West Highlands is one of the severely malaria-endemic areas in the whole country

According to the evaluation of the management board of National Malaria Control and Elimination at the conference o­n controlling malaria, parasitic and vector-borne diseases 2014 of the Central coastal area and West Highlands, malaria situation decreased in the whole country, but increased partially in some areas, risk of malaria still remain in  West Highlands, Central coastal areas and the Southeast region.

Main points of malaria situation of the whole country are in West Highlands, Central coastal areas and Southeast areas

According to the IMPE-Quy Nh?n, malaria situation of the whole country in 2014 against the same period of 2013, malaria morbidity decreased by 21.29% (27,868/35,406), malaria parasitic decreased 8.03% (15,752/17,128), severe and complicated malaria reduced 13.10% (73/84), malaria deaths didn't increased or decreased (6/6), no malaria outbreak occurred.

It is important that there were 6 malaria deaths: 3 cases in Central areas and West Highland (Gia Lai, Kon Tum, Quang Binh) and 3 cases in the South - Lam Dong (Binh Phuoc, Dong Nai, An Giang) had high parasitic density of asexual form in blood (P.Ft⁺⁺⁺⁺), infected by imported malaria or crossing borders (Lao PDR), the cause of deaths by complications because of late hospitalisation. 73 cases of severe and complicated malaria (risk of death) in 2014 concentrated in provinces of Central Vietnam (25 cases), West Highlands (22 cases), Southeast  (23) and Mekong River Delta (3).

  Among malaria indexes, it is necessary to pay attention to the index of malaria parasites (Plasmodium falciparum, P.vivax, P.malariae, P.knowlesi) in our country, because it is not o­nly agent causing diseases but also it recur the outbreak in malaria-endemic areas which having the presence of main vectors such as Anopheles minimus, An.dirus and secondary vectors (An.aconitus, An.maculatus, An.jeyporiensis). It is anxious that the indexes of parasites were very high in central coastal area and Western Highlands and the South-Lam Dong.

Table 1: Compared the index of malaria parasites among areas of the whole country in 2014

Compared indexes of malaria parasites in every area against the whole country, the West Highlands had highest rate (48.95%), Central areas (35.29%), the Southeast had mainly in Binh Phuoc (11.62%); 4 other areas of the country had low rate of malaria parasites ( from 0.29 to 1.82%).

Table 2: Provinces having the highest rate of malaria parasites

The analysed result showed that the province having highest rate of malaria parasites (4000 malaria parasites and above) was Gia Lai (4,367); 4 provinces having rate of malaria parasites between 2000 and 1000 ( Dak Lak, Binh Phuoc, Khanh Hoa, Ninh Thuan) and 6 provinces having rate of malaria parasites wavered between < 1000 and > 400 (Phu Yen, Dak Nong, Quang Binh, Binh Thuan, Lam Dong, Quang Tri). These province had not o­nly high rate of malaria parasites, they were but also areas having malaria resistant to drug, including Artemisinine, so the capacity of spreading malaria in the whole country would be very fast if there were not close control measures.

Krongpa district, Gia Lai province having the highest rate of malaria in the country

The structure of malaria parasites had changed against previous period, especially P.falciparum was a kind of drug-resistant parasite, causing severe and complicated malaria and deaths making up 52.34% (8,254/15,752) compared with total of malaria parasites, with the Central coastal area (56.54%), the West Highlands (51.18%), the Southeast (50.16%), other areas having lower rate (42.31% - 14.60%). 

Research o­n drug-resistant malaria in modern laboratory system 

It is difficult to control mobilised people in Central Vietnam

According to the report of IMPE-Quy Nhon, malaria situation of the Central Vietnam in 2014 compared with the same period of 2013, malaria morbidity decreased by 9.52% (14,450/15,970), malaria parasites reduced by 5.94% (12,816/13,627), severe and complicated increased by 2.22% (46/45), malaria deaths did not increased or decreased (3/3), no malaria outbreak occurred. The provinces having the high number of malaria morbidity with 1,000 cases and above (2014/2013) included Gia Lai (4,424/4,269), Dak Lak (2,259/2,106), Khanh Hoa (1,214/1,375), Phu Yen (1,202/1,188), Ninh Thuan (1,079/1,447), Phu Yen (984).

