Special Issue "Malaria Elimination: Managing Implementation of the Interventions for Success"

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (25 April 2020) | Viewed by 13997

Special Issue Editors

Prof. Maxine A. Whittaker
E-Mail Website
Guest Editor
Division of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
Interests: global health policy; medical anthropology; malaria and other infectious diseases; One Health; health systems research; operational and implementation research
Dr. Effie Espino
E-Mail Website
Guest Editor
Research Institute for Tropical Medicine (RITM), Department of Health (DOH), Muntinlupa, Metro Manila, Philippines
Interests: Malaria elimination
Dr. Lars Henning
E-Mail Website
Guest Editor
Public Health and Tropical Medicine, James Cook University, Townsville, Australia
Interests: Public Health; tropical medicine and infectious diseases; translational research

Special Issue Information

This Special Issue focuses on recent research on the implementation challenges faced and solutions developed by programme managers and policy makers in working towards malaria elimination. The Global Technical Strategy for Malaria 2016–2030 lays out an ambitious vision for the elimination of malaria in at least 35 countries by 2030 and the prevention of re-establishment in countries where it had been eliminated. The RBM Partnership to End Malaria companion document by Malaria Action and Investment to Defeat Malaria 2016–2030 details the need for resourcing, multi-sectoral collaboration, and community engagement to support implementation activities for this shared vision.

The World Malaria Report 2018 noted that while 11 of the WHO identified 21 countries with the potential to eliminate malaria by the year 2020, known as “E-2020 countries”, remain on track to achieve their elimination goals, 10 have reported increases in indigenous malaria cases in 2017 compared with 2016. It stresses that the 4 pillars, “galvanize national and global political attention to reduce malaria deaths; drive impact in country through the strategic use of information; establish best global guidance, policies and strategies suitable for all malaria endemic countries; and implement a coordinated country response”, are critical for every country to remain on track. Within countries, there is an increasingly segmented epidemiological picture of malaria, which creates further complexity for programme managers and policy makers. National malaria programmes now face more complex operations; shifting from control to elimination mode, while maintaining the gains of sub-national malaria elimination.

The Malaria Eradication Scientific Alliance (MESA) developed a malaria Eradication Research Agenda (malERA), to accelerate malaria elimination and, in the longer term, transform the malaria community’s ability to eradicate it globally. The revaluation of this agenda, in 2017, suggested the need for transdisciplinary solutions to develop innovative and integrated implementation approaches that respond to local variations in transmission, health, and social context and management systems.

This Special Issue will feature research, especially implementation and operational research, from the field implementation and management perspectives. This may include scaling up evidence into policy and practice; targeting resources better to local needs; ensuring accessibility of services to remote, mobile and other underserved populations; integrating services while maintaining specialised malaria activities; and maintaining interest in malaria when the caseload is reducing or other diseases become more dominant in disease burden or community and political interest.

Prof. Maxine A. Whittaker
Dr. Effie Espino
Dr. Lars Henning
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Malaria elimination
  • Malaria eradication
  • Community participation
  • Mobile and migrant populations, Implementation research
  • Scaling up
  • Knowledge translation
  • Program management
  • Community engagement
  • Management
  • Policy
  • Segmentation
  • Advocacy
  • Resource allocation
  • Data for decision making

Published Papers (7 papers)

