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Research |
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The Role of Village Malaria Workers in Malaria Elimination |
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Listen to what the team aims and expects of their research project
 Lisa White |
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Abstract
The Thai-Cambodian border area is historically the source of the global diaspora of antimalarial drug resistance. Resistance to chloroquine and sulphadoxine-pyrimethamine in Plasmodium falciparum originated there, spread across Asia and Africa, and caused millions of deaths. Elimination of malaria in Cambodia is now an international priority due to the presence of artemisinin resistance. Every year over 100,000 cases of clinical malaria are reported in Cambodia. Of these, 5000 cases are severe and 500 result in death. Village malaria worker (VMW) schemes in a broad range of transmission settings have consistently resulted in large reductions in mortality from malaria. In meso-endemic areas (11% to 50% parasite positive prevalence), VMW schemes have also resulted in significant reductions in parasite positive prevalence which indicates a potential role in elimination strategy. Mathematical models will be used to define this role in Cambodia.
Reductions in the incidence of clinical malaria and mortality have extremely important public health implications, but are not necessarily useful for elimination purposes where transmission must be reduced. A proxy for reduction in transmission is a reduction in parasite positive prevalence (that is, a reduction in all malaria infection clinical or otherwise). Since in some settings, reductions in prevalence have been observed following the initiation of VMW schemes, we plan to explore the potential for such schemes as components of integrated elimination policies.
Preliminary mathematical models have predicted similar outcomes to those observed in trials. Reductions in prevalence are predicted for meso-endemic areas with elimination being predicted as possible given suitably high coverage and effectiveness of the scheme. We propose to develop a suite of bespoke mathematical models for the optimal application of VMW in Cambodia in the context of elimination. These models can then form the basis for future schemes in other countries in the South East Asia region. |
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Team Members |
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Lisa White
Doctor, Head of Mathematical Modelling
Mahidol-Oxford Tropical Medicine Research Unit
Thailand |
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Duong Socheat
Doctor, Director
National Center for Parasitology, Entomology and Malaria Control
Cambodia |
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Chea Ngoun
Doctor, Vice Director
National Center for Parasitology, Entomology and Malaria Control
Cambodia |
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