Taking the bite out of Malaria

In countries around the world, including Myanmar, malaria is still a very real and deadly threat. The WHO estimates that in 2018 approximately 405,000 people died from this disease and according to Eliminate Malaria, Myanmar accounts for more than half of malaria cases and about three-quarters of malaria deaths in the region. Prospect Burma alumni are amongst those at the forefront of malaria treatment and prevention in Myanmar, and over time have made incredible strides in helping to wipe out this deadly disease.

Dr. Win Han Oo has worked for several years in public health, and from 2016 was working at the Burnet Institute Myanmar (BIMM) in Melbourne, on a team specialising in public health in Myanmar. As Programme Manager, he was in charge of developing ways to combat deadly diseases including malaria and tuberculosis. At this time an opportunity came up for him to undertake a PhD in Public Health, at Deakin University in Australia. In his application for his scholarship, he told us:

“Myanmar is a country in South East Asia Region where malaria burden is highest among the region. Although the malaria disease burden has declined dramatically within the past few decades, the country is threatened by artemisinin resistance malaria. Although Myanmar declared the goal to achieve free of Malaria by 2030, the country is still in the control phase.”

He dedicated his thesis to methods of malaria elimination in the context of primary health care in Myanmar. Today, Dr Win Han Oo continues his work at BIMM, and he is having a huge impact on the prevention and treatment of Malaria in the country.

Today, Myanmar has around 20,000 integrated community volunteers in around 16,000 villages around the country. Dr Win Han Oo estimates that this represents around 1/4 of Myanmar’s villages. The programme started in Myanmar in around 2004. Before that, the prevalence of malaria in the country was very high. But with these volunteers in place, they can offer treatment on the front line, so the patients don’t need to travel to be treated, and there is less of a delay. Over the last decades, incidences of deadly cases of malaria has decreased a lot – in 2017, 218 people died of Malaria in Myanmar compared to an estimated 9,100 in 2006. The team are now focussing their efforts on eliminating the disease altogether.

Dr Win Han Oo explained that there are some difficulties in the way of totally efficient treatment. With the diminishing of malaria, the work the malaria volunteers can also do has diminished too. His team are now working on the idea of training volunteers to be able to treat other diseases too – an idea which he originally posed in his PhD.

Another priority is to strengthen the malaria reporting and surveillance system. He told us:

“When there was an incidence of malaria, the volunteers would have to fill out paper forms, hand these to their supervisor, who would visit the village once a month typically to collect the forms. They would then return to their office where they would type the data into excel spreadsheets. Then, someone from the national office would combine this data and then enter it into a national database. All in all, this is a very lengthy process.”

In order to work towards the total elimination of the disease, Dr Win Han Oo and his team need to know when a positive case appears within 24 hours. To achieve this, an application based mobile reporting system for malaria cases has been developed, to be installed on the volunteers’ phones. The application will allow them to input data which could be submitted instantly, creating an alert in the head office and allowing intervention to happen much sooner. Ideally, this application will replace the traditional paper-based reporting method. Dr Win Han Oo’s team are currently evaluating this method, to be rolled out nationwide.

References
1 https://www.who.int/malaria
2 https://www.eliminatemalaria.net/myanmar/
3 https://www.who.int/malaria/publications/country-profiles/2008/mal2008-myanmar-en.pdf