Background:The China-Myanmar border region presents a great challenge in malaria elimination in China,and it is essential to understand the relationship between malaria vulnerability and population mobility in this re...Background:The China-Myanmar border region presents a great challenge in malaria elimination in China,and it is essential to understand the relationship between malaria vulnerability and population mobility in this region.Methods:A community-based,cross-sectional survey was performed in five villages of Yingjiang county during September 2016.Finger-prick blood samples were obtained to identify asymptomatic infections,and imported cases were identified in each village(between January 2013 and September 2016).A stochastic simulation model(SSM)was used to test the relationship between population mobility and malaria vulnerability,according to the mechanisms of malaria importation.Results:Thirty-two imported cases were identified in the five villages,with a 4-year average of 1 case/year(range:0-5 cases/year).No parasites were detected in the 353 blood samples from 2016.The median density of malaria vulnerability was 0.012(range:0.000-0.033).The average proportion of mobile members of the study population was 32.56%(range:28.38-71.95%).Most mobile individuals lived indoors at night with mosquito protection.The SSM model fit the investigated data(χ2=0.487,P=0.485).The average probability of infection in the members of the population that moved to Myanmar was 0.011(range:0.0048-0.1585).The values for simulated vulnerability increased with greater population mobility in each village.Conclusions:A high proportion of population mobility was associated with greater malaria vulnerability in the China-Myanmar border region.Mobile population-specific measures should be used to decrease the risk of malaria re-establishment in China.展开更多
Background:This paper seeks to assess the function of malaria control consultation and service posts(MCCSPs)that are located on the border areas of Yunnan province,P.R.China,as a strategy for eliminating malaria among...Background:This paper seeks to assess the function of malaria control consultation and service posts(MCCSPs)that are located on the border areas of Yunnan province,P.R.China,as a strategy for eliminating malaria among the mobile and migrant population in these areas.Methods:A retrospective descriptive analytical study was conducted.Blood smear examinations conducted at all MCCSPs in Yunnan from 2008 to 2014 were analysed.A cross-sectional survey was conducted in 2014 to understand how the MCCSPs function and to elucidate the quality of the blood smear examinations that they conduct.Results:Out of the surveyed MCCSPs,66%(39/59),22%(13/59),and 12%(7/59)were attached to local township hospitals,village health clinics,and the county centre for disease control and prevention or private clinics,respectively.More than 64%(38/59)of the posts’staff were part-time workers from township hospitals and village health facilities.Less than 31%(18/59)of the posts’staff were full-time workers.A total of 35 positive malaria cases were reported from seven MCCSPs in 2014.Four MCCSPs were unable to perform their functions due to under staffing in 2014.There was a small fluctuation in blood smear examinations from January 2008 to June 2009,with two peaks during the period from July 2009 to October 2010.The number of blood smear examinations has been increasing since 2011.The yearly mean number of blood smear examinations in each post increased from 44 per month in 2011 to 109 per month in 2014,and the number of positive malaria cases detected by blood smear examinations has declined(χ^(2)=90.67,P=0.000).The percentage of people from Yingjiang county getting blood smear examinations increased between 2008 and 2014,while percentages of the mobile population including Myanmar people,people from other provinces,and people from other Yunnan counties getting blood smear examinations decreased.Conclusion:MCCSPs face challenges in the phase of malaria elimination in Yunnan,China.New case detection strategies should be designed for MCCSPs taking into account the current trends of migration.展开更多
Background:In Cambodia,internal migration involves migrants moving from non-malaria endemic areas to malaria endemic areas and vice versa.The majority of them work in farms or forests with various malaria transmission...Background:In Cambodia,internal migration involves migrants moving from non-malaria endemic areas to malaria endemic areas and vice versa.The majority of them work in farms or forests with various malaria transmission levels.In Cambodia,as one of the national approaches to ensure LLIN accessibility and use among mobile and migrant populations(MMPs),a lending scheme of long lasting insecticide treated nets(LLINs)was initiated among farm workers.Through this net lending program,LLINs and long-lasting insecticide treated hammock nets(LLIHNs)will be distributed annually at workplace(e.g.longstanding farms,plantations,industrial sites,as identified by operational district and health center staff)on a ratio of one LLIN per one worker.The main objective of this study is to assess MMPs’accessibility to LLINs through a lending scheme with plantation owners in remote malaria endemic areas of Cambodia.Methods:The study used a cross-sectional survey among MMPs using two-stage cluster sampling method.The sampling frame is the list of farms in the four provinces of Banteay Meanchey,Battambang,Pailin,and Pursat in western and northwestern Cambodia bordering with Thailand where the LLIN lending scheme was implemented and where an estimated 100000 MMPs worked annually.The assessment was carried out from January to February 2013 in these four provinces.It was estimated that 768 workers would be required.Results:A total of 702 MMPs were interviewed.The ratio of male:female is 1:1.The age group of 21-60 was the largest accounting for 77.6%.About 91%of the MMPs stayed on the farm for less than 6 months.93.2%of them owned either untreated or insecticide treated nets.LLINs and LLIHNs accounted for 89.5%;and 46.6%of them borrowed the nets from a lending scheme.Among those workers who have LLINs/LLIHNs,99%slept under LLINs/LLIHNs the night before.However,only 87.4%knew that sleeping under LLINs/LLIHNs protects against malaria.Conclusions:LLIN lending scheme provides an important delivery channel for a substantial percentage of net accessibility(46.6%)to the Cambodian national free-net distribution campaign in remote malaria endemic areas.展开更多
