To assess malaria situation, difficulties and challenges as well sharing experiences in malaria prevention and elimination, World Health Organization (WHO) delegation including WHO, WHO Western Pacific Region (WPRO/WHO) and WHO in Vietnam worked with Institute of Malariology - Parasitology - Entomology in Ho Chi Minh city (IMPE HCM) and visited Binh Phuoc Department of Health, local health units in Binh Phuoc province on malaria prevention.

WHO representatives are Ph.D. Pedro Alonso - Director of global malaria program; Ph.D. Rabindra Abeyasinghe - Head of malaria, parasites, and diseases transmission vector of WPRO/WHO; Dr. Hiromasa Okayasu - Coordinator, Head of Department malaria elimination of GMS countries; Ph.D. Kidong Park - Director of WHO Vietnam and the members. NIMPE/IMPE representatives are Prof. Le Thanh Dong - Director of IMPE HCM, Ph.D. Nguyen Quang Thieu - Deputy of NIMPE and staff.

In Bu Gia Map District, malaria cases increased by 11.48%, malaria parasite increased by 8.20% in 2018 compared to the same period in 2014, there was no death case. This is a district with the highest malaria prevalence in Binh Phuoc province, and drug-resistant malaria cases, and is also a region with many migrants who are at high risk of malaria. However, in the first 5 months of 2019, malaria cases decreased by 71.84% compared to the same period in 2018, there was no death case. It is might cause by reducing of malaria detection and diagnosis in health facilities in Bu Gia Map district, the total of malaria tests in the first 5 months of 2019 decreased by 52.79% in the same period.The delegation worked with Binh Phuoc Department of Health at the Center for Disease Control, the results showed that in 5 years (from 2014 to 2018), the number of malaria cases decreased, number of malaria death cases range 00 to 01 case. Especially, in the first 5 months of 2019, malaria cases decreased sharply (77.5%) compared to the same period in 2018, local cases accounted for 91.79%. There is no malaria death case and no malaria outbreak. The malaria monitoring system showed that the malaria situation in Binh Phuoc province is cyclical, usually increases in the last months of the year and extends to the beginning of next year, then gradually decreases. Besides, there are many projects implemented in Binh Phuoc providing bednets, hammock, mosquito repellent ... to prevent malaria. Malaria detection, treatment, and case management are also properly implemented. Most of the malaria cases are local people who work in the fields and forests; some work in Cambodia, Dak Nong, Lam Dong, etc.

Finally, the delegation visited and worked with Bu Gia Map commune health station in Bu Gia Map district, visited the malaria prevention point, worked with the staff of these health units and checked malaria records, logbook, working conditions, equipment, supplies, medicines, communication materials and human resources related to malaria prevention. This is one of the three communes with the highest malaria cases in Bu Gia Map district, the "hot spot" of malaria in the South region. The risk people are one who goes to the forest to sleep in the fields, border areas, the army at the national park of Bu Gia Map. Malaria prevention activities have been carried out and got some positive results at the commune level, every year provided double long-lasting insecticide bednets, hammocks, mosquito-repellent creams for mobile people at risk (financial support source from projects).

Looking through reports, discussion and observation directly the implementation of malaria control and prevention activities at all levels of Binh Phuoc province. There are some points below:

1) Local authorities have implemented malaria prevention activities as planned with the funding sources from projects such as RAI2E, HPA, PSI, SCDI, ... in Binh Phuoc province widely. The malaria points initially managed the people who went to the forest, slept on the fields and crossed the border, tested and detected 5 malaria cases of with positive parasite.

2) The current malaria situation in Binh Phuoc has decreased significantly (78.1%) in all health units with no severe malaria cases or death.

3) Regarding malaria parasite proportion, P. falciparum and P. vivax tends to be equal approximately, in the first 5 months of 2019, the rate of P. vivax is higher than that of P. falciparum (120/86). This makes malaria in Binh Phuoc more persistent because most of the P. vivax cases were not clear to get a full course of treatment, due to prolonged treatment period (14 days), leading to a large number of P. vivax still exists in the community.

4) Binh Phuoc has the main vector of malaria transmission, An. minimus, An. dirus, ... Annually, spraying chemicals, impregnating chemical for old bednets. The Global Fund Project supports a lot of long-lasting insecticide bednets, hammocks, and mosquito repellant cream for those who go to forests, sleep in the fields and cross the border. With the unpredictable weather in a large area, it is easy to create vectors with changing behaviors and it causes more difficulties in vector prevention.

5) The management of people going to forest, sleeping and exchanging between epidemic areas is still difficult. This is a major challenge for the prevention and elimination of malaria in Binh Phuoc and the whole country in general. Especially those who go to seasonal business from the region without malaria and mild malaria areas to moderate and severe epidemic areas, leading to the risk of outbreaks.

In general, the delegation judged that the malaria situation in Binh Phuoc province has been fallen sharply. Prognosis in the coming time if drugs to treat resistance cases are available and comply with the current malaria prevention activities, the situation of malaria in Binh Phuoc will continue to decrease and Vietnam will achieve the target of malaria elimination by 2030

End of the meeting, Prof. Le Thanh Dong proposed the authorities of Binh Phuoc province have to manage mobile populations efficiently; strengthen surveillance and provide an appropriate malaria control method for mobile populations such as LLINs, hammocks; Enhance to reach out the high-risk population. Maintain regular monitoring activities, active case detection, case management, early treatment and full course, and good communication at all levels.

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