The Transboundary Impacts of Conflict on Bhutan’s Border Districts: Insurgency, Border Malaria and Cross-Border Healthcare

Abstract Background: Cross-border malaria in Laiza City of Myanmar seriously affected Yingjiang County of China and compromised the national malaria elimination goal. A pilot project on 3+1 strategy of joint cross-border malaria prevention and control was carried out in building border malaria buffer area in the both sides since 2017; Here, 3 was the three preventive lines in Yingjiang County to strengthen targeted measures of elimination malaria in China and +1 was a defined border area in Laiza City to adopt the integrated measures of malaria control in Myanmar.Methods: A retrospective analysis from 2015 to 2019 was conducted that included case detection, parasite prevalence and vector surveillance. Descriptive statistics was used and the incidence or rates were compared. The annual parasite incidence in +1 area of Myanmar, the annual importation rate in Yingjiang County of China and the density of An.Minimus were statistically significant indictors to assess the effect of the joint interventions.Results: In +1 area of Myanmar from 2015 to 2019, the average of annual parasite incidence was (59.11±40.73) / 1000 and plasmodium vivax accounted for 96.27 % of total confirmed cases. After the pilot project, the annual parasite incidence, microscopic parasite prevalence rate and density of An. Minimus reduced by 89%,100% and 93.93% respectively, but the submicroscopic parasite prevalence rate was no significant difference between the two surveys (p =0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The average of annual importation rate from 2015 to 2019 was (0.47±0.15)/1000. After the pilot project, it reduced by 53% of whole county, 67% of the first preventive line, 52% of the second preventive line and 36% of the third preventive line respectively. The density of An. Minimus in the first preventive line reduced by 94.51% and did not have significant difference between that of+1 area of Myanmar (Z value=-1.18，p value=0.24). Conclusion: The pilot project on 3+1 strategy has made remarkable effectiveness and a buffer area of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China. The combined use and expanded coverage of indoor residual spraying and long-lasting insecticidal nets (LLINs) was more effective than only use of LLINs in reducing the transmission of plasmodium vivax caused by An. Minimus. It is necessary to adopt submicroscopic infection interventions to eliminate potential sources of infection in Laiza City of Myanmar.

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Cross-border malaria in Northern Brazil

Malaria Journal ◽

10.1186/s12936-021-03668-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Nicholas J. Arisco ◽

Cassio Peterka ◽

Marcia C. Castro

Keyword(s):

Logistic Regression ◽

Human Mobility ◽

Epidemiological Surveillance ◽

Chi Square ◽

Major Barrier ◽

Malaria Burden ◽

Cross Border ◽

Imported Case ◽

Border Malaria ◽

Northern Brazil

Abstract Background Cross-border malaria is a major barrier to elimination efforts. Along the Venezuela-Brazil-Guyana border, intense human mobility fueled primarily by a humanitarian crisis and illegal gold mining activities has increased the occurrence of cross-border cases in Brazil. Roraima, a Brazilian state situated between Venezuela and Guyana, bears the greatest burden. This study analyses the current cross-border malaria epidemiology in Northern Brazil between the years 2007 and 2018. Methods De-identified data on reported malaria cases in Brazil were obtained from the Malaria Epidemiological Surveillance Information System for the years 2007 to 2018. Pearson’s Chi-Square test of differences was utilized to assess differences between characteristics of cross-border cases originating from Venezuela and Guyana, and between border and transnational cases. A logistic regression model was used to predict imported status of cases. Results Cross-border cases from Venezuela and Guyana made up the majority of border and transnational cases since 2012, and Roraima remained the largest receiving state for cross-border cases over this period. There were significant differences in the profiles of border and transnational cases originating from Venezuela and Guyana, including type of movement and nationality of patients. Logistic regression results demonstrated Venezuelan and Guyanese nationals, Brazilian miners, males, and individuals of working age had heightened odds of being an imported case. Furthermore, Venezuelan citizens had heightened odds of seeking care in municipalities adjacent Venezuela, rather than transnational municipalities. Conclusions Cross-border malaria contributes to the malaria burden at the Venezuela-Guyana-Brazil border. The identification of distinct profiles of case importation provides evidence on the need to strengthen surveillance at border areas, and to deploy tailored strategies that recognize different mobility routes, such as the movement of refuge-seeking individuals and of Brazilians working in mining.

