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 Introduction Background
The Introduction of IMPE Quy Nhon

English Name : INSTITUTE OF MALARIOLOGY, PARASITOLOGY AND ENTOMOLOGY, QUY NHON

Abbreviated : IMPE Quy Nhon

Address : 611B Nguyen Thai Hoc Street, Quy Nhon City, Binh Dinh Province, Viet Nam.

Tel : 056.3846571, 056.3847725

Fax : 056.3846755, 056.3647921

Email : vsrkstctqn@dng.vnn.vn

Website : http://www.impe-qn.org.vn

AN OVERVIEW OF THE INSTITUTE'S HISTORY

            IMPE Quy Nhon has grown out of the Malaria Research Station based in the middle part of Central Vietnam (1968), Quy Nhon Sub-Institute of Malariology, Parasitology and Entomology (1977) and was remamed IMPE Quy Nhon (1998) with the functions of and responsibilites for conducting scientific research work, providing specialist guidelines for the control of malaria, parasitic diseases, vector-borne diseases in 11 coastal provinces (from Quang Binh to Binh Thuan) and 4 highland provinces, namely Gia Lai, Kon Tum, Dak Lak and Dak Nong of Central Vietnam.

Quy Nhon IMPE in

1975 and 1986

Quy Nhon IMPE in

1998 and 2009
In the period 1976-1998

            Right after the South was completely liberated o­n April 30, 1975, the coastal and highland provinces of Central Vietnam came up against malaria outbreaks as a result of large population movements from urban areas and concentrated evacuation centers to their native villages in malaria-endemic areas. In the two years, say, 1976-1977 alone, there occurred as many as 58 malaria outbreaks, involving 699,000 infected residents and 3,976 deaths.

           

Institute's staff in a briefing on the plan for malaria control.

 

            For the containment and rollback of malaria epidemics in such a difficult situation in combination with dealing with war aftermaths and the building of a socialist country and national defence, IMPE Quy Nhon was formed in 1977 and took charge of conducting research work and taking technical measures for malaria control. The Institute's staff devoted themselves to the revolutionary cause by doing everything possible to reduce the epidemic outbreaks, the mortality and morbidity as low as many times compared to the post-liberation years.

Institute's staff serving as human baits
at night to catch mosquitoes
o­n their field trip
 
                                                       

Institute's staff examining blood smears
for the detection of malaria parasites.
                                                                   

Institute's staff staining blood slides for
microscopic examination of
malaria parasites.
                                                        

In the period 1999 to present

During the period 2001-2005, the countrywide incidence of malaria tended to decline drastically. However, the burden of malaria control still rests with the coastal and highland provinces of Central Vietnam, as reflected by 42% being the morbidity rate, 72-81% infection rate, 75-83% severe, complicated malaria and 72-86 % death rate, compared to the whole country. Hence, it came as a particular concern by the Institute over the guidelines and monitoring to be provided for malaria control in the target/key areas. The Institute's staff have monthly and quarterly visits with local people and authorities to provide guidance o­n undertaking antimalarial activities.

ADMINISTRATVE MAP OF COASTAL AND HIGHLAND PROVINCES OF CENTRAL VIETNAM

ACHIEVEMENTS OVER 30 YEARS (1977-2009)

Line Steering and Management

           Early in the innovation period 1987-1990, Viet Nam encountered a lot of difficulties in terms of socio-economic conditions (in the absence of foreign aid from the former Soviet Union) while there were large population movements from lowland areas to mountainous o­nes, from the North to the provinces of Central Highlands to settle down in new economic zones and to perform other tasks. In such situations, there occurred resurgence of malaria with a peak of transmission in 1991, resulting in 205,222 infected cases and 1,777 deaths from 9 major epidemic outbreaks. It had adverse effects o­n the socio-economic development, especially in the resettlement zones. As a result, the national strategy for malaria eradication ought to be converted into malaria control with a view to minimizing the suffered malaria casualties. In the new context, the Institute had to work side by side with the local health authorities and army medical units o­nly to provide direct medical treatment for detected cases and guidance in the containment of malaria outbreaks, particularly in border areas and at the sites of the key construction works, such as high voltage (500 KV) power line network, Yaly hydroelectric scheme, Vinh Son hydroelectric scheme, Azun Pa irrigation project, roadworks, plantations, farms, afforestation projects and factories. It came as a result that the malaria outbreaks could be contained and abated, thus mitigating the mortality and morbidity in the target areas.

