Extended Surveillance for Malaria in the Eastern and Northern Provinces of Sri Lanka through Focused Laboratory Diagnostic Services

Abstract

In 2009, when planning the malaria elimination strategies for Sri Lanka, the Anti Malaria Campaign faced substantial challenges with regard to Parasitological surveillance in the Eastern and Northern Provinces including recruitment of technical staff and accessing high risk populations. Tropical and Environmental Diseases and Health Associates (TEDHA), a private sector organization was called to assist in intensified surveillance to achieve the goal of malaria elimination by 2014. TEDHA selected and trained 112 personnel on Parasitology surveillance. Fully equipped Malaria Diagnostic Laboratories (MDLs) were established in hospitals where government services were lacking. TEDHA complemented Parasitological surveillance through Activated Passive Case Detection in 47 MDLs. Services were extended to outreach through mobile malaria clinics by active case detection. From January 2010 till the close up of TEDHA operations in August 2014, 994,501 individuals were screened for malaria. Nine malaria positives were diagnosed, eight being Plasmodium vivax infections and one a mixed infection. Sri Lanka has made considerable progress towards the elimination drive with no indigenous malaria cases being reported since November 2012. Maintaining a high degree of malaria surveillance is required to ensure that the reservoirs of parasites are detected and treated early so as to prevent the re-introduction of malaria into the country