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| Van Canh district - A high endemic area of malaria and dengue fever. |
Management of malaria and dengue fever at primary healthcare levels in Van Canh district, Binh Dinh province in 2008
Van Canh district is a high endemic area of malaria and dengue fever (DF). In 2008, the IMPE Quy Nhon selected Van Canh district as the plot site for integrating malaria in DF control activities.
Malaria and DF are diseases transmitted by mosquitoes. Because of the complication of malaria epidemiological characteristics, the National Institute of Malariology-Parasitology and Entomology (NIMPE) and IMPE Quy Nhon selected Van Canh district as a pilot malaria control site since 1976 for implementing activities relating to malaria eradication (1976-1983), malaria elimination (1984-1990), and malaria control (1981 to now), and several experiences were drawn for malaria control activities in Central region and the whole contry as well. In recent years, the situation of malaria in Van Canh district has been improved significantly; the indicators of malaria morbidity are low; no deaths and no outbreaks reported. However, in remote areas, the risk of malaria infection is still very high. Besides, the appearance of dengue fever niduses in Van Canh town and surrounding communes has added up the difficulties in controlling the epidemics; especially vector control. Because of the situation of malaria and DF mentioned above, the IMPE Quy Nhon called the Ministry of Health for supports in pilot research on the integrated paradigm of malaria and DF management at primary health-care levels. On May 14, 2009, the IMPE-QN organised the workshop on reviewing the activities over the past year. The workshop reported initial successful activities on integrating malaria and DF management in 2008, and presented the workplan for 2009, and especially acquired suggestions and recommendations from representatives, particulary those at the grass-roots healthcare network. After one year of implementation, the integrated paradigm of malaria and DF management has involved the active and enthusiastic participations and supports from leaders and authorities in communes, villages of Van Canh district; and the close coordination of local health facilities (Binh Dinh provincial health service, Binh Dinh provincial malaria centre, communal and district health centres and so on). In addition, the quality of the grass-roots health care network (district, commune, village) is also improved through technical training courses and practical activities such as management of people working in the forests, sleeping at the field huts; provisions of impregnated bedneta, antimalaria drugs for people living in malaria-endemic areas; blood slide examination for malaria parasites; and delivery of prompt diagnosis and treatment for malaria and DF. At Van Canh district hospital and communal health stations, the quality of diagnosis and treatment is improved significally. The information of malaria and DF is updated frequently at the IMPE's website. Besides the above pilot activities, the Institue often holds the courses of diagnosis and treatment for the poor, ethnic minorities, supported gifts for poor households.  |  | The Institute's staff conducting medical
supporting gifts for poor | examination, distributing drugs and
households in Van Canh district. |
These preliminary results have not only contributed practically to the protection of local people's health, but maintained the gained achievements. Therefore, the project is set to continue in 2009 and the following years. However, some limitations should be taken into consideration: the initial site selection was not carried out in line with the paradigm (some sites had no DF cases), the paradigm did not clearly define the integration of malaria and DF control activities; and especially the organizational changes of health workers in some localities brought about difficulties in disease detection and management.
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