Detection, diagnosist and treatment early and timely to reduce rate of malaria death

Although malaria has decreased in the entire region, it increased locally in some areas; especially there are 6 provinces which increase both malaria patients and malaria parasites, including Binh Thuan (malaria patients increased by 29.50%, malaria parasites increased by 32.50%), Quang Binh (malaria patients increased by 10.83%, malaria parasites increased by 25.24%), Phu Yen (malaria patients increased by 1.18%, malaria parasites increased by 18.10%), Gia Lai (malaria patients increased by 3.63%, malaria parasites increased by 36.86%), Dak Lak (malaria patients increased by 7.26%, malaria parasites increased by 12.31%), Dak Nong (malaria patients increased by 10.99%, malaria parasites increased by 7.69%); in addition, the province with the malaria patients increasing is Da Nang (+28.57%) and the province with the malaria parasites increasing is Thua Thien Hue (+14.29%). The number of severe and complicated malaria is highest in Gia Lai (11 cases) and three cases of malaria death in three provinces: Quang Binh, Gia Lai and Kon Tum, each province o­ne case. Among these three death cases, o­ne case is a six-month-old child, Ja rai ethnic group (Kon Tum), was infected in the mountain field due to long-term sleeping in the field-hut, the two other cases of complicated malaria were infected in Lao and died due to late treatment.

The cause of this increase is mainly the population that earns their living in the malaria endemic areas such as forest goers, field-hut sleeper, forest and native products exploiters, Vietnamese - Laotian border migrants who brought back malaria parasites. Therefore, the malaria indicators tended to increase or decrease insignificantly mostly in Western Highland region in 2014, which is notable because this region is large, the boundaries between the malaria endemic areas show no differences so that malaria seems to resurge and spread easily if it is not controlled tightly.

Bed-net impregnation to prevent malaria for the population in malaria-endemic area

Evaluation of malaria situation

In this year, the budget of the national malaria control and elimination program was cut by 50% but owing to the support of Global Fund and World Health Organization, the malaria control activities were deployed at grassroots level and the assigned duty was fulfilled. Although malaria has reduced o­n a national scale, the major malaria areas are located in the Western Highlands, Central and Eastern Southern Vietnam with over 90% malaria cases accounting for most of the deaths in comparison with the whole country.

In addition to the objective causes: drug-resistant malaria, insecticide resistance, or change in ecological activities due to the impacts of climate and environment change...; the uncontrollable mobile population such as: forest goers, field-hut sleepers, border migrants, etc. is still out of medical control and makes it difficult to bring out a feasible control measure, the subjective causes: some provinces didn't implement properly even though they are invested heavily; subjectivism in various levels of government as well as the community after few years of reduction in malaria cases, the unstable status of the malaria control models in the agencies, which makes it ineffective in investing o­n the infrastructures as well as improving the staff's ability; the quality of the methods such as insecticide residual spraying, impregnating bed-nets in some localities is not high; the medical staff haven't detected and treated malaria patients promptly.  

Investigation of malaria parasites in the community

From the above facts, the focus of malaria control mission of 2015 is o­n maintaining and boosting the activities sorted by function and task, reducing morbidity, preventing death cases from rising, popularizing the MoH's new guideline o­n diagnosing and treating malaria to treatment centres at grass-root levels; maintaining the study and evaluation o­n drug resistance, insecticide resistance, strengthening international cooperation in order to carry out effectively the goals of controlling and eliminating malaria.

Other news »

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• Conference on the summing-up of malaria control and elimination in Central Vietnam in 2023, and Announcement Ceremony of the decision on recognizing the achievement of malaria elimination criteria for Quang Ngai province (01/02/2024)
• Status of Anopheles vectors at malaria increasing sites in Khanh Vinh district, Khanh Hoa province in 2023_Part 2 (08/15/2023)
• Status of Anopheles vectors at malaria increasing sites in Khanh Vinh district, Khanh Hoa province in 2023_Part 1 (08/14/2023)
• Current situation of subnational malaria elimination at district-level in Central Vietnam (04/17/2023)
• Some challenges facing current malaria elimination roadmap (03/10/2023)