About this Research Topic
As per the World Health Organization, vector borne diseases (VBD) pose a considerable threat to human health resulting in about 1/6th of illness and morbidity due to VBDs at the global level and putting over half of the world’s population at risk. With the advent of modern tools of diagnosis, vector control and management of patients, the burden of some VBDs is declining while some forgotten diseases are reemerging. Of major VBDs, malaria, visceral leishmaniasis and lymphatic filariasis are in elimination phase while the incidence of dengue, chikungnuya and Japanese encephalitis is increasing. Malaria is endemic in 97 countries and about 3.4 million individuals are at risk. The disease has been eliminated from 27 countries, and 65 countries which are still in control phases are planning to eliminate malaria by 2020 (10 countries), 2025 (20 countries) and 2030 (35 countries). With the improvement in diagnostic kits, indoor residual spray by synthetic pyrethroids, Long Lasting Nets for prevention from mosquito vectors’ bite and potent drugs, it has become possible to contain high endemicity of most of the VBDs. The problem lies in low endemic areas where, if surveillance is compromised, can result in a spurt of cases. The shrinking global map of malaria reveals that 27 countries have already demonstrated elimination of the disease. In Southeast Asia, only Brunei and Singapore have achieved the state of elimination while Sri Lanka is at the verge of malaria elimination. India has also launched elimination of malaria by the year 2030 which is a challenge being a vast geographic area and having diverse epidemiological paradigms. The operational approach, methodology adopted and experience gained by the countries demonstrating elimination can be emulated by the developing countries, which will save decades of operational years.
At the global level, around 88% of malaria is confined to Africa followed by the Southeast Asian region. In Southeast Asia, only Maldives is free from malaria. The basic reason of staggering in the control phase in developing countries is a lack of resources, shortage of manpower, inaccessibility due to difficult terrain and lack of success stories of demonstrated elimination even in smaller areas.
The major problems in malaria control experienced by endemic countries are inaccessibility, ineffective surveillance, asymptomatic subjects, non-compliance to treatment, and failure in prevention of reintroduction of malaria in malaria-free areas. This Research Topic is an effort to consolidate the operational experience of researchers across Southeast Asia, Africa and South America which have achieved malaria elimination or are moving towards elimination. The experiences of researchers in terms of surveillance tools used, management of asymptomatic and migratory cases, technology adopted for micro-stratification of foci of transmission, measures taken to prevent reintroduction of cases and optimal use of manpower will be elucidated. The lessons learnt will guide countries undergoing the control phase and will go a long way in accelerating the efforts of malaria elimination at the global level.
Keywords: malaria, elimination, asymptomatic, reintroduction, opeartional research
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