Current situation of subnational malaria elimination at district-level in Central Vietnam
Viet Nam is one of the countries at high-risk of malaria all over the world with large malaria-endemic areas. However, due to the suitable strategies for each malaria programme phase, and the Government's investment as well as the domestic and international support, the malaria-endemic areas has been significantly narrowed. According to the result of malaria epidemiological stratification in 2014, the whole country has 1.864 communes, with more 12 millions people living in malaria-endemic areas. However, the prevalence of malaria has been considerably decreased, and it is mainly in socio-economic disadvantaged areas, especially provinces in Central Vietnam. At the present, this region has more than 6 millions people living in malaria-endemic areas, accounting for 52.80% of the population living in malaria-endemic areas of the whole country; specifically with 780,505 people living in hyperendemic areas, making up 66.85% compared with the population living in highly-endemic areas of the whole country. Together with the trend of the world, Viet Nam has been changing the strategies towards malaria elimination. This strategy has achieved positive results; by 2022, Vietnam has had 42/63 provinces/cities achieving the certification of malaria elimination. In malaria elimination activities, every country gives different strategies on the certification of malaria elimination for provincial, district, or communal levels. In Viet Nam, the provincial and district levels will be recogized malaria-free as they achieve the conditions and the criteria on malaria elimination. In Central Vietnam, some of provinces achieved the certification of malaria eliminationat district level. Da Nang city is the first locality which was recognized malaria elimination in Central Vietnam in 2019. At present, the number of recognized districts have increased in the region. There are 157 districts/towns/cities directly under 15 provinces of Central Vietnam. Untill 2022, the region has had 33/157 districts recognized malaria elimination, accounting for 21.02%; among them, the Central region making up 29.63%, the West-Highlands making up 2.04%. Figure 1: Rate of recognized districts of malaria elimination (ME) in Central Vietnam
In general, this rate is still lower compared with other areas of the whole country. However, in some provinces, their districts have achieved the conditions of malaria elimination, but they have not prepared the procedures to achieve the certification of malaria elimination at district levels. Beside, Quang Ngai province has prepared the procedures of malaria elimination certification for the whole province in 2023. Table 1. The number of districts recognized malaria elimination in Central Vietnam Provinces/ cities | Total number of districts | Certification of malaria elimination | 2019 | 2020 | 2021 | 2022 | Kon Tum | 10 | - | - | - | - | Gia Lai | 17 | - | - | - | - | Dak Lak | 14 | - | - | - | Buon Ma Thuot | Dak Nong | 8 | - | - | - | - | Quang Binh | 8 | - | - | - | Dong Hoi, Ba Don | Quang Tri | 8 | - | - | - | - | Quang Nam | 18 | - | - | - | - | Quang Ngai | 14 | - | - | - | - | Binh Dinh | 11 | - | Hoai Nhon | Quy Nhon, An Nhon | Tay Son, Phu My, Phu Cat, Tuy Phuoc | Phu Yen | 9 | - | - | Tuy Hoa, Tuy An, Dong Hoa | Phu Hoa | Khanh Hoa | 9 | - | - | - | Nha Trang, Cam Ranh | Ninh Thuan | 4 | - | - | - | - | Binh Thuan | 10 | - | - | - | - | Da Nang | 8 | ME (8 districts) | | | | TT- Hue | 9 | - | - | - | ME (9 districts) | Total | 157 | 8 | 1 | 5 | 10 |
On the situation of recognition for malaria elimination at ditrict levels, 5/13 provinces have implemented the procedures of malaria elimination with enough conditions and criteria, including Dak Lak, Quang Binh, Binh Dinh, Phu Yen, Khanh Hoa. Binh Dinh province has had 7 districts recognized malaria-free, accounting for highest rate compared with other provinces. Next, Phu Yen province has had 4 districts/towns recognized malaria-free. This number will continue to increase, many provinces have also prepared and made plan for recognition of malaria elimination of some of districts in 2023. Figure 2: Distribution of malaria elimination at district levels in Central Vietnam Source: https://www.arcgis.com The results showed that some of localities have taken the initiative to complete the document of malaria elimination certification. These are achievements in malaria control activities in the past time and the provinces continue to carry out the procedures for district-level malaria elimination certification in the near future. Figure 3: Binh Dinh Center for Disease Control granting the certification of malaria elimination for An Nhon town, Binh Dinh province Source:https://syt.binhdinh.gov.vn/index.php/vi/news/y-te-du-phong/thi-xa-an-nhon-dat-tieu-chi-loai-tru-benh-sot-ret-2436.html
Figure 4: Binh Dinh Center for Disease Control granting the certification of malaria elimination for Tay Son district, Binh Dinh province (Source:https://tayson.binhdinh.gov.vn/vi/news/van-hoa-xa-hoi/le-cong-nhan-huyen-tay-son-dat-tieu-chi-loai-tru-benh-sot-ret-1504.html)
Figure 5: Assessing the document of malaria elimination in Buon Ma Thuot city, Dak Lak province in 2022 Source: https://yte.daklak.gov.vn/ASPX/TinTuc_ChiTiet.aspx?iDV=1&id=88236
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