Bulletin of the World Health Organization
Print version ISSN 0042-9686
HUNG, Le Q. et al. Control of malaria: a successful experience from Viet Nam. Bull World Health Organ [online]. 2002, vol.80, n.8, pp. 660-666. ISSN 0042-9686. http://dx.doi.org/10.1590/S0042-96862002000800011.
OBJECTIVE: To follow malaria prospectively in an ethnic minority commune in the south of Viet Nam with high malaria transmission and seasonal fluctuation, during malaria control interventions using insecticide-treated bednets (ITBNs) and early diagnosis and treatment (EDT) of symptomatic patients. METHODS: From 1994 onwards the following interventions were used: distribution of ITBNs to all households with biannual reimpregnation; construction of a health post and appointment of staff trained in microscopic diagnosis and treatment of malaria; regular supply of materials and drugs; annual cross-sectional malaria surveys with treatment of all parasitaemic subjects, and a programme of community involvement and health education. Surveys were held yearly at the end of the rainy season. During the surveys, demographic data were updated. Diagnosis and treatment of malaria were free of charge. Plasmodium falciparum infection was treated with artesunate and P. vivax infection with chloroquine plus primaquine. FINDINGS: The baseline survey in 1994 recorded 716inhabitants. Of the children under 2years of age, 37% were parasitaemic; 56% of children aged 2-10 years, and 35% of the remaining population were parasitaemic. P. falciparum accounted for 73-79% of these infections. The respective splenomegaly rates for the above-mentioned age groups were 20%, 56%, and 32%. In 1999, the proportion of parasitaemic subjects was 4%, 7% and 1%, respectively, of which P.falciparum contributed 56%. The splenomegaly rate was 0%, 5% and 2%, respectively. CONCLUSIONS: A combination of ITBNs and EDT, provided free of charge, complemented by annual diagnosis and treatment during malaria surveys and community involvement with health education successfully brought malaria under control. This approach could be applied to other regions in the south of Viet Nam and provides a sound basis for further studies in other areas with different epidemiological patterns of malaria.
Keywords : Malaria, Falciparum [prevention and control]; Malaria, Falciparum [diagnosis]; Malaria, Falciparum [drug therapy]; Malaria, Vivax [prevention and control]; Malaria, Vivax [diagnosis]; Malaria, Vivax [drug therapy]; Sesquiterpenes [therapeutic use]; Chloroquine [therapeutic use]; Primaquine [therapeutic use]; Pyrethrins [Bedding and linens]; Pyrethrins [utilization]; Knowledge, attitudes, practice; Health education; Ethnic groups; Prospective studies; Viet Nam.