Although the Lao People’s Democratic Republic(Lao PDR)is comparatively small landlocked country with patterns of both in-and out-migration,its human migration situation has been poorly studied.This is despite all of ...Although the Lao People’s Democratic Republic(Lao PDR)is comparatively small landlocked country with patterns of both in-and out-migration,its human migration situation has been poorly studied.This is despite all of the country’s 18 provinces sharing both official and unofficial border checkpoints with neighboring countries.Economic reforms in the last decade have seen a gradual increase in the promotion of foreign investment,and main towns and transportation networks have been expanding thus offering new opportunities for livelihoods and economic activities.In the last decade,there has also been a significant reduction of reported malaria cases in Lao PDR and while this is an important prerequisite for eliminating malaria in the country,malaria outbreaks reported in the last four years suggest that population mobility,particularly in the south,is an important factor challenging current control efforts.Bolder investment in social sector spending should be geared towards improving health service provision and utilization,ensuring equitable access to primary health care(including malaria)through efforts to achieve universal health coverage targets.This should be extended to populations that are mobile and migrants.The local government plays a critical role in supporting policy and enforcement issues related to private sector project development in the provinces.Cross-border initiatives with neighboring countries,especially in terms of data sharing,surveillance,and response,is essential.Mechanisms to engage the private sector,especially the informal private sector,needs to be explored within the context of existing regulations and laws.Existing and new interventions for outdoor transmission of malaria,especially in forest settings,for high-risk groups including short-and long-term forest workers and their families,mobile and migrant populations,as well as the military must be combined into integrated packages with innovative delivery mechanisms through social marketing approaches.This should happen at multiple points in the mobility pathway and involve the private sector rather than being fully reliant on the national malaria vertical program This article based on the review of existing literature from abstracts and full texts,includes published,peer-reviewed English language literature sourced through PubMed and grey literature sources through Google and Google Scholar.The review included also case reports,sector reports,conference proceedings,research reports,epidemiology studies,qualitative studies,and census reports in both Lao and English languages.The authors used the search terms:malaria and mobile populations,malaria control program and elimination,health system performance,malaria outbreak,Lao PDR;and included articles published until June 2015.展开更多
基金This work was supported by Scientific Project of Shanghai Municipal Commission of Health and Family Planning(No.20164Y0047).
文摘Background:The China-Myanmar border region presents a great challenge in malaria elimination in China,and it is essential to understand the relationship between malaria vulnerability and population mobility in this region.Methods:A community-based,cross-sectional survey was performed in five villages of Yingjiang county during September 2016.Finger-prick blood samples were obtained to identify asymptomatic infections,and imported cases were identified in each village(between January 2013 and September 2016).A stochastic simulation model(SSM)was used to test the relationship between population mobility and malaria vulnerability,according to the mechanisms of malaria importation.Results:Thirty-two imported cases were identified in the five villages,with a 4-year average of 1 case/year(range:0-5 cases/year).No parasites were detected in the 353 blood samples from 2016.The median density of malaria vulnerability was 0.012(range:0.000-0.033).The average proportion of mobile members of the study population was 32.56%(range:28.38-71.95%).Most mobile individuals lived indoors at night with mosquito protection.The SSM model fit the investigated data(χ2=0.487,P=0.485).The average probability of infection in the members of the population that moved to Myanmar was 0.011(range:0.0048-0.1585).The values for simulated vulnerability increased with greater population mobility in each village.Conclusions:A high proportion of population mobility was associated with greater malaria vulnerability in the China-Myanmar border region.Mobile population-specific measures should be used to decrease the risk of malaria re-establishment in China.
基金China UK Global Health Support programme(GHSP-OP101)for financial support.
