Wen Shawn, Harvard Kelly E, Gueye Cara Smith, Canavati Sara E, Chancellor Arna, Ahmed Be-Nazir, Leaburi John, Lek Dysoley, Namgay Rinzin, Surya Asik, Thakur Garib D, Whittaker Maxine Anne, Gosling Roly D
Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA.
Centre for Biomedical Research, Burnet Institute, 85 Commercial Road, Melbourne, VIC, Australia.
Malar J. 2016 May 10;15(1):271. doi: 10.1186/s12936-016-1319-1.
Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission.
A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN).
All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure.
Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.
亚太地区在减轻疟疾负担方面取得了重大进展，该地区正在积极追求2030年区域消除疟疾的目标。从疟疾控制转向消除疟疾，要求国家疟疾控制规划（NMCPs）将干预措施针对高风险人群，这些人群往往无法获得卫生服务，流动性高，难以通过常规措施进行检测、治疗和追踪，而且如果未被诊断，可能会维持寄生虫库并导致持续传播。
制定了一份定性的自由文本问卷，并在亚太疟疾消除网络（APMEN）的18个伙伴国家中的17个国家进行了分发。
所有14个回复调查的国家都确定了各自国家中疟疾高风险的关键人群。13个国家参与了疟疾相关信息、教育和宣传（IEC）材料的传播。8个国家进行诊断筛查，包括对流动和移民工人、军事人员和/或海外工人的筛查。10个国家报告在高风险人群中分发或推荐使用长效驱虫蚊帐（LLINs），而较少国家采用其他预防措施，如室内滞留喷洒（IRS）（2个国家）、空间驱避剂（4个国家）、化学预防（5个国家）和大规模药物管理（MDA）（3个国家）。尽管并非专门针对高风险人群，但11个国家报告使用大规模血液调查作为监测工具，10个国家绘制病例数据图。大多数国家疟疾控制规划缺乏监测和评价结构。
亚太地区各国已确定高风险人群，并针对这些群体采取了干预措施，但关于这些干预措施有效性的信息有限。像亚太疟疾消除网络这样的平台提供了分享与发现、针对和成功清除高风险人群中的疟疾相关的方案和经验教训的机会。跨境共享方案数据可能会进一步加强国家和区域消除疟疾的努力。当缺乏关于该主题的科学证据来辅助决策时，这种实际经验的交流对国家疟疾控制规划来说是非常宝贵的，并且可以进一步支持国家疟疾控制规划制定战略，以在2030年前实现无疟疾的亚太地区。
