Malaria on isolated Melanesian islands prior to the initiation of malaria elimination activities

Pacific Malaria Initiative Survey Group, , Vector Borne Disease Control Programme, , Atkins, Christine, Auliff, Alison, Bain, Lisa M., Cheng, Qin, Cooper, Robert, Harris, Ivor Ernest, Ebringer, Andrew, Edstein, Mike, Elmes, Nathan, Gray, Karen, Humphries, John, Johnson, Marie-Louise, Krause, Darren, Lilley, Ken, MacKenzie, Donna, McPherson, Brady, Perrin, Rob, Shanks, G. Dennis, Sharrock, Wesley W., Staley, John, Waters, Norman C., Atkinson, Jo-an, Clements, Archie, Dove, Georgina, Forsyth, Simon, Kelly, Gerard, Marston, Luke, Reid, Heidi, Riley, Ian, Vallely, Andrew, and Whittaker, Maxine (2010) Malaria on isolated Melanesian islands prior to the initiation of malaria elimination activities. Malaria Journal, 9. 218.

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Abstract

Background: The Australian Government's Pacific Malaria Initiative (PacMI) is supporting the National Malaria Program in both Solomon Islands and Vanuatu, complementing assistance from the Global Fund for AIDS, Tuberculosis and Malaria (GFATM). Two remote island groups - Tafea Province, Vanuatu and Temotu Province, Solomon Islands have been selected by the governments of both countries as possible malaria elimination areas. To provide information on the prevalence and distribution of the disease within these island groups, malariometric surveys were conducted during the wet seasons of 2008.

Methods: In Tafea Province, a school-based survey was conducted which included the 2-12 y age group, while in Temotu a village based all-ages survey was conducted. An effort was made to sample villages or schools from a wide an area as possible on all islands. Diagnosis was initially based on Giemsa stained blood slides followed by molecular analysis using polymerase chain reaction (PCR).

Results: In Tafea Province, 73% (5238/7150) of children (2-12 y) were surveyed and in Temotu Province, in the all-ages survey, 50.2% (8742/17410) of the provincial population participated in the survey. In both Vanuatu and Solomon Islands malariometric surveys of their southern-most islands in 2008 showed relatively low over-all malaria parasite prevalence (2 to 3%). Other features of malaria in these island groups were low parasitaemia, low gametocyte carriage rates, low spleen rates, low malaria associated morbidity, a high incidence of asymptomatic infections, and a predominance of Plasmodium vivax over Plasmodium falciparum.

Conclusion: For various reasons malaria rates are declining in these provinces providing a favourable situation for local malaria elimination. This will be advanced using mass distribution of bed nets and selective indoor residual spraying, the introduction of rapid diagnostic tests and artemisinin combination therapy, and intensive case detection and surveillance. It is as yet uncertain whether malaria parasites can themselves be sustainably eliminated from entire Melanesian islands, where they have previously been endemic. Key issues on the road to malaria elimination will be continued community involvement, improved field diagnostic methods and elimination of residual P. vivax parasites from the liver of asymptomatic persons.

Item ID: 48015
Item Type: Article (Research - C1)
ISSN: 1475-2875
Keywords: Melanesia, Pacific, Vanuatu, Solomon Islands, malaria, elimination
Additional Information:

© 2010 Shanks and The Pacific Malaria Initiative Survey Group (PMISG) on behalf of the Ministries of Health of Vanuatu and Solomon Islands; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funders: AusAID
Date Deposited: 09 May 2017 22:49
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920408 Health Status (e.g. Indicators of Well-Being) @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 50%
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