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Research

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Article
Are Malaria Risk Factors Based on Gender? A Mixed-Methods Survey in an Urban Setting in Ghana
Trop. Med. Infect. Dis. 2021, 6(3), 161; https://doi.org/10.3390/tropicalmed6030161 - 02 Sep 2021
Cited by 2 | Viewed by 1884
Abstract
Malaria still represents one of the most debilitating and deadly diseases in the world. It has been suggested that malaria has different impacts on women and men due to both social and biological factors. A gender perspective is therefore important to understand how [...] Read more.
Malaria still represents one of the most debilitating and deadly diseases in the world. It has been suggested that malaria has different impacts on women and men due to both social and biological factors. A gender perspective is therefore important to understand how to eliminate malaria. This study aimed to investigate malaria from a gender perspective in a non-for-profit private health facility, HopeXchange Medical Centre, based in Kumasi (Ghana). A sequential mixed-methods design, comprising quantitative and qualitative methods, was used. This study found low ownership (40%) and use (19%) of insecticide-treated nets (ITNs). Most malaria cases were women (62%), who were less educated and had more external risk factors associated with infection. Our study reported a trend of preferring malaria self-medication at home, which was practiced mostly by men (43%). Our data suggest that women are more likely to be exposed to malaria infections than men, especially due to their prolonged exposure to mosquito bites during the most dangerous hours. Our study highlighted the need for future malaria control policies to be more focused on social and behavioral aspects and from a gender perspective. Full article
Article
Knowledge of Antimalarials and Health Seeking Behaviour of Households in Case of Suspected Malaria in Democratic Republic of the Congo
Trop. Med. Infect. Dis. 2021, 6(3), 157; https://doi.org/10.3390/tropicalmed6030157 - 26 Aug 2021
Cited by 2 | Viewed by 1384
Abstract
(1) Background: The Democratic Republic of the Congo (DRC) is heavily affected by malaria despite availability of effective treatments. Ignorance and unrecommended behaviour toward a suspected malaria case in households may contribute to this problem. (2) Method: In communities of one rural and [...] Read more.
(1) Background: The Democratic Republic of the Congo (DRC) is heavily affected by malaria despite availability of effective treatments. Ignorance and unrecommended behaviour toward a suspected malaria case in households may contribute to this problem. (2) Method: In communities of one rural and one urban Health Centres in each of the 11 previous provinces of DRC, all households with a case of malaria in the 15 days prior to the survey were selected. The patient or caregiver (responder) were interviewed. Logistic regression was used to assess predictors of knowledge of recommended antimalarials and adequate behaviour in case of suspected malaria. (3) Results: 1732 households participated; about 62% (1060/1721) of the responders were informed about antimalarials, 70.1% (742/1059) knew the recommended antimalarials and 58.6% (995/1699) resorted to self-medication. Predictors of knowledge of antimalarials were education to secondary school or university, information from media and smaller households. Predictors of good behaviour were Catholic religion and smaller households. Receiving information from Community Health Workers (CHWs) failed to be determinants of knowledge or adequate behaviour. (4) Conclusion: malaria control in DRC is hampered by ignorance and non-adherence to national recommendations. These aspects are influenced by unsuccessful communication, size of households and level of education. Full article
Article
Identification of Mutations in Antimalarial Resistance Gene Kelch13 from Plasmodium falciparum Isolates in Kano, Nigeria
Trop. Med. Infect. Dis. 2020, 5(2), 85; https://doi.org/10.3390/tropicalmed5020085 - 27 May 2020
Cited by 7 | Viewed by 2258
Abstract
Malaria control relies on first-line treatments that use artemisinin-combination therapies (ACT). Unfortunately, mutations in the plasmodium falciparum kelch13 gene result in delayed parasite clearance. Research on what is causing ACT failure is non-existent in northwestern Nigeria. Thus, the presence of mutations in kelch13 [...] Read more.
Malaria control relies on first-line treatments that use artemisinin-combination therapies (ACT). Unfortunately, mutations in the plasmodium falciparum kelch13 gene result in delayed parasite clearance. Research on what is causing ACT failure is non-existent in northwestern Nigeria. Thus, the presence of mutations in kelch13 in P. falciparum isolates from Kano, Nigeria was investigated in this study. Microscopic examination of 154 blood samples obtained from patients revealed a high prevalence of P. falciparum infection (114 positive individuals, slide positivity rate = 74.03%). The 114 patients were administered Cartef® (ACT) and out of the 50 patients that returned for the 14-day follow up, 11 were positive for P. falciparum (slide positivity rate = 22%). On day 0, 80 samples out of 114 and 11 samples on day 14 (91 out of 125 microscopy-positive samples) were positive with Plasmodium according to the PCR of cytochrome oxidase I, which corresponds to 72.8%. A fragment of the kelch13 gene encompassing the propeller domains was sequenced in 49 samples, alongside samples of the susceptible strain pf_3D7. Low polymorphism was observed, suggesting a lack of selection on this gene, and only six mutations (Glu433Gly, Phe434Ile, Phe434Ser, Ile684Asn, Ile684Thr and Glu688Lys) were found. The epidemiologic impact of these mutations and their potential role in ACT resistance needs to be investigated further. Full article
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Article
The Evolution of the Malaria Clinic: The Cornerstone of Malaria Elimination in Thailand
Trop. Med. Infect. Dis. 2019, 4(4), 143; https://doi.org/10.3390/tropicalmed4040143 - 13 Dec 2019
Cited by 5 | Viewed by 1732
Abstract
Background: Malaria Clinics (MCs) have served communities in Thailand since 1965 and are still playing a critical role in providing early diagnosis and effective treatment of malaria. Methods: We reviewed six decades of published manuscripts, articles, strategies, and plans regarding MC operations in [...] Read more.
Background: Malaria Clinics (MCs) have served communities in Thailand since 1965 and are still playing a critical role in providing early diagnosis and effective treatment of malaria. Methods: We reviewed six decades of published manuscripts, articles, strategies, and plans regarding MC operations in Thailand;,and analyzed national program surveillance data in both malaria control and malaria elimination phases. Results: MCs accounted for 39.8% of malaria tests and 54.8% of positive cases by the end of the 1980s. The highest number of MCs established was 544 in 1997. MCs contributed to 6.7% of all tests and 30% of all positive cases over the 2015–2017 period. Between 2017 and June 2019, during the malaria elimination phase, MCs continued to test an average of 67% of all persons tested for malaria, and confirmed 38.3% of all positive cases detected in the country. Conclusions: Testing and positive rates of MCs are on a gradual decline as the overall burden of malaria declines annually, which may reflect decreasing transmission intensity. Although the number of MCs in the last three years has been stable (n = 240), the attrition of MC staff poses a real challenge to the longevity of MCs in the absence of a human resource plan to support the elimination phase. It is necessary to identify and support capacity gaps and needs as MCs are absorbed into an integrated and decentralized program, while ensuring that the Division of Vector Borne Diseases (DVBD) maintains its necessary technical and advisory role. Full article
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Review

