SS= 55, FU= 14, TF= 15-25%MefloquineSS= 26, FU= 14, ACPR= 100%2005: Artesunate + LumefantrineSS= 43, ACPR= 100%2006: Artesunate + LumefantrineSS= 24, FU= 28, ACPR= 100%
Luangnamtha Province2001-2002: ChloroquineSS= 36, FU= 14, TF= 30-55%Fansidar SS= 39, FU= 14, TF= 18%2003: Artesunate + MefloquineSS= 53, FU= 42, ACPR= 100%Artesunate + LumefantrineSS= 47, FU= 42, ACPR= 93%
Champasack & Savannakhet2001-2002: ChloroquineSS= 78, FU= 14-42, TF= 30-55%FansidarSS= 122, FU= 14-42, TF= 10-18%Chloroquine + FansidarSS= 109, FU= 42, TF= 8 %2002-2003: Artesunate + MefloquineSS= 108, FU= 42, ACPR= 100%Artesunate + Lumefantrine SS= 107, FU= 42, ACPR= 97%
Saravane Province2003: FansidarSS= 21, FU= 28, S= 76.2%, RI=9.5%, RII/RII= 14.3%
Sekong Province1999: ChloroquineSS= 50, FU= 28, S= 38%, RII= 42.5%, RIII= 6%
Trend of anti - malarial drug resistance in the last 5 years
SS= Sample sizeFU= Follow up daysTF= Treatment failure (total)ACPR= Adequate Clinical & Parasitological Respons
Legend
100 0 100 200 Kilometers
N
P.phetsouvanh malaria situation update 2008
ການແຈກຢາຍຂອງຍຸງນຳເຊື້ອ
A n . m in im u sA n . m a c u la t u sA n . d ir u s
A n .m in im u sA n .m a c u la t u s
A n .m i n i m u sA n .m a c u l a tu sA n . je yp o r i e n s i s
A n .m in i m u sA n .m a c u la tu sA n .d i r u s
A n . m in im u sA n . d ir u sA n . m a c u la tu s
A n .m in im u sA n .d i ru sA n .m a c u la t u sA n .je y p o r ie n s is
A n .m in im u sA n .d i ru sA n .m a c u la t u s
A n .m in im u sA n .d i ru sA n .je y p o r ie n s isA n .m a c u la t u s
A n .m in im u sA n .m a c u la t u sA n .d i ru s
A n .m in im u sA n .d iru sA n .m a c u la t u s
A n .m in im u sA n .m a c u la t u sA n .je y p o r ie n s is
A n .m in i m u sA n .m a c u la tu s
H O U A P H A N
S A V A N N A K H E T
S A Y A B O U R Y
K H A M M O U A N E
C H A M P A S S A K
O U D O M X A Y
L U A N G P H R A B A N G
B O L I K H A M X A Y
S A R A V A N E
X I E N G K H O U A N G
S E K O N G
V I E N T I A N E
DISTRIBUTION OF MALARIA DISTRIBUTION OF MALARIA VECTORSVECTORS
P.phetsouvanh malaria situation update 2008
--
100100100100100100100100Saloy(XeponeSaloy(Xepone))An.dirusAn.dirus1616
Napho(NongNapho(Nong))An.dirusAn.dirus1515
100100100100100100100100Phiamayfarm(LamamPhiamayfarm(Lamam))An.dirusAn.dirus1414
--100100100100
100100100100100100
--100100100100
--100100100100
Toungnor(ThatengToungnor(Thateng))Toungnor(ThatengToungnor(Thateng))Toungnor(ThatengToungnor(Thateng))
An.dirusAn.dirusAn.aconitusAn.aconitusAn.maculatusAn.maculatus
1313
100100100100100100100100Pakvane(HilheupPakvane(Hilheup))An.nivipesAn.nivipes1212
100100100100100100100100NaNa--AngAng ((FuangFuang))An.minimusAn.minimus1111
100100100100100100100100Nampa(PaksaneNampa(Paksane))An.nivipesAn.nivipes1010
100100------NaNa--May(BolykanMay(Bolykan))An.nivipesAn.nivipes99
----
100100100100
100100--
100100--
Thamlay(XeybanfayThamlay(Xeybanfay))Thamlay(XeybanfayThamlay(Xeybanfay))
An.vagusAn.vagusAn.nivipesAn.nivipes
88
100100--
100100100100
94.7394.73--
100100--
KounephavanKounephavan((ThakeekThakeek))KounephavanKounephavan
An.vagusAn.vagus77
100100100100100100100100NaphoNapho ((PaksengPakseng))An.muculatusAn.muculatus66
--100100--100100NaNa--Yang (Yang (NambarNambar))An.minimusAn.minimus55
100100--
100100100100
----
--100100
Panekom(XayabulyPanekom(Xayabuly))An.jeyporiensisAn.jeyporiensisAn.maculatusAn.maculatus
44
100100100100100100--PakkemPakkem ((KenethaoKenethao))An.jeyporiensisAn.jeyporiensis33
100100--
100100++
100100--
100100--
Huangkuang1(Long)Huangkuang1(Long)An.maculatusAn.maculatusAn.minimusAn.minimus
22
100100100100100100100100DoneDone--May(SingMay(Sing))An.jeyporiensisAn.jeyporiensis11
ALPHACYPERMATHRINALPHACYPERMATHRIN30mg/m30mg/m22
DELTAMETHRINDELTAMETHRIN0.05%0.05%
DDTDDT4%4%
PERMETHRIN PERMETHRIN 0.75%0.75%
MORTALITEIS IN BIOASSAYS WITHMORTALITEIS IN BIOASSAYS WITHSTUDY SITESTUDY SITESPECIESSPECIESNoNo
P.phetsouvanh malaria situation update 2008
Achievements• Malaria is not ranking in the top ten diseases reported by
MoH• Malaria network is expanded from central down to village• A total of 3.4 Mio. People were protected under ITN• 88,38% of uncomplicated Pf were tested and treated
accordingly with RDT/CoArtem• 95,51% of severe Pf received Artesunate inj.• Malaria R4 was proposed for RCC.
P.phetsouvanh malaria situation update 2008
New innovatives• Initiation of PPM in 4 provinces of Laos (3 South
and 1 North)• Re-stratification of Malaria endemic areas with
NIMPE, Vietnam• Set up sentinel sites for malaria in 3
provinces(central, North and South)• Bed net survey under plan• Scaling up malaria control for EMG from 1
province to 5.• Quality assurance of RDT and ACT
P.phetsouvanh malaria situation update 2008
New innovatives(Cont’)• Set up QA on microscopy at 3 regional sites:
North, Central and South• Combat anti-malarial fake and substandard drug
under collaboration with FDD• Initialize motivation mechanism for VHV in
working for malaria.• Improve MIS and LIS at village, HC level, district
and province level.
P.phetsouvanh malaria situation update 2008
conclusions• Malaria has been much reduced and is not among the
10 to be reported diseases of MoH• New policies and strategy and intervention tools need to
be revised as malaria drops• Need for re-stratification of malaria endemic areas as
soon as possible• Concentrate all the efforts, budget and tools in high
malaria endemic foci in the South of Laos• Apply findings from new innovations to malaria
implementation
P.phetsouvanh malaria situation update 2008
Thank you
KHOP CHAYTHANK YOUKHOPKHOP CHAYCHAYTHANK YOUTHANK YOU