Update on the APMEN Malaysian Case Study

The Malaysian case study was developed during the third annual APMEN meeting (APMEN III) in Kota Kinabalu in 2011.  During this meeting, APMEN held a study tour focusing on the history and current work of the community-based health worker (volunteers) program in Sabah.  The organisation of the study tour was facilitated by Dr. Moh Seng Chang, now the Chair of the APMEN Vector Control Working Group, who also provided dissemination of a report and data on the program.  Additionally, innovative intersectoral collaborations between the Vector Borne Disease Control program and private palm oil and rubber plantations were presented as part of the overview of Malaysia’s program for meeting participants.  The study tour subsequently spurred discussions between APMEN meeting participants, Dr. Christina Rundi of the National Disease Control Division, Malaysia as well as the Sabah Health Department team, in particular Dr. Jenarun Jelip, around the potential to develop a case study on Malaysia for APMEN.   All parties agreed that Sabah State would be an interesting place to conduct a comprehensive overview of progress and challenges related to malaria elimination, in order to gather as much information as possible on the national context and the private public partnerships.

Through the close collaboration between Dr Rundi and the UCSF Global Health Group, which leads the case study work, the case study partners were brought together to craft the objectives, topics of focus and the timeline for a case study on Malaysia.  Ms. Kelly Sanders, MSc., was recruited through the UCSF Global Health Group to conduct the in country data collection.  Ms Sanders arrived in Malaysia in mid February and began immediately collecting aggregate epidemiologic data at the National Vector Borne Disease Control office with Dr. Rundi and her staff.  The next two and a half months were spent in Sabah with the state level malaria control program officers, collecting additional data (see Chart 1for sample results), making site visits, observing meetings and learning about the program. The Sabah Vector Borne Disease office, lead by Dr. Jenarun Jelip and supported by Mr. Yusof Rashman, provided Kelly with technical information, program details and logistical support. During this time, Kelly was also able to meet with other APMEN collaborators, Dr. Noor Rain Abdullah and Dr. Moh Seng Chang, who provided additional perspectives on the malaria situation in Malaysia, and offered technical support throughout the study. Upon approval for the qualitative component of the study, Kelly conducted comprehensive interviews on the malaria program with key personnel in the National office, the Sabah and Sarawak (East Malaysia) and the Malacca, Negeri Sembilan and Selangor states in West Malaysia. These comprehensive interviews focused on key programmatic information, detailing both program activities and malaria epidemiology over the past two decades.

[Data collected at the Sabah state Vector Borne Disease Office, 2012]

In addition to the program interviews, Kelly interviewed District Health Officers and plantation management from throughout the Sabah state, about the intersectoral relationship between private palm oil, rubber and acacia plantations and the government malaria program. The collaboration of the state and district offices was crucial, and the district malaria officers contributed significantly to the success of the project by participating in interviews and providing logistical and technical support for Kelly.

Preliminary findings from the 34 key informant interviews with over 55 participants show a wide variety of collaborative efforts between the Vector Borne Disease offices and plantation management and staff. These include privately subsidized and/or subcontracted IRS, government malaria sub-sector offices on private land, and a number of varying financial, programmatic and logistical support inputs from both groups. These relationships were often developed in response to outbreaks, and discussions regarding collaborative efforts were usually initiated by government health offices. In light of the substantial number of migrant workers employed by plantations in Sabah, collaborative efforts between the private sector and the government will continue to be key in identifying and working with migrant populations. Additionally, the information gathered regarding these private-public partnerships may act as a blueprint for other APMEN countries facing similar challenges. The case study will launched in 2013 as part of the WHO Global Malaria Programme – UCSF Global Health Group case study series on malaria elimination, in collaboration with APMEN.

New APMEN product tools launched

APMEN Video: Paving the Way for Malaria Elimination

The Asia Pacific Malaria Elimination Network promotional video ‘Paving the Way for Malaria Elimination’ is now available on DVD to all members and friends of APMEN. Officially launched at the APMEN V annual meeting in Bali , the 9-minute feature shares the story of APMEN, introduces Country Partners and Partner Institutions, highlights the work of the Vivax and Vector Working groups. It also shares the successes, challenges and priorities for APMEN, such as P.vivax research in the Asia Pacific.

Country Partners of APMEN made the call for further advocacy tools to highlight their work during the APMEN IV business meeting in Seoul in 2012.

The video was first shown at the Malaria 2012: Saving Lives in the Asia Pacific in November 2012, where APMEN and its Country Partners were well represented.

To view the video, click here

Vector Pocket Guide

At the recent APMEN V Annual Technical and Business meeting in Bali (4-7 March, 2013), in conjunction with the Vector Working Group, APMEN launched the first edition of the Vector Pocket Guide; a compact vector identification manual designed for researchers in the field.

Developed by APMEN Partner Institution the Armed Forces Research Institute for Medical Sciences (AFRIMS) based in Thailand, the pocket-sized guide details 26 different species of vectors from the Asia Pacific Region, including morphology charts and a specific outline of the distribution, bionomics and medical importance of each.

Dr Alongkot Ponolowat, Chief, Vector Biology and Control of AFRIMS, said the production of the guide involved collaboration with several country partners and their respective biosystematics and entomology departments.

“While this guide is specifically for the primary vectors in the region, we hope to develop it in the future to include secondary vectors, and include more details with the feedback from APMEN country members.” he said.

Chair of the Vector Working Group Professor Moh Seng Chang added the pocket guide is a distinguishing and important vector identification tool for the entomologists and technicians in the APMEN countries.

“It signifies the complexity of the malaria vectors and the need to accurately identify the vector species in different ecological settings for malaria elimination in the Asia Pacific region.” he said.

If you would like to order samples of the Vector Pocket Guide, please email the APMEN Secretariat (apmen@sph.uq.edu.au).

DVD for P. vivax DNA extraction

An instructional DVD on Plasmodium vivax DNA extraction is now available to assist researchers and National Malaria Control Programs to better understand the diversity of Plasmodium vivax in their communities.

An important theme of the Vivax Working Group has been the molecular analysis of the Plasmodium vivax (P. vivax) isolates across different APMEN countries. These genotyping projects provide insights into the movement of malaria parasites, the cause of outbreaks, the origin of infections, declining drug efficacy against P. vivax  and the local epidemiology of malaria (such as patterns of relapse).  Modern technologies have progressed considerably and now offer the opportunity to analyse the whole genome of the parasite. An instructional DVD for the standard operating procedures for P. vivax DNA extraction is now available to assist researchers to better understand the diversity of P. vivax in their communities. Developed by the APMEN Vivax Working Group, and researchers from Menzies School of Health Research in Darwin, the DVD demonstrates a simple technique for sample preparation for whole genome analysis.

Professor Ric Price, Chair of the APMEN Vivax Working Group, explained the importance of sharing research methodologies within the Network.

“The DVD highlights a simple process that can be used to provide quality samples for whole genome analysis.  Although this technology in itself won’t provide immediate translation into clinical practice it will help us to design a bar code from which we can develop simple and applicable techniques for surveillance to optimise national malaria programs activities.”

Menzies Research Officer Dr Sarah Auburn, who is helping to build laboratory capacity for P. vivax genotyping for APMEN, recently published on ‘Effective Preparation of P. vivax Field Isolates for High-Throughput Whole Genome Sequencing’ in PLoS ONE. That paper can be accessed here .

The development of tools, such as this video, are a critical component of APMEN’s efforts to build regional capacity in molecular surveillance and further support the development of innovative strategies to better understand and measure the impact of malaria in the Asia Pacific Region.

For a free copy of this DVD, email the APMEN secretariat (apmen@sph.uq.edu.au)

New Partner Institutions welcomed

The Asia Pacific Malaria Elimination Network is pleased to announce the addition of three new partner institutions to the Network: the Pasteur Institute of Cambodia (IPC), the Foundation for Innovative New Diagnostics (FIND) and James Cook University (JCU). Partner Institutions are vital to achieving the goals of the Network, and with their strong support through academic, public and private sector institutions, they provide additional technical expertise, funding, information sharing, and often conduct complementary research activities that continue to inform the evidence base.

