Malaria incidence in Myanmar 2005-2014

Steady but fragile progress towards elimination

Thet Thet Mu, Aye Aye Sein, Tint Tint Kyi, Myo Min, Ne Myo Aung, Nicholas M. Anstey, Myat Phone Kyaw, Chit Soe, Mar Mar Kyi, Josh Hanson

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    Abstract

    Background: There has been an impressive recent reduction in the global incidence of malaria, but the development of artemisinin resistance in the Greater Mekong Region threatens this progress. Increasing artemisinin resistance is particularly important in Myanmar, as it is the country in the Greater Mekong Region with the greatest malaria burden. If malaria is to be eliminated in the region, it is essential to define the spatial and temporal epidemiology of the disease in Myanmar to inform control strategies optimally.

    Results: Between the years 2005 and 2014 there was an 81.1 % decline in the reported annual incidence of malaria in Myanmar (1341.8 cases per 100,000 population to 253.3 cases per 100,000 population). In the same period, there was a 93.5 % decline in reported annual mortality from malaria (3.79 deaths per 100,000 population to 0.25 deaths per 100,000 population) and a 87.2 % decline in the proportion of hospitalizations due to malaria (7.8 to 1.0 %). Chin State had the highest reported malaria incidence and mortality at the end of the study period, although socio-economic and geographical factors appear a more likely explanation for this finding than artemisinin resistance. The reduced malaria burden coincided with significant upscaling of disease control measures by the national government with support from international partners. These programmes included the training and deployment of over 40,000 community health care workers, the coverage of over 60 % of the at-risk population with insecticide-treated bed nets and significant efforts to improve access to artemesinin-based combination treatment. Beyond these malaria-specific programmes, increased general investment in the health sector, changing population demographics and deforestation are also likely to have contributed to the decline in malaria incidence seen over this time.

    Conclusions: There has been a dramatic fall in the burden of malaria in Myanmar since 2005. However, with the rise of artemisinin resistance, continued political, financial and scientific commitment is required if the ambitious goal of malaria elimination in the country is to be realized.

    Original languageEnglish
    Article number503
    Pages (from-to)1-9
    Number of pages9
    JournalMalaria Journal
    Volume15
    Issue number1
    DOIs
    Publication statusPublished - 18 Oct 2016

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    Myanmar
    Malaria
    Incidence
    Population
    Insecticide-Treated Bednets
    Community Health Services
    Chin
    Federal Government
    Mortality
    Conservation of Natural Resources

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    Mu, Thet Thet ; Sein, Aye Aye ; Kyi, Tint Tint ; Min, Myo ; Aung, Ne Myo ; Anstey, Nicholas M. ; Kyaw, Myat Phone ; Soe, Chit ; Kyi, Mar Mar ; Hanson, Josh. / Malaria incidence in Myanmar 2005-2014 : Steady but fragile progress towards elimination. In: Malaria Journal. 2016 ; Vol. 15, No. 1. pp. 1-9.
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    title = "Malaria incidence in Myanmar 2005-2014: Steady but fragile progress towards elimination",
    abstract = "Background: There has been an impressive recent reduction in the global incidence of malaria, but the development of artemisinin resistance in the Greater Mekong Region threatens this progress. Increasing artemisinin resistance is particularly important in Myanmar, as it is the country in the Greater Mekong Region with the greatest malaria burden. If malaria is to be eliminated in the region, it is essential to define the spatial and temporal epidemiology of the disease in Myanmar to inform control strategies optimally. Results: Between the years 2005 and 2014 there was an 81.1 {\%} decline in the reported annual incidence of malaria in Myanmar (1341.8 cases per 100,000 population to 253.3 cases per 100,000 population). In the same period, there was a 93.5 {\%} decline in reported annual mortality from malaria (3.79 deaths per 100,000 population to 0.25 deaths per 100,000 population) and a 87.2 {\%} decline in the proportion of hospitalizations due to malaria (7.8 to 1.0 {\%}). Chin State had the highest reported malaria incidence and mortality at the end of the study period, although socio-economic and geographical factors appear a more likely explanation for this finding than artemisinin resistance. The reduced malaria burden coincided with significant upscaling of disease control measures by the national government with support from international partners. These programmes included the training and deployment of over 40,000 community health care workers, the coverage of over 60 {\%} of the at-risk population with insecticide-treated bed nets and significant efforts to improve access to artemesinin-based combination treatment. Beyond these malaria-specific programmes, increased general investment in the health sector, changing population demographics and deforestation are also likely to have contributed to the decline in malaria incidence seen over this time. Conclusions: There has been a dramatic fall in the burden of malaria in Myanmar since 2005. However, with the rise of artemisinin resistance, continued political, financial and scientific commitment is required if the ambitious goal of malaria elimination in the country is to be realized.",
    keywords = "Artemisinin resistance, Epidemiology, Greater Mekong Region, Malaria, Myanmar, Public health",
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    Mu, TT, Sein, AA, Kyi, TT, Min, M, Aung, NM, Anstey, NM, Kyaw, MP, Soe, C, Kyi, MM & Hanson, J 2016, 'Malaria incidence in Myanmar 2005-2014: Steady but fragile progress towards elimination', Malaria Journal, vol. 15, no. 1, 503, pp. 1-9. https://doi.org/10.1186/s12936-016-1567-0

    Malaria incidence in Myanmar 2005-2014 : Steady but fragile progress towards elimination. / Mu, Thet Thet; Sein, Aye Aye; Kyi, Tint Tint; Min, Myo; Aung, Ne Myo; Anstey, Nicholas M.; Kyaw, Myat Phone; Soe, Chit; Kyi, Mar Mar; Hanson, Josh.

