Annual conference on Malaria Malaria situation in Pailin, Cambodia Naga World Hotel Phnom Penh 21-22 March 2013
Presentation Outline
Geography • Location: 376 km Northwest of Phnom Penh, and 86 km from Battambang Province. • Surface : 1,097.66 km ² • Population : 70,486 persons(2012) • Borderland : North, East and South bordering with Battambang province of Cambodia and West bordering with Chanthaburi, Thailand • The international check-point (Prom check-point) to against to Ban Phakat check-point of Pongnamron, Chanthaburi in Thailand.
Pailin has 1 city and 1 district, 8 Communes, 83 administrative villages and 31 annexed villages. Health facility coverage : – 1 PHD – 1 RH – 6 HCs – 114Villages= 184VHV, and 225 VMWs working in all Villages, and – 45 farm owners with MMWs for 30 Villages
Malaria Achievements in Pailin
Early Diagnosis And Treatment (EDAT) Strengthen public health facilities providing 24H services for malaria (1 RH & 6 HCs) Diagnose malaria by RDT at community, and by microscope at HFs Treat malaria with recommended Anti-malaria drugs (Ex. first line for Duo-cotexcin, Malarone, and second line for Quinine & Tetra, … ) Promote private sector engagement in malaria control ( Private & Public Mixed = PPM)
EDAT (Continued) 92 VMWs in 46 villages supported by FHI360 and other 67 villages supported by MC with 133 VMWs (New VMWs were upgraded from VHSGs in the village) 45 MMWs in 30 villages selected and trained to provide early diagnosis and treatment and also health education to mobile and migrant populations at the farms. Rapidly Detected and treated the malaria through outreach activities by HC staffs.
Operational research/Study Therapeutic Efficacy Study (TES on Malaria drugs). Follow-up of malaria treatment with Malarone (Pilot Project). G6PD rapid test Study . Entomology study, etc.
Cross-border Activities • Joint cross border meeting at national levels on malaria control and prevention (reference from the meeting result at Bangkok and Siem Reap). • Joint World Malaria Day (25 April). • Screening migrant workers at malaria post, at the border check-point. • Cross-border meeting with Chanthaburi PHO/ Pongnamron (Twin-Cities) on malaria ( ID patient card at the border used). • Harmonized and Joint BCC bi-lingual materials pre- testing
LLIN distribution & Re-impregnation 10
Tend of Treated, Severe and Death Cases in Pailin from 2004-2012 10000 8695 9000 8623 7888 8000 7000 6000 5000 4000 3000 2000 1454 1365 1408 1027 785 282 1000 231 169 203 504 46 12 82 15 4 1 1 2 0 0 13 0 21 0 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 Tot Cases Severe Cases Death Cases
Malaria Incidence & Mortality Rate in Pailin from 2004-2012 ( Health Facility and VMW ) 200 180 174 160 158 Treated Cases/1,000 147 140 120 100 80 60 40 29 23 21 30 17 20 11 9 8 4 2 2 0 0 0 0 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 Incidence Rate/1000 Mortality/100,000
Parasite Species Distribution, 2011-2012 Mixt Pf Pf Mix 9% 13% 17% 13% Pv Pv 74% 74% 2011 2012
Spacies Trent, 2006-2012 Pailin 7000 PF PV MIXT 6000 5000 4000 3000 2000 1000 0 2006 2007 2008 2009 2010 2011 2012
Malaria cases for mobile and permanent people in Pailin, 2012 1200 989 1000 Tested 800 Positive 583 600 400 227 165 200 0 Mobile Permanent
Malaria cases by age and sex Pailin, 2012 300 251 250 200 Male Female 150 100 68 50 20 18 17 13 4 1 0 0-4yr 5-14yr 15-49yr >49yr
Identification of Success Factors
1-Malaria Case Management : Encourage malaria treatment based on parasitological confirmation (RDT/microscope) Ban prescribing/selling Artemisinin derivative monotherapy to patient Refer malaria cases from private sectors to public health facilities and to VMWs/MMWs. 2-Prevention : Full ITN coverage for local population, LLIN coverage for mobile and migrant population, Re-impregnation of existing conventional nets, IRS, .. Health Education.
3-Partnership MOH/CNM WHO Local authorities and community volunteers URC/CAP-Malaria Malaria Consortium (MC) FHI-360 and other partners Thai counterparts.
Institutional Development, Program Management Development of comprehensive AOP. Regular Supervision & Monitoring on actual implementation (for both public and private sectors). Supply system (Test and drugs) and Emergency response. Quality Assurance (Q/A) of malaria microscopy. Trainings, meetings and workshops on specific and relevant topics to health staffs, community volunteers and all partners. Program coordination under guidance from MoH/CNM. Program reporting and dissemination of the results.
Challenges • • • •
Some Activities by photo
Delegation of WHO and MOH Visited Phnom Dambang village (VMW)
Delegation of WHO and MOH Visited Krochab HC
Delegation of WHO and MOH Visited Farm owners and workers
Delegation of WHO and MOH Visited Pharmacy store
Pro-SWG meeting for Malaria elimination
Worl rld Mala laria ria Day with Thai i dele legatio ion
LLIN/LLIHN distribution in Pailin for 2012
Sup upervis ision on on LLI LIN/L /LLI LIHN HN used ed at the he villa llage
Training on malaria diagosis and treatment to health staffs
Training on Malaria diagosis and treatment to VMW/ W/MMW
Mont onthly hly mee eetin ting g with ith VMWs/MMWs
Bi Bi-mo monthly meeting with VHSG (Village Health Supporting Gro roup)
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