Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific

Wen, Shawn, Harvard, Kelly E., Smith Gueye, Cara, Canavati, Sara E., Chancellor, Arna, Ahmed, Be-Nazir, Leaburi, John, Lek, Desoley, Namgay, Rinzin, Surya, Asik, Thakur, Garib D., Whittaker, Maxine Anne, and Gosling, Roly D. (2016) Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific. Malaria Journal, 15. 271. pp. 1-14.

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Background: 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.

Methods: A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN).

Results: 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.

Conclusion: 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.

Item ID: 44242
Item Type: Article (Research - C1)
ISSN: 1475-2875
Keywords: malaria elimination; high-risk populations; mobile populations; migrant populations; hard-to-reach populations; populations at higher risk; Asia Pacific
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© The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Funders: Australian Department of Foreign Affairs and Trade, Bill and Melinda Gates Foundation
Date Deposited: 02 Jun 2016 22:34
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420315 One health @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
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