Populations in malaria-endemic areas are examined and
treated
medically for malaria by the Institute's staff.

In the period 1991-2005, in coordination with the local authorities the Institute carried out surveys o­n malaria cases and provided medical examination and treatment for 2,293,026 patients and examined 15,018,131 blood slides microsopically, also distributed and supplied free-of-charge malaria medications, insecticide and other medical materials and equipment totally valued at 227,460,459,000 Vietnamese dong to malaria-stricken populations. In the period 2003-2005, in collaboration with WHO, the Institute launched deworming operations benefited by 90,000 primary school children in 9 central provinces. More importantly, in recent years, the Institute has timely detected cases of Fascioliasis liver fluke o­n the increase in several provinces and approximately 2,000 cases were medically treated from the disease. Last but not least, the Institute was involved in staff training in this field and set up a network of specialist treatment for intestinal parasites in 15 target provinces; thereby laying a firm foundation for the national programme o­n the control of worm and fluke diseases to be implemented later o­n.

Patients coming to IMPE Quy Nhon's
clinic for fasioliasis and parasitic
diseases treatment.
 
                                                   

The Institute's leaders and WHO's
experts inspected deworming
operations at a primary school.

                                                 

During the period 2001-2005, the countrywide incidence of malaria tended to decline drastically. However, the burden of malaria control still rests with the coastal and highland provinces of Central Vietnam, as reflected by 42% being the morbidity rate, 72-81% infection rate, 75-83% severe, complicated malaria and 72-86 % death rate, compared to the whole country. Hence, it came as a particular concern by the Institute over the guidelines and monitoring to be provided for malaria control in the target/key areas. The Institute's staff have monthly and quarterly visits with local people and authorities to provide guidance o­n undertaking antimalarial activities. Many malaria control teams of the the Institute had to be posted at "hot spots" to provide technical supports for the hospitals and the grass-roots health networks of the provinces of Dak Nong, Gia Lai, Kon Tum, Dak Lak, Quang Nam, Quang Tri, Khanh Hoa, Ninh Thuan etc.,. In order to take over these gruelling tasks, most of the Institute's staff had to endure hardships and accept a meager income, with which they could hardly make both ends meet while they combed day and night remote areas, border areas for medical examination, treatment and healthcare to be given to malaria patients. They even exposed themselves to mosquito bites as human baits for the sake of their research missions. Many of them had several infections with malaria and suffered a physically and mentally deprived health condition, and an emotionally deprived private life. Their great enthusiasm for their career and their devotion to working for patients, for people deserve to be highly appreciated, as they had made a minute but significant contribution to the rollback of malaria over many years.

  

The Institute's Board of Directors o­n a supervising and technically steering
mission
the coastal and highland provinces of Central Vietnam.

In reference to the malaria control indicators of 2005 in comparison with those of 1991, the morbidity dropped by 79.95%; severe, complicated malaria cases by 98.14%. The mortality also delined by 99.27% in the absence of malaria epidemics, by which it means that malaria outbreaks were contained and rolled back gradually and many malarious areas were narrowed down in terms of malaria transmission. These results have shown that notwithstanding being specifically characterized by such a situation, during 15 years (1991-2005) the central region under the Institute's malaria control led the country in achieving the objectives of reducing the morbidity, mortality and containment of malaria outbreaks. These achievements have contributed not o­nly to the public healthcare, to the Party's policies to be well implemented o­n rendering medical examination and treatment to the poor, ethnic minorities in remote areas, but also settling down the populations in new human resettlement zones, promoting the socio-economic and cultural development, and national defence in strategic areas of particular concern by the Party and the State.

         
             The above-mentioned achievements are associated with the continuous expansion of the Institute, as reflected by the fact that Quy Nhon Sub-IMPE was renamed Institute of Malariology, Parasitology and Entomology Quy Nhon o­n November 30, 1998. The Institute was catergorized as Type I research institute by the Ministry of Health, which has marked a gigantic progress made by the Institute in the innovation process.

Scientific research

            In the period 1991-2005, the Institute presided over and executed two national-level projects under the national programme (1991-1995), 29 ministerial-level projects, 13 international cooperation projects and 112 grassroot-level projects.

          The projects involved mostly the fields of malaria epidemiology, malaria entomology, malaria chemotherapy, vector-borne diseases, intestinal parasitology. The project findings/results have been adopted in reality and brought about realistic approaches to malaria control and first-line public healthcare.

Institute's Director talking over malaria research
findings at the lab.

Scientific Council assessing the Institute's findings of
a ministerial
-level scientific research project.

Malaria Epidemiology

           Malaria epidemiology involves the study o­n the role and functions of microscopic points in relation to the detection, diagnosis and early treatment of malaria cases at grass-roots levels, the study o­n epidemiological stratification with interventional control measures; thereby serving as a baseline for malaria control planning. It also includes the study o­n epidemiological characteristics and effective interventional measures against malaria in human communities o­n plantations, populations spending the night in mountain fields, free migrants, eventually with the aim of reducing the risk of malaria infection in these human communities. Finally, it involves the application of NESTED PCR and giemsa staining techniques to identify the strains of P. falciparum, P. vivax and P. malariae.

    Dept. of Epidemiology staff on a monitoring
                  mission at grassroot level

Institute's staff intepretating the stratification
of malaria Epidemiology

   Dept. of Epidemiology staff and the commune
           health service staining blood slides
                     for lab examination.

Malaria Parasitology and Malaria Treatment

           A reduction in deaths from malaria in recent years, say, 144 cases (1998) down to o­nly 13 cases in 2005 is due to the fact that the Institute had undertaken many urgently needed projects with the aim of abated malaria deaths and formulating a periodically appropriate strategy for malaria treatment. In doing so, the malaria chemotheraphy has involved the assessment of the current situation of managing antimalarial drugs at all levels to enhance the effectiveness of drug administration under the malaria control programme. It also includes the study o­n drug resistence and the monitoring of the efficacy of therapeutic regimens for drug-resistance; the assessment of the causes of non-coagulated blood in malaria cases and the study o­n malaria immunity in the populations of malaria-endemic areas and finally the recommendations o­n effective malaria control measures.

Institute's staff conducting medical
 drug to local people

examination and distributing 
o­n their field trip.
Intestinal Parasitology

           The intestinal parasitology involves the study o­n the epidemiological characteristics of intestinal worms and flukes, the current situation of human infections with liver flukes, namely Opsithorchis viverrini and Fasciola gigantica in Central Vietnam, thereby recommending effective control measures, also the identification of those fluke species by PCR.

Staff talking over the images of
intestinal parasites.
 

Bovine liver under dissection for
Fasiola gigantica by technicians.

Medical Entomology

         The entomological activities involve the study o­n Anopheline mosquitoes as malaria vectors and other insects like Culicinae as the carrier of dengue fever, Japanese encephalitis and extensive research work in the field of molecular biology (PCR), electrophoresis and genetics for the purpose of identifying the genera of mosquitoes, namely An. minimus and An. dirus as the primary vectors, the study o­n some of biological characteristics of vectors and others factors related to malaria transmission, the efficacy of insecticides engaged in the malaria control programme, thereby recommending effective control measures.

Entomologists identifying the larvae
of Anopheline species.

Identifying mosquito species by PCR. 

Protein electrophoresis o­n Anopheles to identify
the composition of species from complexes.

Colony of anopheline mosquitoes
at the laboratory.

Training
 
         
            Since 1977 up to date, the Institute has conducted 29 training courses for secondary technicians under the full-time, formal scheme and 2 training courses for secondary technicians under the non-formal scheme, totally attended by 921 participants. These trainees have assigned properly to strengthen malaria control activities at all levels, many of whom hold important positions in the basic health service. Retraining has also been arranged in 5,510 classes, attended by 110,432 participants who are health workers at various levels.

           In collaboration with Hanoi University of Medicine, the Institute conducted two post-graduate courses of study in the field of parasitology for the Institute's staff and the regional provinces, graduating 13 trainees who study M.Sc. in medicine.

         

 Institute's in-training students sitting for the
final exam o­n laboratory techniques.

 Board of examiners evaluating the medical M.Sc.
theris for the Institute's trainees.

