Mekong delta area in Vietnam

- 14 provinces, 30 milion pop.- most malaria case are imported case- P. f (60%), and P.v - An. epiroticus (insecticed resistance in coach pro)

=> no local malaria case by 2020

TT TỉnhBNSR AT TV KST

2012 2011 2012 2011 2012 2011 2012 20111 Lâm Đồng 176 183 0 0 0 0 166 1752 Đồng Nai 136 207 2 2 0 0 93 1383 Bình Dương 76 98 8 4 0 1 75 794 Bình Phước 1.596 1.829 16 14 0 1 1.512 1.6195 Tây Ninh 30 62 0 1 0 0 28 596 BR-VT 129 118 0 0 0 0 11 97 TP. HCM 58 35 0 0 0 0 55 328 Long An 9 17 0 0 0 0 9 179 Tiền Giang 11 4 0 0 0 0 11 4

10 An Giang 11 11 1 3 0 0 10 911 Bến Tre 21 18 1 0 0 0 20 1812 Kiên Giang 14 16 0 0 0 0 12 1113 Đồng Tháp 42 20 5 2 0 1 29 1314 Vĩnh Long 5 8 0 1 0 1 5 815 Trà Vinh 39 49 0 0 0 0 20 816 Cần Thơ 0 4 0 0 0 0 0 417 Hậu Giang 5 2 0 0 0 0 5 218 Sóc Trăng 66 180 0 0 0 0 8 1919 Bạc Liêu 50 74 0 0 0 0 45 5720 Cà Mau 125 172 0 2 0 0 55 42

Tổng cộng 2.599 3.107 33 29 0 4 2.169 2.323

1. The existing mal surveillance in the area

Case definitions:• Microcopic exammination / RDTs (PCD, ACD)• Clinical diagnosis.

Method for confirmation and theire QA:• 100% positive slides and 10% negative one were

checked at higher level.

Personel responsible for case detection, involvement of other entities than pulic health services:• Village health worker/commune, Microcopic point• Military, private sector, farms…

Laboratory methods:• Microcopic exammination / RDTs

1. The existing mal surveillance in the area

Methods of reporting:• Monthly/quarter/6 months/annual routin reports

(week reports?)• Case report immediatly (for every confirmed malaria

case)Reports and feed – back produced by central level• Unusual (mainly in 6 months or annual mittings; Case

report immediatly)Coverage:• Whole area

1. The existing malaria surveillance…

2. Identify the changes required for the surveillance system to be adequate for elimination

Prioritize these changes:• Microcopic points QA (technical staff) + RDTs• VHWs• Set up an immediately report for every confirmed

case (simply 100% confirmation). • Case investigation and classification, identify foci• Foci investigation and delimitation, classification

Prioritize these changes:• Guidline on vectorial control method

according to forcus class. • Legislation of private sector on compulsory

reporting• Over the counter sale of antimalaious drugs

should be stopped, but access to antimalaria in other provinces to analyse (highland, …).

2. Identify the changes required for the surveillance system to be adequate for elimination

3. Draft national guidelines for malaria surveillance, including the above features:

Microcopic points QA (technical staff) + RDTs:• Training and retraining, supervision of MPs in QA • Functional defination for microcopic points.• Coverage RDTs in remote where the microcopic point not

reach. Take slide simultaneously with RDT and send to MP for examination.

• The MPs must feed – back to communities in 24 h (tel, others) and take an immediately report for every confirmed case.

• Guidline quality control of all laboratory services that diagnose malaria.

VHWs:• Training and retraining (malaria elimination

measurements)

• Functional defination for VHWs: take examination every mobile population when they comeback from endemic area and people have malaria symptoms. Adequate and prompt treatment every positive case.

3. Draft national guidelines for malaria surveillance, including the above features:

Case investigation and classification, identify foci:• Establish a mobile team (province and district) to do

epidemiological investigation of every confirmed case and classification, identify foci.

• Set up national malaria case register.• Training and quality control for all public and private

clinical services that diagnose and/or treat malaria.

3. Draft national guidelines for malaria surveillance, including the above features:

Guidline on VC method according to forcus class:• Guidline on IRS in timely in foci• Mornitor VC in routine and suddently in necessary case Legislation of private sector on compulsory reporting:• Make a form report with in detail of WWW… they have

to report• Assignment on supervision of private sector’s report

3. Draft national guidelines for malaria surveillance, including the above features:

Over the counter sale of antimalaious drugs should be stopped, but access to antimalaria in other provinces to analyse (highland, …):• MOH issue official regulations on sale antimalaria

drugs (in detail for every different area)• Assignment on supervision of OTC.

3. Draft national guidelines for malaria surveillance, including the above features: