Yapabandara Manel A M G, Sarmento Raul, de Fatima Mota Maria do Rosario, don Bosco Johanes, Martins Nelson, Wickremasinghe Ananda R
Formerly World Health Organization, Dili, Timor Leste.
Ministry of Health, Dili, Timor Leste.
Malar J. 2015 Mar 11;14:109. doi: 10.1186/s12936-015-0614-6.
Malaria has been a major public health problem in the newly established Democratic Republic of Timor Leste with over 200,000 cases being reported in 2006 and 2007. The National Malaria Control Programme (NMCP) was established in 2003. The progress made in malaria control in Timor Leste is reported.
Records maintained at the NMCP, the district health services, the Health Information and Management System, the National Laboratory on malaria diagnosis and entomological data of the NMCP were reviewed.
There has been a 97% decrease in the reported malaria incidence from 2006 (223,002 cases) to 2012 (6,202 cases). 185,106 clinical cases reported in 2006 decreased to 2,016 in 2012 with introduction and expansion of malaria microscopy services and introduction of monovalent RDTs in 2008 and bivalent RDTs in 2010 in all parts of the country. The National Treatment Guidelines using ACT as the first-line treatment for Plasmodium falciparum infections and introduction of monovalent RDTs, led to a 42% and a 33% decrease from 2007 to 2008 in reported clinical and total malaria cases, respectively. LLINs were distributed initially to pregnant females and children under five and later per every two persons living in high-risk areas (based on microstratification at sub-district level). IRS was carried out in three districts in 2010 and extended to six districts in 2012. Anopheles barbirostris and Anopheles subpictus have been incriminated as malaria vectors. A National Laboratory, which routinely cross checks blood smears for quality assurance of microscopy was established. Malaria focal points at regional, district and sub district level, entomology surveillance staff, monitoring and evaluation officers, and quality control technicians were appointed to strengthen malaria control activities at all levels in the country.
The 97% decrease in the incidence of malaria in Timor Leste is due to application of evidence-based malaria control methods that included enhancing improved quality surveillance, early diagnosis and prompt treatment of cases with effective anti-malarials, targeted vector control, human resource development and deployment, commitment of staff, GFATM funding and technical assistance from WHO.
疟疾一直是新成立的东帝汶民主共和国的一个主要公共卫生问题，2006年和2007年报告的病例超过20万例。国家疟疾控制规划（NMCP）于2003年设立。本文报告了东帝汶在疟疾控制方面取得的进展。
查阅了NMCP、地区卫生服务机构、卫生信息与管理系统、国家疟疾诊断实验室以及NMCP的昆虫学数据所保存的记录。
从2006年（223,002例）到2012年（6,202例），报告的疟疾发病率下降了97%。随着疟疾显微镜检查服务的引入和扩展，以及2008年在全国所有地区引入单价快速诊断检测（RDT）和2010年引入双价RDT，2006年报告的185,106例临床病例在2012年降至2,016例。将以青蒿素联合疗法（ACT）作为恶性疟原虫感染的一线治疗方法的国家治疗指南以及单价RDT的引入，分别使2007年至2008年报告的临床疟疾病例和总疟疾病例减少了42%和33%。长效驱虫蚊帐（LLIN）最初分发给孕妇和五岁以下儿童，后来根据高危地区（基于分区层面的微观分层）每两人发放一顶。2010年在三个地区开展了室内滞留喷洒（IRS），2012年扩展到六个地区。已确认巴拉望按蚊和伪威氏按蚊为疟疾传播媒介。建立了一个国家实验室，该实验室定期对血涂片进行交叉检查以确保显微镜检查的质量。在区域、地区和分区层面任命了疟疾协调员、昆虫学监测人员、监测与评估官员以及质量控制技术人员，以加强该国各级的疟疾控制活动。
东帝汶疟疾发病率下降97%归因于采用了基于证据的疟疾控制方法，包括加强改进质量监测、对病例进行早期诊断并使用有效的抗疟药物进行及时治疗、有针对性的病媒控制、人力资源开发与部署、工作人员的投入、全球抗击艾滋病、结核病和疟疾基金（GFATM）的资金以及世界卫生组织的技术援助。
