World Health Organization Regional Office for South-East Asia

Malaria Situation in SEAR Countries

Sri lanka

 

Bangladesh

Bhutan

DPR Korea

India

Indonesia

Maldives

Myanmar

Nepal

Sri lanka

Thailand

Timor-Leste

During pre eradication era, nearly 40% of the population was subject to malaria annually and malaria deaths accounting for 6% of total deaths from all causes. In 1945, the estimated malaria cases and deaths were around 2.5 million and 8,500 respectively.� Sri Lanka had started large scale spray operation in 1947 and achieved tremendous success too.�� The spectacular successes of the early years of the malaria eradication programme were nullified by the country-wide epidemic in 1967/1968, when over half a million cases were detected.� The epidemic pressure relented in subsequent years, and by 1972, the incidence was brought down to 132 605 detected cases.� The situation thereafter reversed once- again and the number of cases detected increased progressively to 400 777 in 1975 with a Slide Positivity Rate of 26.7%. The most alarming fact in the malaria situation was the increase in the proportion of P. falciparum infections which, from less than 0.5% in 1968, reached 8.3% in 1974, and almost doubled to 15.9% in 1975.� The number of deaths due to P.falciparum has also increased.� With widespread resistance of A. culicifacies to DDT, malathion spraying was introduced in 1975 in areas of P.falciparum transmission affording protection to nearly one million people.� Towards the end of 1976 DDT spraying was completely discontinued and during 1977 exclusively malathion was used as an adulticide.

 

After 1975, the situation continued to improve till 1982.�� The number of cases came down to 38,5667, API 2.5 per thousand and SPR touched 3.4% respectively and Pf% remained under check i.e., below 5%.� The situation� deteriorated there after again and became worst during 1986 and 1987 when number of reported cases rose to 412,521 and 676,569 respectively due to epidemic.� The API, SPR during the said period were 25.5 per thousand, 28.1% and 41.5 per thousand, 34.6 % respectively.� In 1991, reported number of cases again rose to 400263 with API 29.1 per thousand and SPR 28.6%.� The situation improved slowly there after and� in 1995, the reported number of cases touched at 142,294 ,an decrease of 64.5%, API came down to 14 per thousand� SPR at 13.0%.� But again this success again did not last long and situation deteriorated there after In 1997, the reported cases again rose to 218, 550 an increase of 53.6%, API reached up to 18.9 per thousand and SPR� rose to 16.4%.� During 2001 - 2007, country has shown tremendous improvement in malaria situation.� Reported malaria cases came down from 66,522 cases to 150 cases only in 2007, showing a reduction of 98.5%. After 1984, though Pf% remained fluctuating between 20% to 25% but steadily gone up and touched it highest mark at 27% in 1987 and finally to 7% in 2008. No death has been reported in 2008.� After Maldives, Sri Lanka has reached to the stage to eradicate the malaria from the country. The country has achieved RBM as well as MDG�s Targets well before time.

 

In Sri Lanka transmission occurs in most parts of the country.� P.vivax is the predominant parasite, and A.culicifaces the most important vector.� Chloroquine resistance in P. falciparum is increasing.� There has been an increase of vector populations in areas where water development projects have been implemented with a subsequent increase in malaria transmission.� Indoor residual spraying (IRS) has been the main vector control measure used in the country.� In view of the resistance to DDT and malathion, the rotational use of fenitrothion and a pyrethroids is now being practiced with the aim of reducing the load of transmission of malaria.

Malaria Situation in Sri lanka, 2008 :

At a Glance

Total population����

: 21.0 million

Population in malarious areas

: 6.74 million

Number of Lab confirmed malaria cases

: 670

Number of� probable malaria cases�

: 0

Number of deaths due to malaria

: 0 (Reported)

No. of Severe Malaria

Cases

N.A.

Cases treated with ACTs

: 32

No of LLINs Distributed

: 253,000

No. of effective LLINs+ITNs (cumulative) availability

 

 

Population protected with ITNs

: 1.5 million

Population protected

with IRS

: 650,742

Vectors: An. Culicifacies� and resistant to DDT and Malathion

*      Supported by Global Fund

*      Reached to pre-elimination stage of malaria

 

Malaria Cases in Sri Lanka, 1960-2008

 

Goals and Targets:

 

To reduce malaria morbidity and mortality until the disease is no longer a public health problem in the country.

 

Targets

 

Baseline data in

2005

2010

To reduce the API among at risk population in the country

 

0.4

 

> 0.1

To sustain zero mortality from malaria in Sri Lanka

00�

�� 00

To reduce the proportion of

P. falciparum infection

5.7%

>3

To eliminate the occurrence of malaria infections in pregnant women.

NA

00

To reduce the proportion of malaria infections in children below 5 yrs

10%

>5%

 

Control strategy:

    Early detection and prompt treatment is the mainstay of parasite control with support from health    infrastructure.

  Usage of�  Rapid diagnostic kits for the early detection of malaria in the population living in areas of conflict and the border villages.

  Strengthen the entomological units in the regional offices and establish computer-based surveillance.

    IRS with Malathion used as the major vector control measures on selective basis.

    Other control methods used are insecticide-treated nets for personal protection and community awareness through health education

Issues and Challenges:

     Present epidemiological and entomological surveillance system has failed to warn the malaria outbreaks early enough for timely intervention

     Lapses in the existing epidemiological surveillance system e.g. not reporting clinically treated patients and patients treated from private institutions

     Lapses in the existing quality control systems have failed to deliver the expected results

     Lack of research based information has created problems in planning malaria control activities.

     Inadequate training opportunities has slowed down incorporation of recent advances in the field of malariology

     Lack of laboratory facilities at central and district level

     Lack of management skills at all levels

 

Partners and donors

*     WHO

*     The Global Fund

*     Sarvodaya

*     Lions International

 

Other related information :

     Country profile � World Malaria report 2008

   Reported Malaria Morbidity (/1000) and Mortality Rate (/100000) in Sri Lanka, 2000-2008 [PDF 62 KB]

 

 

| | | | | |
���������������������