The Pasteur Institute of Cambodia (IPC) is a member of the global Institut Pasteur network, which includes 32 institutes worldwide, and was established in 1953. Following the civil war it was relocated and a new facility was opened following an agreement between the Royal Government of Cambodia and Institut Pasteur in France. The IPC dedicates it work to the prevention of and response to infectious diseases, including HIV/AIDS, tuberculosis, hepatitis and malaria. Housed in Phnom Penh, the Institute is located in an area known for the emergence of drug-resistant pathogens, including Plasmodium falciparum and P. vivax. The IPC collaborates closely with the Ministry of Health in Cambodia, conducts cutting edge research in its laboratories, and builds local capacity by training Cambodian researchers and scientists. Dr. Didier Ménard, an active participant in the APMEN Vivax working group, currently manages the Malaria Molecular Epidemiology Unit. The IPC will help to build APMEN’s technical expertise, particularly regarding research related to Plasmodium vivax and emerging drug resistance in Southeast Asia. Additionally, the IPC is well positioned to participate in the APMEN Fellowship Program, with excellent lab training opportunities for fellows from around the region

The Foundation for Innovative New Diagnostics (FIND) is a Swiss non-profit organization that works to develop affordable, easy-to-use and cutting edge diagnostic tests for infectious diseases. FIND works with international research institutions, non-profits and private companies to develop new technologies, and partners with 55 manufacturing partners worldwide to ensure low prices for its diagnostic tools. The organization also works in close collaboration with the World Health Organization, specifically the Global Malaria Programme and the Special Programme on Research in Tropical Diseases (TDR). FIND focuses its malaria diagnostic work in two main areas: case management and elimination. Within these areas, FIND works to develop new diagnostic tools that push technological boundaries, and more importantly, can be easily accessed and implemented in low resource settings. FIND will bring to APMEN technological expertise on key areas of importance for malaria elimination: new tools for case finding and quality control of current tools. In collaboration with APMEN country partners, this will help address elimination priorities including population-based malaria screening, case finding and G6PD deficiency detection in low endemic settings. The organization will also participate in the APMEN Vivax Working Group.

The third new partner institution, James Cook University (JCU), was established in 1970 in Townsville and Cairns, Australia. JCU houses the Anton Breinl Centre for Public Health & Tropical Medicine within the School of Public Health, Tropical Medicine and Rehabilitation Sciences, which is internationally renowned for its postgraduate public health training programs. The Anton Breinl Centre (ABC) works in tropical Australia and neighbouring countries, specifically focusing on remote and rural communities. James Cook University also hosts the Australian Institute of Tropical Medicine and is a member of the Queensland Tropical Health Alliance.  Of particular relevance for APMEN, JCU houses the secretariat of the Vector Ecology and Control Network (VECNet); a consortium of vector control experts that works to gather and model data on malaria transmission, with the aim of informing research and strategies in malaria endemic countries. Several staff members of JCU are currently members of the APMEN Vector Control Working Group, and will continue to provide technical expertise, particularly in light of plans by the working group to develop operational research projects related to vector control. JCU plans to provide support for the APMEN Fellowship Program by providing training for fellows that may not be available in their home country.

Each new partner institution will provide critical expertise in their respective areas, expanding APMEN’s capacity to share information between countries and partners, undertake capacity building activities and build evidence related to malaria elimination in the Asia Pacific region.

APMEN V Meeting Summary Statement

The Asia Pacific Malaria Elimination Network, led by the 14 Country Partners of the Network, is pleased to announce the release of the APMEN V Meeting Summary Statement, generated from the recent fifth annual APMEN meeting, which took place in Bali, Indonesia, March 4 to 7, 2013.

The Statement proposes four major areas of focus for the Network over the next 12 months, and highlights the Network’s commitment to reducing malaria incidence in the Asia Pacific Region.

Read and share the full statement here.

APMEN Media Release

To celebrate World Malaria Day 2013, APMEN has launched a video featuring Co-Chair of the Network, Sir Richard Feachem.

View the media release and watch the video here .