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Author response: Using parasite genetic and human mobility data to infer local and cross-border malaria connectivity in Southern Africa

10.7554/elife.43510.022 ◽

2019 ◽

Author(s):

Sofonias Tessema ◽

Amy Wesolowski ◽

Anna Chen ◽

Maxwell Murphy ◽

Jordan Wilheim ◽

...

Keyword(s):

Southern Africa ◽

Human Mobility ◽

Author Response ◽

Cross Border ◽

Mobility Data ◽

Border Malaria

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The 2019 Isdell:Flowers Cross Border Malaria Initiative Round Table: community engagement in the context of malaria elimination

Malaria Journal ◽

10.1186/s12936-019-3054-x ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Alexandra Gordon ◽

Rebecca J. Vander Meulen ◽

Alysse Maglior

Keyword(s):

Private Sector ◽

Community Engagement ◽

Malaria Elimination ◽

Round Table ◽

Government Officials ◽

Community Members ◽

Cross Border ◽

Border Malaria ◽

Effective Community

AbstractGovernment officials, representatives from malaria endemic communities, and nonprofit, academic, and private sector partners convened at the 2019 Isdell:Flowers Cross Border Malaria Initiative Round Table in Livingstone, Zambia from February 28–March 1, 2019 to discuss the necessity of community engagement and the involvement of those directly affected by malaria in malaria elimination efforts. Participants shared practical examples and principles of successful community engagement over the course of the Round Table. Three core principles of effective community engagement emerged: (1) there is no “one size fits all” community engagement strategy, (2) community engagement must be a bidirectional activity, and (3) community members must be at the heart of malaria elimination efforts.

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Imported Plasmodium falciparum and locally transmitted Plasmodium vivax: cross-border malaria transmission scenario in northwestern Thailand

Malaria Journal ◽

10.1186/s12936-017-1900-2 ◽

2017 ◽

Vol 16 (1) ◽

Cited By ~ 20

Author(s):

Patchara Sriwichai ◽

Stephan Karl ◽

Yudthana Samung ◽

Kirakorn Kiattibutr ◽

Jeeraphat Sirichaisinthop ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Plasmodium Vivax ◽

Malaria Transmission ◽

Cross Border ◽

Border Malaria ◽

Northwestern Thailand

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Border Malaria Associated with Multidrug Resistance on Thailand-Myanmar and Thailand-Cambodia Borders: Transmission Dynamic, Vulnerability, and Surveillance

BioMed Research International ◽

10.1155/2013/363417 ◽

2013 ◽

Vol 2013 ◽

pp. 1-13 ◽

Cited By ~ 45

Author(s):

Adisak Bhumiratana ◽

Apiradee Intarapuk ◽

Prapa Sorosjinda-Nunthawarasilp ◽

Pannamas Maneekan ◽

Surachart Koyadun

Keyword(s):

Multidrug Resistance ◽

Global Perspectives ◽

Cross Border ◽

Vector Population ◽

Ecological Changes ◽

Border Malaria ◽

Population Migrations ◽

And Control ◽

Border Population ◽

Movement Activities

This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread ofPlasmodium falciparumandPlasmodium vivaxmultidrug resistance (MDR) malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world’s most MDR falciparum and vivax malaria on these chaotic borders.

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A participatory approach to address within‐country cross‐border malaria: the case of Menoreh Hills in Java, Indonesia

Malaria Journal ◽

10.1186/s12936-021-03673-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Riris Andono Ahmad ◽

Astri Ferdiana ◽

Henry Surendra ◽

Tyrone Reden Sy ◽

Deni Herbianto ◽

...

