Elsevier

Acta Tropica

Volume 117, Issue 3, March 2011, Pages 225-228
Acta Tropica

Short communication
Malaria prevention and control in Bhutan: Successes and challenges

https://doi.org/10.1016/j.actatropica.2010.11.008Get rights and content

Abstract

This paper highlights on the current malaria situations in Bhutan and its challenges for future prevention and control strategies. In Bhutan, malaria affects more than half of the entire population, mostly residing in the southern districts bordering with Indian states of Assam and West Bengal. Over the past ten years, due to concerted efforts, the morbidity and mortality due to malaria has significantly declined. These preventive and control measures focused on the mass distribution of long lasting insecticidal treated nets, focal indoor residual spray and use of artemisinin-based combination therapies. However, considerable challenge lies ahead and research is needed to generate local evidence for sustainable elimination of malaria from Bhutan. The article should be of value and interest to planners, malaria programs and for future researchers on malaria in Bhutan.

Graphical abstract

This paper highlights on the current malaria situations in Bhutan and its challenges for future prevention and control strategies. In Bhutan, malaria affects more than half of the entire population, mostly residing in the southern districts bordering with Indian states of Assam and West Bengal. Over the past ten years, due to concerted efforts, the morbidity and mortality due to malaria has significantly declined. These preventive and control measures focused on the mass distribution of long lasting insecticidal treated nets, focal indoor residual spray and use of artemisinin-based combination therapies. However, considerable challenge lies ahead and research is needed to generate local evidence for sustainable elimination of malaria from Bhutan. The article should be of value and interest to planners, malaria programs and for future researchers on malaria in Bhutan.

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Research highlights

▶ We examined the current malaria situations and its challenges in Bhutan. ▶ Malaria cases decreased from 12,591 cases in 1999 to 329 in 2008. ▶ LLINs and ACT (artemether/lumefantrine) were the main strategies employed. ▶ Shortages of human resources and cross border issues are the main challenges for the malaria elimination in Bhutan.

Section snippets

Conflict of interest

The authors have no conflict of interest.

Acknowledgments

The study is funded by UNICEF/UNDP/World Bank/WHO Special programme for Research and Training in Tropical Diseases (TDR). Gratitude to The Commission on Higher Education, Ministry of Education of Thailand and Royal Government of Bhutan for the institutional support.

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    It is high time to siege the opportunity to scale up intervention tools that are evidence-based and for developing stronger health delivery systems for equity in healthcare services (Mendis et al., 2009; WHO, 2008, 2010). It is vital for the north-eastern states that share international border with Bhutan, Bangladesh and Myanmar (which are just as malaria endemic) to develop cross-border initiatives for information exchange and coordinated action in providing healthcare access for marginalized population groups to prevent intensification and spread of drug-resistant malaria (Shah et al., 2011; Tobgay et al., 2011). There is a need for continuous monitoring and evaluation, and research investment in new and improved interventions, including potent antimalarials and vaccines that can be integrated with existing biomedical strategies to meet the future challenges of malaria elimination efforts (Feachem et al., 2009; John et al., 2011; Alonso et al., 2011; WHO, 2011).

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