Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.

<h4>Background</h4>Sri Lanka has a long history of malaria control, and over the past decade has had dramatic declines in cases amid a national conflict. A case study of Sri Lanka's malaria programme was conducted to characterize the programme and explain recent progress.<h4>M...

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Autores principales:	Rabindra R Abeyasinghe, Gawrie N L Galappaththy, Cara Smith Gueye, James G Kahn, Richard G A Feachem
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/84128cdc2df045d2bdc51ce007ebfb71
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spelling	oai:doaj.org-article:84128cdc2df045d2bdc51ce007ebfb712021-11-18T07:07:13ZMalaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.1932-620310.1371/journal.pone.0043162https://doaj.org/article/84128cdc2df045d2bdc51ce007ebfb712012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22952642/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Sri Lanka has a long history of malaria control, and over the past decade has had dramatic declines in cases amid a national conflict. A case study of Sri Lanka's malaria programme was conducted to characterize the programme and explain recent progress.<h4>Methods</h4>The case study employed qualitative and quantitative methods. Data were collected from published and grey literature, district-level and national records, and thirty-three key informant interviews. Expenditures in two districts for two years--2004 and 2009--were compiled.<h4>Findings</h4>Malaria incidence in Sri Lanka has declined by 99.9% since 1999. During this time, there were increases in the proportion of malaria infections due to Plasmodium vivax, and the proportion of infections occurring in adult males. Indoor residual spraying and distribution of long-lasting insecticide-treated nets have likely contributed to the low transmission. Entomological surveillance was maintained. A strong passive case detection system captures infections and active case detection was introduced. When comparing conflict and non-conflict districts, vector control and surveillance measures were maintained in conflict areas, often with higher coverage reported in conflict districts. One of two districts in the study reported a 48% decline in malaria programme expenditure per person at risk from 2004 to 2009. The other district had stable malaria spending.<h4>Conclusions/significance</h4>Malaria is now at low levels in Sri Lanka--124 indigenous cases were found in 2011. The majority of infections occur in adult males and are due to P. vivax. Evidence-driven policy and an ability to adapt to new circumstances contributed to this decline. Malaria interventions were maintained in the conflict districts despite an ongoing war. Sri Lanka has set a goal of eliminating malaria by the end of 2014. Early identification and treatment of infections, especially imported ones, together with effective surveillance and response, will be critical to achieving this goal.Rabindra R AbeyasingheGawrie N L GalappaththyCara Smith GueyeJames G KahnRichard G A FeachemPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e43162 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rabindra R Abeyasinghe Gawrie N L Galappaththy Cara Smith Gueye James G Kahn Richard G A Feachem Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
description	<h4>Background</h4>Sri Lanka has a long history of malaria control, and over the past decade has had dramatic declines in cases amid a national conflict. A case study of Sri Lanka's malaria programme was conducted to characterize the programme and explain recent progress.<h4>Methods</h4>The case study employed qualitative and quantitative methods. Data were collected from published and grey literature, district-level and national records, and thirty-three key informant interviews. Expenditures in two districts for two years--2004 and 2009--were compiled.<h4>Findings</h4>Malaria incidence in Sri Lanka has declined by 99.9% since 1999. During this time, there were increases in the proportion of malaria infections due to Plasmodium vivax, and the proportion of infections occurring in adult males. Indoor residual spraying and distribution of long-lasting insecticide-treated nets have likely contributed to the low transmission. Entomological surveillance was maintained. A strong passive case detection system captures infections and active case detection was introduced. When comparing conflict and non-conflict districts, vector control and surveillance measures were maintained in conflict areas, often with higher coverage reported in conflict districts. One of two districts in the study reported a 48% decline in malaria programme expenditure per person at risk from 2004 to 2009. The other district had stable malaria spending.<h4>Conclusions/significance</h4>Malaria is now at low levels in Sri Lanka--124 indigenous cases were found in 2011. The majority of infections occur in adult males and are due to P. vivax. Evidence-driven policy and an ability to adapt to new circumstances contributed to this decline. Malaria interventions were maintained in the conflict districts despite an ongoing war. Sri Lanka has set a goal of eliminating malaria by the end of 2014. Early identification and treatment of infections, especially imported ones, together with effective surveillance and response, will be critical to achieving this goal.
format	article
author	Rabindra R Abeyasinghe Gawrie N L Galappaththy Cara Smith Gueye James G Kahn Richard G A Feachem
author_facet	Rabindra R Abeyasinghe Gawrie N L Galappaththy Cara Smith Gueye James G Kahn Richard G A Feachem
author_sort	Rabindra R Abeyasinghe
title	Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
title_short	Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
title_full	Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
title_fullStr	Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
title_full_unstemmed	Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
title_sort	malaria control and elimination in sri lanka: documenting progress and success factors in a conflict setting.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/84128cdc2df045d2bdc51ce007ebfb71
work_keys_str_mv	AT rabindrarabeyasinghe malariacontrolandeliminationinsrilankadocumentingprogressandsuccessfactorsinaconflictsetting AT gawrienlgalappaththy malariacontrolandeliminationinsrilankadocumentingprogressandsuccessfactorsinaconflictsetting AT carasmithgueye malariacontrolandeliminationinsrilankadocumentingprogressandsuccessfactorsinaconflictsetting AT jamesgkahn malariacontrolandeliminationinsrilankadocumentingprogressandsuccessfactorsinaconflictsetting AT richardgafeachem malariacontrolandeliminationinsrilankadocumentingprogressandsuccessfactorsinaconflictsetting
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Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.

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