The public health response to a Plasmodium malariae outbreak in Penampang district, Sabah during a COVID-19 movement control order

Malaria Journal

Research

Kamruddin Ahmed¹  Mohd Rohaizat Hassan²  Rozita Hod²  Nurul Athirah Naserrudin³  Sam Froze Jiee⁴  Mohammad Saffree Jeffree⁵  Jiloris Julian Frederick Dony⁶  Bobby Habil⁷  Ahmad Firdaus Bin Mohamed⁷  Siti Syarifah Akma Ibrahim⁷  Anisah Jantim⁷  Richard Culleton⁸  Kimberly M. Fornace⁹ 

[1] Borneo Medical Health and Research Centre,, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia;Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia;Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan;Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia;Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia;Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia;Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia;Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia;Kota Kinabalu Public Health Laboratory, Ministry of Health, Kota Kinabalu, Malaysia;Penampang District Health Office, Ministry of Health, Kota Kinabalu, Malaysia;Proeto-Science Center, Ehime University, Matsuyama, Japan;School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK;Faculty of Infectious and Tropical Diseases and Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK;Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore;

关键词: Plasmodium malariae;    Sabah;    Malaysia;    Malaria outbreak;    Healthcare services during COVID-19;    Risk-behavior to malaria;   

DOI  :  10.1186/s12936-023-04693-1

 received in 2023-07-25, accepted in 2023-08-29,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSince 2018, no indigenous human malaria cases has been reported in Malaysia. However, during the recent COVID-19 pandemic the World Health Organization is concerned that the pandemic might erode the success of malaria control as there are reports of increase malaria cases in resource limited countries. Little is known how the COVID-19 pandemic has impacted malaria in middle-income countries like Malaysia. Here the public health response to a Plasmodium malariae outbreak occurred in a village in Sabah state, Malaysia, during a COVID-19 movement control order is reported.MethodsAn outbreak was declared following the detection of P. malariae in July 2020 and active case detection for malaria was performed by collecting blood samples from residents residing within 2 km radius of Moyog village. Vector prevalence and the efficacy of residual insecticides were determined. Health awareness programmes were implemented to prevent future outbreaks. A survey was conducted among villagers to understand risk behaviour and beliefs concerning malaria.ResultsA total of 5254 blood samples collected from 19 villages. Among them, 19 P. malariae cases were identified, including the index case, which originated from a man who returned from Indonesia. His return from Indonesia and healthcare facilities visit coincided with the movement control order during COVID-19 pandemic when the healthcare facilities stretched its capacity and only serious cases were given priority. Despite the index case being a returnee from a malaria endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities. All cases were symptomatic and uncomplicated except for a pregnant woman with severe malaria. There were no deaths; all patients recovered following treatment with artemether-lumefantrine combination therapy. Anopheles balabacensis and Anopheles barbirostris were detected in ponds, puddles and riverbeds. The survey revealed that fishing and hunting during night, and self-treatment for mild symptoms contributed to the outbreak. Despite the index case being a returnee from a malaria-endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities.ConclusionThe outbreak occurred during a COVID-19 movement control order, which strained healthcare facilities, prioritizing only serious cases. Healthcare workers need to be more aware of the risk of malaria from individuals who return from malaria endemic areas. To achieve malaria elimination and prevention of disease reintroduction, new strategies that include multisectoral agencies and active community participation are essential for a more sustainable malaria control programme.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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