Aims: Myanmar achieved an 82% decrease in malaria between 2012 and 2017, with a total of 84,464 reported cases in 2017. The country plans to eliminate P. falciparum malaria by 2025, which involves the rollout of elimination-focused activities such as case investigation (CI). The Ayeyarwady Region of Myanmar launched CI in low endemic townships in June 2017. An operational review of the first ten months of CI was conducted to assess this rollout and determine best practices going forward.
Methods: A descriptive quantitative analysis of available investigation data was conducted in tandem with an open-ended qualitative survey. The quantitative portion involved collecting and tabulating CI forms and assessing patterns and gaps in the data. The qualitative portion involved phone calls to staff responsible for CI to survey perceived difficulty and comprehension of the investigation and classification processes.
Results: Between June 2017 and April 2018, there were 102 cases of malaria in Ayeyarwady’s low endemic townships. Of these cases, 24% were investigated and 6% were classified. Among investigated cases, 75% were male and 40% were between the ages of 30-50. The most common response to occupation was farmer. All of the classified cases were imported from within Myanmar. Results also indicated low completeness of CI forms (43% of fields filled on average). Qualitative results suggested the major reasons cases were not investigated were a lack of clarity on job responsibilities, delayed case notification, and confusion with the long CI forms.
Conclusion: Additional measures are needed to ensure the successful investigation and subsequent classification of cases in Ayeyarwady. Causes of delayed notification should be addressed to ensure prompt case investigations. CI form revision and refresher trainings may be needed to ensure form comprehension and clarify the roles of staff responsible for CI.