“To properly implement an effective surveillance and response system we need ability and we need action.” Professor Gao Qi, SRWG Chair

The APMEN SRWG provides a forum to assist national malaria programs in identifying strong, evidence-based surveillance strategies that allow programs to identify and respond to every malaria infection. Malaria programs and partners work together to adapt and share surveillance system tools and strategies. The SRWG supports APMEN countries through sharing field-ready surveillance tools, and provide training and support to programs that is tailored to the specific challenges they are facing as they move towards elimination.

Assessing malaria surveillance systems to improve case-based  surveillance 

Malaria elimination requires strong, evidence-based surveillance strategies that allow programs to identify and respond to every malaria infection. The APMEN SRWG, with the technical support of the Jiangsu Institute of Parasitic Diseases (JIPD), is conducting assessments with Country Partners to identify solutions to improve implementation of case-based surveillance. Findings and recommendations gained through this process will be used by the SRWG and national programs to develop country-specific work plans. The work plans will identify areas in which SRWG and Partner Institutions in the region can support programs in the short-, medium-, and long-term to implement solutions to overcome barriers in implementing case-based surveillance.

To date, Bangladesh, Nepal, Philippines, Solomon Islands, and Thailand have participated in the assessment. The Bangladesh assessment was the first to be completed. SRWG and APMEN Partner Institution icddr,b have just completed the first activity in response to the findings of the assessment. In early August, 17 entomologists were trained in-country on how to better use entomological surveillance tools to improve the effectiveness of program activities. Details of the training below.

SRWG, in collaboration with JIPD conducted a surveillance and response assessment with Bangladesh in February 2019. Sub-national elimination targets have been set and there is a strong commitment from the National Malaria Control Program (NMCP) in partnership with local NGO’s and research institutions, technical partners and other stakeholders to meet these targets. Following the assessment, SRWG, JIPD and the NMCP agreed that the implementation of a more robust case-based surveillance system using a 1-3-7-type of model would be strengthened if improvements were made in 5 keys areas: capacity to develop geo-spatial data, entomological surveillance, development of standard operating procedures (SOPs) for elimination districts, linking program data sets, and updating microscopy guidelines.

SRWG worked with APMEN Partner Institution icddr,b to conduct a training program for entomological surveillance. In early August 2019, 17 entomologists from central and sub national programs were trained to use the Entomological Surveillance Planning Tool (ESPT), a tool developed by UCSF’s  Malaria Elimination Initiative. The training focused on how to identify and monitor foci with active transmission and how to correlate entomological data in focus with case investigation, temporal malaria incidence, rainfall, land usage, human behavior, and other meta-data to inform rapid and effective response.

Skills  transferred to participants

• How to install light traps and collect mosquitoes from the light traps
• How to collect larval samples following standard procedures
• How to conduct human landing surveys
• How to conduct insecticide resistance monitoring
• How to analyze mosquito data to understand biting behaviour and insecticide resistance

The SRWG would like to thank its partners for this training and assessment activity: The National Malaria Control Program in Bangladesh, icddr,b, and the Civil Surgeons Office in Dhaka, Rangamati, Chittagong, Commilla, Sunamgani, Netrakona, Jamalpur, Pabna, and Rangamati, and Brac. We would also like to thank lead trainer Dr Neil Lobo.

Entomological Surveillance as a Cornerstone of Malaria Elimination: A Critical Appraisal.

Strengthening malaria program skills and practices to manage and use geospatial data and technologies

In response to the capacity building request from Country Partners, SRWG collaborated with RITM, MORU and LSTMH and Geo-Health Labs to organize a basic training for risk and receptivity mapping using customized GIS techniques. The training was attended by 40 participants from Malaysia, Papua New Guinea, Philippines, Solomon Islands, and Vanuatu. During the 5 days of training, participants attended lectures, practical sessions in computer laboratories and participated in field exercises. In the coming months, SRWG will be meeting with training participants to determine in what ways the training has improved their mapping activities within the national programs.

• Clarify the concepts and the process behind the making of a good thematic map including use of data from other sources
• Train participants on the use of open-source software (QGIS and GeoODK) to collect data and produce thematic maps
• Guide national malaria programs (NMPs) towards geo-enabling their information system to support malaria elimination

Are our Surveillance and Response  Programs Ready for P. knowlesi?
  Current Tools to Combat Malaria with Special Focus on Plasmodium knowlesi Workshop

P. knowlesi is occurring in all South East Asian Countries except Timor Leste and presents a threat to malaria elimination efforts, particularly in Malaysia.

In February the Department of Parasitology at the Faculty of Medicine, University of Malaya hosted a workshop and training to review tools and approaches to improve the targeting of P. knowlesi public health interventions. SRWG supported counterparts from Thailand and Malaysia to join. During the training, participants participated in lectures, practical exercises and tools and product reviews.

The transmission of P.  knowlesi is closely linked to spatial and temporal proximity, particularly with macaques. As part of the training, participants reviewed and practiced using both licensed and public domain software that can be used for spatial-temporal analysis. They also learnt how to use these tools for visualization, exploration and modelling. Trainings to use these programs will not only benefit malaria elimination efforts – the same tools and techniques are being used by national programs in their dengue, helminthiasis, chikungunya and Zika activities.

SRWG would like to acknowledge National Center for Parasitology, Entomology and Malaria Control in Cambodia and the Bureau of Vector-Borne Diseases in Thailand for their support and participation in the training. We also extend thanks to the University of Malaya host and organizer of the training.

Technical skills reviewed and refreshed

• Using GIS to create a database and spatial visualization
• Microscopic species identification
• Performing LAMP assay for P. knowlesi
• PCR assay for all five human malaria species