文摘Background:This paper seeks to assess the function of malaria control consultation and service posts(MCCSPs)that are located on the border areas of Yunnan province,P.R.China,as a strategy for eliminating malaria among the mobile and migrant population in these areas.Methods:A retrospective descriptive analytical study was conducted.Blood smear examinations conducted at all MCCSPs in Yunnan from 2008 to 2014 were analysed.A cross-sectional survey was conducted in 2014 to understand how the MCCSPs function and to elucidate the quality of the blood smear examinations that they conduct.Results:Out of the surveyed MCCSPs,66%(39/59),22%(13/59),and 12%(7/59)were attached to local township hospitals,village health clinics,and the county centre for disease control and prevention or private clinics,respectively.More than 64%(38/59)of the posts’staff were part-time workers from township hospitals and village health facilities.Less than 31%(18/59)of the posts’staff were full-time workers.A total of 35 positive malaria cases were reported from seven MCCSPs in 2014.Four MCCSPs were unable to perform their functions due to under staffing in 2014.There was a small fluctuation in blood smear examinations from January 2008 to June 2009,with two peaks during the period from July 2009 to October 2010.The number of blood smear examinations has been increasing since 2011.The yearly mean number of blood smear examinations in each post increased from 44 per month in 2011 to 109 per month in 2014,and the number of positive malaria cases detected by blood smear examinations has declined(χ^(2)=90.67,P=0.000).The percentage of people from Yingjiang county getting blood smear examinations increased between 2008 and 2014,while percentages of the mobile population including Myanmar people,people from other provinces,and people from other Yunnan counties getting blood smear examinations decreased.Conclusion:MCCSPs face challenges in the phase of malaria elimination in Yunnan,China.New case detection strategies should be designed for MCCSPs taking into account the current trends of migration.
文摘Background:In Cambodia,internal migration involves migrants moving from non-malaria endemic areas to malaria endemic areas and vice versa.The majority of them work in farms or forests with various malaria transmission levels.In Cambodia,as one of the national approaches to ensure LLIN accessibility and use among mobile and migrant populations(MMPs),a lending scheme of long lasting insecticide treated nets(LLINs)was initiated among farm workers.Through this net lending program,LLINs and long-lasting insecticide treated hammock nets(LLIHNs)will be distributed annually at workplace(e.g.longstanding farms,plantations,industrial sites,as identified by operational district and health center staff)on a ratio of one LLIN per one worker.The main objective of this study is to assess MMPs’accessibility to LLINs through a lending scheme with plantation owners in remote malaria endemic areas of Cambodia.Methods:The study used a cross-sectional survey among MMPs using two-stage cluster sampling method.The sampling frame is the list of farms in the four provinces of Banteay Meanchey,Battambang,Pailin,and Pursat in western and northwestern Cambodia bordering with Thailand where the LLIN lending scheme was implemented and where an estimated 100000 MMPs worked annually.The assessment was carried out from January to February 2013 in these four provinces.It was estimated that 768 workers would be required.Results:A total of 702 MMPs were interviewed.The ratio of male:female is 1:1.The age group of 21-60 was the largest accounting for 77.6%.About 91%of the MMPs stayed on the farm for less than 6 months.93.2%of them owned either untreated or insecticide treated nets.LLINs and LLIHNs accounted for 89.5%;and 46.6%of them borrowed the nets from a lending scheme.Among those workers who have LLINs/LLIHNs,99%slept under LLINs/LLIHNs the night before.However,only 87.4%knew that sleeping under LLINs/LLIHNs protects against malaria.Conclusions:LLIN lending scheme provides an important delivery channel for a substantial percentage of net accessibility(46.6%)to the Cambodian national free-net distribution campaign in remote malaria endemic areas.
文摘Although the Lao People’s Democratic Republic(Lao PDR)is comparatively small landlocked country with patterns of both in-and out-migration,its human migration situation has been poorly studied.This is despite all of the country’s 18 provinces sharing both official and unofficial border checkpoints with neighboring countries.Economic reforms in the last decade have seen a gradual increase in the promotion of foreign investment,and main towns and transportation networks have been expanding thus offering new opportunities for livelihoods and economic activities.In the last decade,there has also been a significant reduction of reported malaria cases in Lao PDR and while this is an important prerequisite for eliminating malaria in the country,malaria outbreaks reported in the last four years suggest that population mobility,particularly in the south,is an important factor challenging current control efforts.Bolder investment in social sector spending should be geared towards improving health service provision and utilization,ensuring equitable access to primary health care(including malaria)through efforts to achieve universal health coverage targets.This should be extended to populations that are mobile and migrants.The local government plays a critical role in supporting policy and enforcement issues related to private sector project development in the provinces.Cross-border initiatives with neighboring countries,especially in terms of data sharing,surveillance,and response,is essential.Mechanisms to engage the private sector,especially the informal private sector,needs to be explored within the context of existing regulations and laws.Existing and new interventions for outdoor transmission of malaria,especially in forest settings,for high-risk groups including short-and long-term forest workers and their families,mobile and migrant populations,as well as the military must be combined into integrated packages with innovative delivery mechanisms through social marketing approaches.This should happen at multiple points in the mobility pathway and involve the private sector rather than being fully reliant on the national malaria vertical program This article based on the review of existing literature from abstracts and full texts,includes published,peer-reviewed English language literature sourced through PubMed and grey literature sources through Google and Google Scholar.The review included also case reports,sector reports,conference proceedings,research reports,epidemiology studies,qualitative studies,and census reports in both Lao and English languages.The authors used the search terms:malaria and mobile populations,malaria control program and elimination,health system performance,malaria outbreak,Lao PDR;and included articles published until June 2015.