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Review
Vector-Focused Approaches to Curb Malaria Transmission in the Brazilian Amazon: An Overview of Current and Future Challenges and Strategies
Trop. Med. Infect. Dis. 2020, 5(4), 161; https://doi.org/10.3390/tropicalmed5040161 - 20 Oct 2020
Cited by 3 | Viewed by 2684
Abstract
In Brazil, malaria transmission is mostly confined to the Amazon, where substantial progress has been made towards disease control in the past decade. Vector control has been historically considered a fundamental part of the main malaria control programs implemented in Brazil. However, the [...] Read more.
In Brazil, malaria transmission is mostly confined to the Amazon, where substantial progress has been made towards disease control in the past decade. Vector control has been historically considered a fundamental part of the main malaria control programs implemented in Brazil. However, the conventional vector-control tools have been insufficient to control or eliminate local vector populations due to the complexity of the Amazonian rainforest environment and ecological features of malaria vector species in the Amazon, especially Anopheles darlingi. Malaria elimination in Brazil and worldwide eradication will require a combination of conventional and new approaches that takes into account the regional specificities of vector populations and malaria transmission dynamics. Here we present an overview on both conventional and novel promising vector-focused tools to curb malaria transmission in the Brazilian Amazon. If well designed and employed, vector-based approaches may improve the implementation of malaria-control programs, particularly in remote or difficult-to-access areas and in regions where existing interventions have been unable to eliminate disease transmission. However, much effort still has to be put into research expanding the knowledge of neotropical malaria vectors to set the steppingstones for the optimization of conventional and development of innovative vector-control tools. Full article
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Review
Impact of Health Systems on the Implementation of Intermittent Preventive Treatment for Malaria in Pregnancy in Sub-Saharan Africa: A Narrative Synthesis
Trop. Med. Infect. Dis. 2020, 5(3), 134; https://doi.org/10.3390/tropicalmed5030134 - 22 Aug 2020
Cited by 2 | Viewed by 1354
Abstract
Malaria in pregnancy is a public health challenge with serious negative maternal and newborn consequences. Intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine is recommended for the control of malaria during pregnancy within endemic areas, but coverage for the recommended ≥3 doses IPTp regimen has [...] Read more.
Malaria in pregnancy is a public health challenge with serious negative maternal and newborn consequences. Intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine is recommended for the control of malaria during pregnancy within endemic areas, but coverage for the recommended ≥3 doses IPTp regimen has remained suboptimal. We searched PubMed, Cochrane library, and HINARI database from 1 January 2010 to 23 May 2020, for studies investigating the effect of the health system on IPTp implementation. Data extraction was independently performed by two investigators and evaluated for quality and content. Health system barriers and facilitators were explored using thematic analysis and narrative synthesis. Thirty-four out of 1032 screened articles were included. Key health system issues affecting the provision and uptake of IPTp were the ambiguity of policy and guidelines for IPTp administration, human resource shortages, drug stock-outs, conflicting policy implementation on free IPTp provision, hidden costs, unclear data recording and reporting guidelines, and poor quality of care. Factors affecting the supply and demand for IPTp services involve all pillars of the health system across different countries. The success of health programs such as IPTp will thus depend on how well the different pillars of the health system are articulated towards the success of each program. Full article
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Review
Strengthening Surveillance Systems for Malaria Elimination by Integrating Molecular and Genomic Data
Trop. Med. Infect. Dis. 2019, 4(4), 139; https://doi.org/10.3390/tropicalmed4040139 - 03 Dec 2019
Cited by 7 | Viewed by 1444
Abstract
Unprecedented efforts in malaria control over the last 15 years have led to a substantial decrease in both morbidity and mortality in most endemic settings. However, these progresses have stalled over recent years, and resurgence may cause dramatic impact on both morbidity and [...] Read more.
Unprecedented efforts in malaria control over the last 15 years have led to a substantial decrease in both morbidity and mortality in most endemic settings. However, these progresses have stalled over recent years, and resurgence may cause dramatic impact on both morbidity and mortality. Nevertheless, elimination efforts are currently going on with the objective of reducing malaria morbidity and mortality by 90% and malaria elimination in at least 35 countries by 2030. Strengthening surveillance systems is of paramount importance to reach those targets, and the integration of molecular and genomic techniques into routine surveillance could substantially improve the quality and robustness of data. Techniques such as polymerase chain reaction (PCR) and quantitative PCR (qPCR) are increasingly available in malaria endemic countries, whereas others such as sequencing are already available in a few laboratories. However, sequencing, especially next-generation sequencing (NGS), requires sophisticated infrastructure with adequate computing power and highly trained personnel for data analysis that require substantial investment. Different techniques will be required for different applications, and cost-effective planning must ensure the appropriate use of available resources. The development of national and sub-regional reference laboratories could help in minimizing the resources required in terms of equipment and trained staff. Concerted efforts from different stakeholders at national, sub-regional, and global level are needed to develop the required framework to establish and maintain these reference laboratories. Full article
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