            More particularly, the Institute's staff have had their technical qualification enhanced, indicated by 15 additional 15 post-graduates, 20 additional graduates promoted from the middle level. In addition, there are presently two doctoral candidates, 3 under post-graduate education, 4 undergraduates and 3 under middle-training in political science. Most of the staff are knowledgeable of a foreign language and computer-literate at level A and level B.

Mass Communication and Education

          So as to reduce the malaria incidence and establish the sustainability of the malaria control programme, the Institute launched a variety of campaigns for malaria control in coordination with the regional provinces, Woman's Union, Youth Union/League, Red Cross Society and Farmer's Association. In the period 1994-2005 as many as 10,959 rounds of propaganda talks and radio broadcasts were arranged for an audience of 25,653,341. Video shows and cultural shows are arranged for 10,002,744 viewers. The Institute also published 822 articles about malaria control in newspapers and o­n the radio, issued 2,837,019 posters and leaflets and 1,153 billboards/hoardings. It organized many conferences o­n the socialization of malaria control and loaded a lot news and information into the Institute's website. It enabled the general public/ mass to be aware of the causative agent and hazardous effects of malaria so that they would change their backward living habits to protect themselves against malaria infection.

          

An Institute's staff communicating
with Bana ethnic populations
about malaria.
  
                                                             

Institute's staff treating bednets
to be supplied to ethnic minorities
in malarious areas.
 
                                                

            Noticeably in 2001, in collaboration with the Vietnam-EC Malaria Control Project and the Editorial Board of VTV3, the Institute arranged a TV show titled "At home o­n Sunday" for the ethnic minorities in 3 provinces of the Central Highlands with the motto "Declare war o­n malaria". This TV show was highly appreciated by government authorities at all levels and served as a countrywide campaign for malaria control. It also revealed the Party and State's attention to the ethnic minorities in the Central Highlands.

International Cooperation

            The Institute has expanded the international cooperation in training and scientific research, involving CARE International, UNICEF, U.S. Navy Environmental and Preventive Medicine Unit No.6, Nayoga University of Japan during the period 1995-1998, Japanese Society of Tropical Medicine in Gia Lai (1977-2000), World Bank and WHO since 1997 up to date, Vietnam-Australia Malaria Control Project (1996-2006), Netherlands-Vietnam Medical Committee (MCNV) since 1990 up to date; Vietnam-EC Malaria Control Project (1997-2002), Institute of Chinese Traditional Medicine and Pharmacology since 1994 up to date; Global Fund (VGF) since 2005 up to now; Asian Development Bank since 2006 up to now and the Australian Army Malaria Institute since 2006 up to now. A large number of research papers have been published in national and foreign journals of science. The research findings have been applied successfully to the malaria control programme. Many staff-members have been sent o­n international training courses, research missions, workshops and study tours in China, India, Australia, Thailand, Malaysia, Singapore, Indonesia and the Philippines.

The Institute in collaboration with Liverpool University (UK)

The Institute in collaboration with Australian Army Malaria
Institute in the field of malaria.

   

Ngo Thi Huong, Ph.D., Head of Department of Molecular Biology,
o­n a study tour of Australia.
 

Management of Resources

            The management of resources has been undertaken properly to ensure against loss, damage, wasteful abuse and corruption by means of disclosed financial statements, public auditing, inspection and self-inspection o­n a yearly basis. The management scheme is always highly appreciated by the competent authorities. In spite of financial constraints, the Institute has ensured its accountablity and transparency in the management of resources. It has always received a favourable concern by the State and the Ministry of Health over the investment in upgrading the physical and technical insfrastructure facilities; thereby being developed into a internationally renown institute.

Institute's annual plans in review. 

Checking upon and inspect supplies periodically.

 Supplying and distributing supplies to
the target provinces.

            As well as receiving and distributing equipment and supplies, malaria medications and insecticides in such a way as to ensure that the annual malaria control campaign will promptly launched in the target provinces, the Institute send a rescue team in charge in timely dispensing epidemics control supplies to such provinces frequently hit by typhoons and floods as Thua Thien-Hue, Quang Nam, Da Nang and Binh Dinh.

06/12/2009
Translated by Tran Minh Quy and Huynh Thi An Khang  
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