Malaria elimination: Ambitious or achievable?

April 27, 2022

Reading Time: 2 minutes

Bangladesh is on track to end malaria – cases fell by 91% in endemic areas (from 84,690 in 2008 to 7,294 in 2021). Real-time case notification, strong surveillance systems and continuation of treatment and services even during the pandemic have all contributed to this feat.

The clock is ticking away for the world to reach its malaria targets by 2030.

The World Health Organisation estimates 241 million cases of malaria in 2021, which took approximately 627,000 lives globally. Despite the breakthroughs in health, Bangladesh still accounts for 0.15% of the total estimated malaria cases in southeast Asia.

Malaria services being provided at one of the mobile sub centres in Cox Bazar, Bangladesh. Photo credit: 2021 © BRAC

Shrinking the malaria map 

Bangladesh’s malaria programme has tailored interventions to achieve the targets of National Malaria Strategy 2021-2025. Its phase-wise elimination targets different zones – Mymensingh, Sylhet, Chattogram, and Cox’s Bazar – and aims to reduce the burden of the disease in three districts in the Chittagong Hill Tract region by 2025. It also aims to completely interrupt local transmission nationwide by 2030.

The government and its non-profit partners are working together to implement the national strategy, with case-based surveillance playing a vital role in the elimination of malaria in the aforementioned zones.

Conducting Rapid Diagnostic Test (RDT). Photo credit: 2021 © BRAC

Early diagnosis and prompt treatment and surveillance are crucial to achieving the targets to end malaria. With the support of the Government of Bangladesh, the programme has been reporting real-time cases and conducting early case investigations. Based on the investigations, cases are classified and action is taken accordingly.

Despite the coexisting pandemic, the continuation of diagnosis, treatment and preventive services, as well as awareness raising activities such as door-to-door visits, have helped Bangladesh to continue progressing toward the goal. The national programme’s consistent support in reducing the malaria burden cannot be overlooked.

Health worker using geographical information systems for real-time reporting of malaria positive patients. Photo credit: 2021 © BRAC

Integrating innovation 

A breakthrough initiative from BRAC this year has been the integration of geographical information system (GIS) technology for mapping malaria cases at the community level in five endemic districts in Bangladesh, namely Bandarban, Rangamati, Khagrachari, Cox’s Bazar, and Chattogram. The mapping provides information to local staff, enabling them to make prompt decisions and determine appropriate interventions.

Community service providers have been equipped with tablets, so they can capture the locations of confirmed malaria cases along with additional information such as malaria diagnosis, treatment, and use of long-lasting insecticidal net (LLIN) by each patient who has been tested positive.

Another tool to inform action will be the second version of the District Health Information System (DHIS 2), soon to be live. It is an open-source software platform in Bangladesh which auto-generates a bulletin with the latest health data, based on reports and analysis. Malaria data will be integrated into the platform which will support all aspects of elimination-related data collection and analysis including case investigation.

LLIN utilisation by women and children under five in Naikkhongchari upazila, Bandarban. Photo Credit: 2021 © BRAC

Bangladesh is treading closer to a zero malaria reality, with real-time case notification, strengthened surveillance systems and continued treatment and other services guiding the way. With malaria cases falling by 91% in endemic areas, (from 84,690 in 2008 to 7,294 in 2021), Bangladesh is well on track.

Read more: Liberating Bangladesh from malaria: How far have we come in the last 50 years?

Dr Kazi Mariam Naher is an Epidemiologist in BRAC’s malaria elimination programme.

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