• Case management of malaria in Swaziland, 2011-2015: on track for elimination?

      Dlamini, SV; Kosgei, RJ; Mkhonta, N; Zulu, Z; Makadzange, K; Zhou, S; Owiti, P; Sikhondze, W; Namboze, J; Reid, A; et al. (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Objective: To assess adherence to malaria diagnosis and treatment guidelines (2010 and 2014) in all health care facilities in Swaziland between 2011 and 2015. Methods: This was a cross-sectional descriptive study involving all health care facilities that diagnosed and managed malaria cases in Swaziland. Patients' age, sex, diagnosis method and type of treatment were analysed. Results: Of 1981 records for severe and uncomplicated malaria analysed, 56% of cases were uncomplicated and 14% had severe malaria. The type of malaria was not recorded for 30% of cases. Approximately 71% of cases were confirmed by rapid diagnostic tests (RDT) alone, 3% by microscopy alone and 26% by both RDT and microscopy. Of the uncomplicated cases, 93% were treated with artemether-lumefantrine (AL) alone, 5% with quinine alone and 2% with AL and quinine. Amongst the severe cases, 11% were treated with AL alone, 44% with quinine alone and 45% with AL and quinine. For severe malaria, clinics and health centres prescribed AL alone more often than hospitals (respectively 13%, 12% and 4%, P = 0.03). Conclusion: RDTs and/or microscopy results are used at all facilities to inform treatment. Poor recording of malaria type causes difficulties in assessing the prescription of antimalarial drugs.
    • Changing distribution and abundance of the malaria vector Anopheles merus in Mpumalanga Province, South Africa

      Mbokazi, F; Coetzee, M; Brooke, B; Govere, J; Reid, A; Owiti, P; Kosgei, R; Zhou, S; Magagula, R; Kok, G; et al. (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Background: The malaria vector Anopheles merus occurs in the Mpumalanga Province of South Africa. As its contribution to malaria transmission in South Africa has yet to be ascertained, an intensification of surveillance is necessary to provide baseline information on this species. The aim of this study was therefore to map An. merus breeding sites in the Ehlanzeni District of Mpumalanga Province and to assess qualitative trends in the distribution and relative abundance of this species over a 9-year period. Methods: The study was carried out during the period 2005-2014 in the four high-risk municipalities of Ehlanzeni District. Fifty-two breeding sites were chosen from all water bodies that produced anopheline mosquitoes. The study data were extracted from historical entomological records that are captured monthly. Results: Of the 15 058 Anopheles mosquitoes collected, 64% were An. merus. The abundance and distribution of An. merus increased throughout the four municipalities in Ehlanzeni District during the study period. Conclusion: The expanded distribution and increased abundance of An. merus in the Ehlanzeni District may contribute significantly to locally acquired malaria in Mpumalanga Province, likely necessitating the incorporation of additional vector control methods specifically directed against populations of this species.
    • Engagement of Public and Private Medical Facilities in Tuberculosis Care in Myanmar: Contributions and Trends Over an Eight-Year Period

      Nwe, T; Saw, S; Le Win, L; Mon, M; van Griensven, J; Zhou, S; Chinnakali, P; Shah, S; Thein, S; Aung, S (BioMed Central, 2017-09-01)
      As part of the WHO End TB strategy, national tuberculosis (TB) programs increasingly aim to engage all private and public TB care providers. Engagement of communities, civil society organizations and public and private care provider is the second pillar of the End TB strategy. In Myanmar, this entails the public-public and public-private mix (PPM) approach. The public-public mix refers to public hospital TB services, with reporting to the national TB program (NTP). The public-private mix refers to private general practitioners providing TB services including TB diagnosis, treatment and reporting to NTP. The aim of this study was to assess whether PPM activities can be scaled-up nationally and can be sustained over time.
    • International Non-Governmental Organizations' Provision of Community-Based Tuberculosis Care for Hard-To-Reach Populations in Myanmar, 2013-2014

      Soe, KT; Saw, S; van Griensven, J; Zhou, S; Win, L; Chinnakali, P; Shah, S; Mon, MM; Aung, ST (BioMed Central, 2017-03-24)
      National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection.
    • Malaria profiles and challenges in artemisinin resistance containment in Myanmar

      Nwe, TW; Oo, T; Wai, KT; Zhou, S; van Griensven, J; Chinnakali, P; Shah, S; Thi, A (BioMed Central, 2017-04-25)
      This study examined evolving malaria profiles from January, 2010 to December, 2014 to evaluate achievements and challenges of implementing measures to prevent and control spread of artemisinin resistance in Myanmar.