    In: Malaria Journal, Vol. 15, No. 1, 503, 18.10.2016, p. 1-9.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Malaria incidence in Myanmar 2005-2014

    T2 - Steady but fragile progress towards elimination

    AU - Mu, Thet Thet

    AU - Sein, Aye Aye

    AU - Kyi, Tint Tint

    AU - Min, Myo

    AU - Aung, Ne Myo

    AU - Anstey, Nicholas M.

    AU - Kyaw, Myat Phone

    AU - Soe, Chit

    AU - Kyi, Mar Mar

    AU - Hanson, Josh

    N1 - National Health and Medical Research Council of Australia (Program Grant 1037304 and Fellowships to NA [1042072] and JH [1054195]).

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    N2 - Background: There has been an impressive recent reduction in the global incidence of malaria, but the development of artemisinin resistance in the Greater Mekong Region threatens this progress. Increasing artemisinin resistance is particularly important in Myanmar, as it is the country in the Greater Mekong Region with the greatest malaria burden. If malaria is to be eliminated in the region, it is essential to define the spatial and temporal epidemiology of the disease in Myanmar to inform control strategies optimally. Results: Between the years 2005 and 2014 there was an 81.1 % decline in the reported annual incidence of malaria in Myanmar (1341.8 cases per 100,000 population to 253.3 cases per 100,000 population). In the same period, there was a 93.5 % decline in reported annual mortality from malaria (3.79 deaths per 100,000 population to 0.25 deaths per 100,000 population) and a 87.2 % decline in the proportion of hospitalizations due to malaria (7.8 to 1.0 %). Chin State had the highest reported malaria incidence and mortality at the end of the study period, although socio-economic and geographical factors appear a more likely explanation for this finding than artemisinin resistance. The reduced malaria burden coincided with significant upscaling of disease control measures by the national government with support from international partners. These programmes included the training and deployment of over 40,000 community health care workers, the coverage of over 60 % of the at-risk population with insecticide-treated bed nets and significant efforts to improve access to artemesinin-based combination treatment. Beyond these malaria-specific programmes, increased general investment in the health sector, changing population demographics and deforestation are also likely to have contributed to the decline in malaria incidence seen over this time. Conclusions: There has been a dramatic fall in the burden of malaria in Myanmar since 2005. However, with the rise of artemisinin resistance, continued political, financial and scientific commitment is required if the ambitious goal of malaria elimination in the country is to be realized.

    AB - Background: There has been an impressive recent reduction in the global incidence of malaria, but the development of artemisinin resistance in the Greater Mekong Region threatens this progress. Increasing artemisinin resistance is particularly important in Myanmar, as it is the country in the Greater Mekong Region with the greatest malaria burden. If malaria is to be eliminated in the region, it is essential to define the spatial and temporal epidemiology of the disease in Myanmar to inform control strategies optimally. Results: Between the years 2005 and 2014 there was an 81.1 % decline in the reported annual incidence of malaria in Myanmar (1341.8 cases per 100,000 population to 253.3 cases per 100,000 population). In the same period, there was a 93.5 % decline in reported annual mortality from malaria (3.79 deaths per 100,000 population to 0.25 deaths per 100,000 population) and a 87.2 % decline in the proportion of hospitalizations due to malaria (7.8 to 1.0 %). Chin State had the highest reported malaria incidence and mortality at the end of the study period, although socio-economic and geographical factors appear a more likely explanation for this finding than artemisinin resistance. The reduced malaria burden coincided with significant upscaling of disease control measures by the national government with support from international partners. These programmes included the training and deployment of over 40,000 community health care workers, the coverage of over 60 % of the at-risk population with insecticide-treated bed nets and significant efforts to improve access to artemesinin-based combination treatment. Beyond these malaria-specific programmes, increased general investment in the health sector, changing population demographics and deforestation are also likely to have contributed to the decline in malaria incidence seen over this time. Conclusions: There has been a dramatic fall in the burden of malaria in Myanmar since 2005. However, with the rise of artemisinin resistance, continued political, financial and scientific commitment is required if the ambitious goal of malaria elimination in the country is to be realized.

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    KW - Epidemiology

    KW - Greater Mekong Region

    KW - Malaria

    KW - Myanmar

    KW - Public health

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