Keyword(s):

National Level ◽

High Mobility ◽

Malaria Prevention ◽

Participatory Approach ◽

Network Governance ◽

Public Health Issue ◽

Participatory Action ◽

Cross Border ◽

Border Malaria ◽

Significant Public Health

Abstract Background Malaria remains a significant public health issue in Indonesia. Most of the endemic areas are in the eastern parts of Indonesia, but there are a few remaining foci of persistent endemic malaria in Java, particularly in Menoreh Hills, a region bordering three districts of two provinces on this island. Despite a commitment to build a partnership to eliminate cross-border malaria, there is a lack of understanding of how this partnership might be translated into an implementable strategic plan. The study aims to provide evidence of how a participatory approach was used to strengthen the cross-border collaboration and stakeholders’ capacity to develop a joint strategic, operational, and costing plan for cross-border malaria elimination. Methods A participatory action research was conducted from January to August 2017, involving participants from the village, district, provincial, and national levels. This study was conducted in seven phases, including document review, focus group discussions (FGDs), planning and costing workshops, and a dissemination meeting. A total of 44 participants from primary health centres (PHC) and 27 representatives of affected villages in three districts, 16 participants from the district and provincial malaria programmes and planning bureaus, and 11 participants from the national level were involved in the processes. Data on priority issues, costing, programme coverage, and administration were collected. Thematic coding and feedback were used for analysis. Results Problems identified by stakeholders included low community awareness and participation in malaria prevention, high mobility across three districts, lack of financial and human resources, lack of inter-district coordination, and poor implementation of migration surveillance. Cross-border strategies identified to address malaria were improving cross-border migration surveillance, strengthening the network, governance, and advocacy of malaria control implementation across borders, and developing the malaria information system. A working group composed of the three districts’ representatives authorized to decide on cross-border issues will be created. Conclusions The participatory approach was applicable in cross-border malaria planning for within-country settings and useful in enhancing stakeholders’ capacities as implementers. While done in a participatory way, the joint plan crafted was a non-binding agreement; stakeholders should advocate to ensure adequate funds are poured into mobilizing the programme.

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Effectiveness of Joint 3+1 Malaria Strategy Along China-Myanmar Cross Border Areas

10.21203/rs.3.rs-132294/v1 ◽

2020 ◽

Author(s):

Zu-rui Lin ◽

Shi-gang Li ◽

Xiao-dong Sun ◽

Xiang-rui Guo ◽

Zhi Zheng ◽

...

Keyword(s):

Plasmodium Vivax ◽

Prevalence Rate ◽

Indoor Residual Spraying ◽

Parasite Prevalence ◽

Pilot Project ◽

Vector Surveillance ◽

Buffer Area ◽

Cross Border ◽

Border Malaria ◽

Significant Difference

Abstract Background: Cross-border malaria in Laiza City of Myanmar seriously compromised the achieving goal of malaria elimination in Yingjiang County of China. A pilot project on 3+1 strategy of joint cross-border malaria prevention and control was carried out in building border malaria buffer area in the both sides since 2017; Here, 3 was the three preventive lines in Yingjiang County to strengthen targeted measures of elimination malaria in China and +1 was a defined border area in Laiza City to adopt the integrated measures of malaria control in Myanmar. Methods: A retrospective analysis from 2015 to 2019 was conducted and the descriptive statistics was used to analyze and compare the data of malaria case detection, parasite prevalence and vector surveillance. Results: In +1 area of Myanmar from 2015 to 2019, the average of annual parasite incidence was (59.11±40.73) / 1000 and plasmodium vivax accounted for 96.27 % of total confirmed cases. After the pilot project, the annual parasite incidence, microscopic parasite prevalence rate and density of An. Minimus reduced by 89%,100% and 93.93% respectively, but the submicroscopic parasite prevalence rate was no significant difference between the two surveys (p =0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The average of annual importation rate from 2015 to 2019 was (0.47±0.15)/1000. After the pilot project, it reduced by 53% of whole county, 67% of the first preventive line, 52% of the second preventive line and 36% of the third preventive line respectively. Conclusion: The pilot project on 3+1 strategy has made remarkable effectiveness and a buffer area of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China. The combined use and expanded coverage of indoor residual spraying and long-lasting insecticidal nets (LLINs) was more effective than only use of LLINs in reducing the transmission of plasmodium vivax caused by An. Minimus. It is necessary to adopt submicroscopic infection interventions to eliminate potential sources of infection in Laiza City of Myanmar.

