Class instructor and Student. Photo by Brian Donnelly
Reducing malaria transmission and malaria-related deaths requires comprehensive, integrated programming. CHS and its affiliate, University Research Co., LLC, engage in a wide range of malaria prevention and control activities. In communities, we work with government and civil society to promote, distribute, and hang long-lasting, insecticide-treated bed nets. We also helm them mobilize their communities to promote sustained use of malaria interventions.
At the facility level, we ensure that providers have the skills, medicines, and equipment needed for intermittent preventive treatment during pregnancy, improved diagnosis through the use of rapid diagnostic tests and quality microscopy, and strengthened case management using artemisinin combination therapy. Supportive supervision of health care providers at the health facility and community levels reinforces these skills. At the national level, we improve the quality and use of malaria data and enhance procurement and logistics to ensure a reliable supply of high-quality drugs and diagnostics.
Our activities are based on rigorous operational research that identifies the best models for reducing malaria transmission in the local context and entomological research to guide policy and programming decisions to reduce insecticide resistance and improve vector control.
In Ghana, URC’s Promoting Malaria Prevention and Treatment (ProMPT) project and the National Malaria Control Program developed an innovative door-to-door delivery and hang-up campaign model, which led to dramatic increases in net ownership and use. Social mobilization through traditional leaders, local radio, and mobile vans reinforces volunteers’ messages on net use and care.
In Myanmar, Cambodia, and Thailand, URC’s Control and Prevention of Malaria (CAP-Malaria) Project is scaling up prevention efforts, improving quality and effectiveness of diagnosis and treatment at both the facility and community levels, building capacity of malaria control partners, and increasing the availability of strategic information. To more effectively meet the needs of mobile and migrant workers, the project is implementing a lending scheme of long-lasting insecticide-treated nets: the project loans nets to temporary farm workers through the farm owners. We also work with taxi drivers—who transport migrant workers from their homes to the farms—to disseminate malaria information.
URC supports rapid scale-up of prevention and treatment for pregnant women in Ghana and Benin, where malaria in pregnancy poses a significant threat to mothers and newborns. In Cambodia, Ghana, Myanmar, and Thailand, we are working with community health workers to strengthen early diagnosis and prompt treatment at the community level.
In partnership with the World Health Organization and the Foundation for Innovative New Diagnostics, URC developed a job aid and training program to enable volunteer community health workers to use malaria rapid diagnostic tests, sparing patients trips to health facilities and long waits for diagnosis and treatment. These materials have been translated into several languages, and the job aid is now part of rapid diagnostic distribution systems worldwide. Read about our research on malaria diagnostic tools.
Recent evidence on the emergence of parasite resistance to artemisinin in Southeast Asia’s Greater Mekong Region has raised global concern. The Malaria Control in Cambodia (MCC) Project conducted surveillance to pinpoint the location and extent of drug-resistant cases in western Cambodia. Collaborating with the World Health Organization and the National Malaria Control Programme, MCC conducted community-level Day 3 surveillance of Plasmodium falciparum malaria. In addition, MCC mapped drug-resistant malaria cases discovered in two health facilities. Confirmed cases were followed for 28 days to assess the treatment. Over a quarter of these cases were positive on Day 3, indicating possible resistance to artemisinin-based combination therapy. These findings helped guide implementation of directly observed therapy for malaria and program support needs. The follow-on CAP-Malaria Project will implement studies to determine the spread of artemisinin-resistant malaria in other countries in the region.