Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

The incidence of malaria cases continued to drop dramatically in rural and remote Myanmar villages after community workers trained only to detect and treat malaria began providing basic health care as well as malaria services. Adding the health services to malaria control benefitted the villagers access to health and improved malaria services – paving the way for malaria elimination.

Local people on an elephant in Myanmar

Villages where trained community health workers (CHWs) provided malaria diagnosis and treatment experienced a 70% decline in P. falciparum and a 64% drop in P. vivax malaria incidence for each year of operation, the scientists say in a study published in BMC Medicine.

But as malaria fell so did the number of people being screened. When community health workers began offering a broader package of health services – including for tuberculosis (TB), respiratory tract infections, malnutrition and diarrhoea, while continuing to screen for malaria – health improved and so did malaria control.

“To maintain effective malaria control in hard to reach areas village health workers were trained both to screen and treat malaria and to handle other common health care needs,” said study author Oxford Prof Frank Smithuis, Director of the Myanmar Oxford Clinical Research Unit (MOCRU) and the NGO Medical Action Myanmar (MAM) in Yangon, Myanmar.

“This significantly reduced malaria transmission and kept patients coming in to be screened for malaria, which is essential if we are to eliminate malaria in Myanmar,” explained Prof Smithuis.

The study did a retrospective analysis of over half a million malaria rapid diagnostic tests conducted between 2011 and 2016 by 1,335 CHWs supported by MAM in cooperation with the Myanmar Department of Health. Its results have important implications for Myanmar and other SE Asian countries racing to eliminate malaria.

“This study demonstrates that to eliminate malaria in hard to reach areas, CHWs networks should be offering malaria screening and treatment and basic health care,” said study contributor Mahidol and Oxford University Prof Sir Nicholas White. “Training health workers to just screen for malaria is not sustainable. These CHWs must offer a package for common health problems. This will sustain the popularity of the CHW services, benefit the accessibility of health services for the community and ensure that malaria is eliminated and then stays eliminated.”

“Many of the people we studied live in communities with no medical care of any kind other than local “quacks” and so remote that it could take 1-2 days of hard travel to reach them,” said Dr Alistair McLean, lead author. “Offering people in hard-to-reach communities a package of basic quality health services is essential to prevent malaria resurgence.”

The project was funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria, the 3 Millennium Development Goal Fund, Planet Wheeler Foundation, Kadoorie Charitable Foundation, DAK Foundation, and The WellcomeTrust (UK).

MOCRU is the Myanmar Unit of the Mahidol Oxford Tropical Medicine Research Unit (MORU), a Wellcome-funded tropical health network based in Bangkok, Thailand.

Similar stories

Meta-analysis informed the updated WHO guidelines for treatment of uncomplicated malaria in the first trimester of pregnancy

A new WWARN meta-analysis, commissioned by the World Health Organization and which informed a change to its treatment guidelines, has been published in The Lancet. The study provides compelling evidence that artemether-lumefantrine should now replace quinine as the treatment of choice in the first trimester.

Combating drug-resistant malaria

MORU research has contributed to strategies to eliminate malaria in the Greater Mekong Sub-region, helping to prevent the spread of drug-resistant malaria and improving health provision and outcomes for remote communities.

Study shows clear link between antibiotic treatment and acquisition of AMR bacteria in children

A study of the genetic diversity of Streptococcus pneumoniae, the bacterium responsible for hundreds of thousands of infant deaths each year, found that deep sequencing whole pneumococcal populations gave unsurpassed sensitivity for detecting multiple colonisations and was twice as effective at detecting invasive virulent strains of the bacteria as current best methods, say researchers in a study published in Nature Microbiology.

Antimalarial chemoprophylaxis for forest goers could help accelerate malaria elimination in Cambodia

Giving people antimalarials during and after visiting the forest reduced their risk of contracting malaria 6-fold, and could be the missing piece towards eliminating malaria in Asia-Pacific and South America, say Mahidol and Oxford University researchers in a study published in The Lancet Infectious Diseases.

Four CTMGH researchers awarded full professorships

We are delighted to announce that four of our researchers have been awarded the title of Professor, in recognition of their research achievements, contribution to teaching, and contribution to the general work of the Nuffield Department of Medicine, University of Oxford.

INTERBIO-21st study findings could help predict infants at risk of obesity

Fetal abdomen growth and the mother’s blood fat metabolites very early in pregnancy influence a child’s weight, body fat, vision and neurodevelopment at 2 years of age