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A participatory approach to address within-country cross-border Malaria: the case of Menoreh Hills in Java, Indonesia

10.21203/rs.3.rs-98599/v2 ◽

2021 ◽

Author(s):

Riris Andono Andono Ahmad ◽

Astri Ferdiana ◽

Henry Surendra ◽

Tyrone Reden Sy ◽

Deni Herbianto ◽

...

Keyword(s):

National Level ◽

High Mobility ◽

Malaria Prevention ◽

Participatory Approach ◽

Network Governance ◽

Public Health Issue ◽

Participatory Action ◽

Cross Border ◽

Border Malaria ◽

Significant Public Health

Abstract Background Malaria remains Indonesia's significant public health issue. Most of the endemic areas are in the eastern parts of Indonesia. However, there are a few remaining foci of persistent endemic malaria in Java, particularly in Menoreh Hill, a region bordering three districts of two provinces on this island. Despite a commitment to build a partnership to eliminate cross-border malaria, there is a lack of understanding of how this partnership might be translated into an implementable strategic plan. The study aims to provide evidence of how a participatory approach was used to strengthen the cross-border collaboration and stakeholders' capacity to develop a joint strategic, operational, and costing plan for cross-border malaria elimination. Methods We performed participatory action research from January to August 2017, involving participants from the village, district, provincial, and national levels. This study was conducted in seven phases, including document review, focus group discussions (FGDs), planning and costing workshops, and a dissemination meeting. A total of 44 participants from primary health centers (PHC) and 27 representatives of affected villages in three districts, 16 participants from the district and provincial malaria programs and planning bureaus, and 11 participants from the national level were involved in the processes. Data on priority issues, costing, program coverage, and administration were collected. We use thematic coding and feedback for analysis. Results Problems identified by stakeholders included low community awareness and participation in malaria prevention, high mobility across three districts, lack of financial and human resources, lack of inter-district coordination, and poor implementation of migration surveillance. Cross-border strategies identified to address malaria were improving cross-border migration surveillance, strengthening the network, governance, and advocacy of malaria control implementation across borders, and developing the malaria information system. A working group composed of the three districts' representatives authorized to decide on cross-border issues will be created. Conclusion The participatory approach was applicable in cross-border malaria planning for within-country settings and useful in enhancing stakeholders' capacities as implementers. While done in a participatory way, the joint plan crafted was a non-binding agreement; stakeholders should advocate to ensure adequate funds are poured into mobilizing the program.

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Contributing to Elimination of Cross-Border Malaria Through a Standardized Solution for Case Surveillance, Data Sharing, and Data Interpretation: Development of a Cross-Border Monitoring System

JMIR Public Health and Surveillance ◽

10.2196/15409 ◽

2020 ◽

Vol 6 (3) ◽

pp. e15409

Author(s):

Raphael Saldanha ◽

Émilie Mosnier ◽

Christovam Barcellos ◽

Aurel Carbunar ◽

Christophe Charron ◽

...

Keyword(s):

Time Series ◽

Monitoring System ◽

Malaria Control ◽

Expert Knowledge ◽

Scientific Evidence ◽

Heterogeneous Data ◽

Surveillance Systems ◽

Malaria Surveillance ◽

Cross Border ◽

Border Malaria

Background Cross-border malaria is a significant obstacle to achieving malaria control and elimination worldwide. Objective This study aimed to build a cross-border surveillance system that can make comparable and qualified data available to all parties involved in malaria control between French Guiana and Brazil. Methods Data reconciliation rules based on expert knowledge were defined and applied to the heterogeneous data provided by the existing malaria surveillance systems of both countries. Visualization dashboards were designed to facilitate progressive data exploration, analysis, and interpretation. Dedicated advanced open source and robust software solutions were chosen to facilitate solution sharing and reuse. Results A database gathering the harmonized data on cross-border malaria epidemiology is updated monthly with new individual malaria cases from both countries. Online dashboards permit a progressive and user-friendly visualization of raw data and epidemiological indicators, in the form of time series, maps, and data quality indexes. The monitoring system was shown to be able to identify changes in time series that are related to control actions, as well as differentiated changes according to space and to population subgroups. Conclusions This cross-border monitoring tool could help produce new scientific evidence on cross-border malaria dynamics, implementing cross-border cooperation for malaria control and elimination, and can be quickly adapted to other cross-border contexts.

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