Malaysia in on track to achieve malaria elimination by 2020. In 2017 only 85 cases of human indigenous malaria were reported in the country. However, we are faced with risk of malaria reintroduction because of our proximity to countries with high malaria burden and influx of foreign labor force from malaria endemic countries. In 2017, 415 cases of imported malaria were reported in the country. In an attempt to mitigate, Ministry of Health Malaysia developed a Guideline for Prevention of Malaria Re-Introduction. In the guideline, a system to objectively assess malaria foci in terms of risk of malaria re-introduction is described. This paper aims to briefly describe this system and share data extracted from the system.
The system starts with identification of Malaria foci using a preliminary assessment tool for anopheles breeding. Malaria foci are enrolled for further assessment in terms of receptivity and vulnerability. Receptivity data are collected using a standardized receptivity form that contains 9 entomological parameters. Vulnerability data are collected using a standardized vulnerability form that contains 10 parameters related to malaria epidemiology and population characteristics related to risk of malaria infection. Malaria Reintroduction Index is generated by multiplying the weighting factors of the different level of receptivity and vulnerability indices.
To date 16,080 malaria foci have been enrolled in the system for further assessment. Assessment have been completed in 9,065 malaria foci, out of which 339 (3.7%) had high risk of malaria reintroduction, and 969 (10.7%) had medium risk of malaria reintroduction.
Malaria foci with high risk of malaria reintroduction have been prescribed with a set of interventions which include vector control using IRS and/or ITN. These foci will be reassessed after two cycles of IRS and/or ITN. This system will continue to assist Malaysia to effectively mitigate malaria reintroduction.