Malaria situation in Pailin, Cambodia

Naga World Hotel Phnom Penh

21-22 March 2013

Annual conference on Malaria

Presentation Outline

Geography

• Location: 376 km Northwest of Phnom Penh, and 86 km from Battambang Province.

• Surface : 1,097.66 km²

• Population : 70,486 persons(2012)

• Borderland : North, East and South bordering with Battambang province of Cambodia and West bordering with Chanthaburi, Thailand

• The international check-point (Prom check-point) to against to Ban Phakat check-point of Pongnamron, Chanthaburi in Thailand.

Pailin has 1 city and 1 district, 8 Communes, 83 administrative villages and 31 annexed villages.

Health facility coverage : – 1 PHD

– 1 RH

– 6 HCs

– 114Villages= 184VHV, and 225 VMWs working in all Villages, and

– 45 farm owners with MMWs for 30 Villages

Malaria Achievements

in Pailin

Early Diagnosis And Treatment (EDAT)

Strengthen public health facilities providing 24H services for malaria (1 RH & 6 HCs)

Diagnose malaria by RDT at community, and by microscope at HFs

Treat malaria with recommended Anti-malaria drugs (Ex. first line for Duo-cotexcin, Malarone, and second line for Quinine & Tetra,…)

Promote private sector engagement in malaria control ( Private & Public Mixed = PPM)

EDAT (Continued)

92 VMWs in 46 villages supported by FHI360 and other 67 villages supported by MC with 133 VMWs (New VMWs were upgraded from VHSGs in the village)

45 MMWs in 30 villages selected and trained to provide early diagnosis and treatment and also health education to mobile and migrant populations at the farms.

Rapidly Detected and treated the malaria through outreach activities by HC staffs.

Operational research/Study

Therapeutic Efficacy Study (TES on Malaria

drugs).

Follow-up of malaria treatment with Malarone

(Pilot Project).

G6PD rapid test Study .

Entomology study, etc.

Cross-border Activities

• Joint cross border meeting at national levels on malaria control and prevention (reference from the meeting result at Bangkok and Siem Reap).

• Joint World Malaria Day (25 April).

• Screening migrant workers at malaria post, at the border check-point.

• Cross-border meeting with Chanthaburi PHO/ Pongnamron (Twin-Cities) on malaria ( ID patient card at the border used).

• Harmonized and Joint BCC bi-lingual materials pre-testing

10

LLIN distribution & Re-impregnation

Tend of Treated, Severe and Death

Cases in Pailin from 2004-2012

7888

8695 8623

1454 1365 14081027

785504

282203 169 231

82 46 12

13 2115 4 1 1 2 0 0 0 00

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

2004 2005 2006 2007 2008 2009 2010 2011 2012

Tot Cases Severe Cases Death Cases

Malaria Incidence & Mortality Rate in

Pailin from 2004-2012

( Health Facility and VMW )

158

174

147

29 23 2117

11 9

30

82 2 4

0 0 0 00

20

40

60

80

100

120

140

160

180

200

2004 2005 2006 2007 2008 2009 2010 2011 2012

Tre

ated

Cas

es/1

,000

Incidence Rate/1000 Mortality/100,000

Parasite Species Distribution, 2011-2012

Pf 17%

Pv 74%

Mixt 9%

Pf13%

Pv74%

Mix13%

2011 2012

Spacies Trent, 2006-2012 Pailin

0

1000

2000

3000

4000

5000

6000

7000

2006 2007 2008 2009 2010 2011 2012

PF PV MIXT

Malaria cases for mobile and

permanent people in Pailin, 2012

583

989

165227

0

200

400

600

800

1000

1200

Mobile Permanent

Tested

Positive

Malaria cases by age and sex

Pailin, 2012

420

251

131

18

68

17

0

50

100

150

200

250

300

0-4yr 5-14yr 15-49yr >49yr

Male

Female

Identification of Success Factors

1-Malaria Case Management :

Encourage malaria treatment based on parasitological

confirmation (RDT/microscope)

Ban prescribing/selling Artemisinin derivative monotherapy to

patient

Refer malaria cases from private sectors to public health

facilities and to VMWs/MMWs.

2-Prevention :

Full ITN coverage for local population,

LLIN coverage for mobile and migrant population,

Re-impregnation of existing conventional nets, IRS, ..

Health Education.

3-Partnership

MOH/CNM

WHO

Local authorities and community volunteers

URC/CAP-Malaria

Malaria Consortium (MC)

FHI-360 and other partners

Thai counterparts.

Institutional Development, Program Management

Development of comprehensive AOP.

Regular Supervision & Monitoring on actual implementation

(for both public and private sectors).

Supply system (Test and drugs) and Emergency response.

Quality Assurance (Q/A) of malaria microscopy.

Trainings, meetings and workshops on specific and relevant

topics to health staffs, community volunteers and all partners.

Program coordination under guidance from MoH/CNM.

Program reporting and dissemination of the results.

Challenges •

•

•

•

Some Activities by

photo

Delegation of WHO and MOH Visited Phnom Dambang village (VMW)

Delegation of WHO and MOH Visited Krochab HC

Delegation of WHO and MOH Visited Farm owners and workers

Delegation of WHO and MOH Visited Pharmacy store

Pro-SWG meeting for Malaria elimination

World Malaria Day with Thai delegation

LLIN/LLIHN distribution in Pailin for 2012

Supervision on LLIN/LLIHN used at the village

Training on malaria diagosis and treatment to health staffs

Training on Malaria diagosis and treatment to VMW/MMW

Monthly meeting with VMWs/MMWs

Bi-monthly meeting with VHSG (Village Health Supporting Group)

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Thank you for your attendant !