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Malaria surveillance in camps for displaced population and migrants: Thai-Myanmar border 1995-2006

Malaria surveillance in camps for displaced population and migrants: Thai-Myanmar border 1995-2006. A collaboration between: SMRU, MSF-F, AMI, IRC, ARC, MHD With the participation of TBBC and HIS/CCSDPT. Kanchanaburi, May 2007. Camps situation: Background.

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Malaria surveillance in camps for displaced population and migrants: Thai-Myanmar border 1995-2006

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  1. Malaria surveillance in camps for displaced population and migrants:Thai-Myanmar border1995-2006 A collaboration between: SMRU, MSF-F, AMI, IRC, ARC, MHD With the participation of TBBC and HIS/CCSDPT Kanchanaburi, May 2007

  2. Camps situation: Background • 1984: 7 camps in Tak province, 10,000 persons • 1994: 32 camps from Mae Hong Son to Chumpon provinces, 77,000 persons During that period: • Frequent malaria outbreaks during camps relocation • 40% of total consultations due to malaria • 1st cause of mortality in the camps • 1% of pregnant women dying of malaria each year • 80% of malaria due to P. falciparum

  3. P. falciparum resistance to antimalarials 100 80 M25 M15 60 Cure Rate (%) SP 40 CQ 20 1975 1980 1985 1990 1995 Years (Mefloquine) (Fansidar) (Chloroquine) • 1991-92: First MAS trials • 1994: MAS3 in the camps

  4. Malaria Task Force • Established in mid-1995 to control epidemics and to develop a coherent malaria control program in the camps based on: • Weekly surveillance system • Reliable laboratory diagnosis with Q.C. • Unique treatment guideline based on mefloquine and artesunate combination therapy and regular update on new protocols

  5. Population coverage Bangkok a Population as reported by the Thai Burmese Border Consortium (TBBC) monthly report

  6. Malaria morbidity & mortality * Probably underestimated, as some camps reported fever cases only

  7. Malaria cases per 1,000 residents

  8. Ratio PF/PV by age group

  9. Ratio PF/PV in adults of Mae La

  10. P. falciparum distribution by sex Mae La camp: adults

  11. Malaria cases in clinics for migrant workers

  12. ED and MAS3 in the camps 1986 40% of consultations 1 malaria case/person/yr 24% of all deaths 1994-96: ACT in all camps ~ 25% of consultations 0.5 malaria case/person/yr 10% of all deaths 2001 3% of consultations 0.1 malaria case/person/yr 3% of all deaths 2006 3% of consultations 0.1 malaria case/person/yr <1 % of all deaths

  13. Malaria prevalence in migrant workers – May 07 (2006: PF 9.8% - PV 6.5%)

  14. MAS efficacy

  15. Conclusion • No epidemics since 1997 in the camps for displaced population • 4-fold reduction in malaria PF since 1996 in camps • MAS still effective • PF remains among the adult male population, particularly among those leaving the camps overnight and the migrants THEREFORE • Malaria surveillance and regular reporting still needed especially in the mobile population • Collaborative effort on both sides of the border necessary • MAS efficacy monitoring essential

  16. Thanks to: • All laboratory teams & HIS officers for their timely contribution to the MTF weekly surveillance system • Miss Kerala for collecting, storing and computerizing all those reports

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