RT Journal Article
SR Electronic
T1 Comprehensive evaluation of malaria reactive surveillance and response strategies in Lao People’s Democratic Republic: a mixed-methods study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e083060
DO 10.1136/bmjopen-2023-083060
VO 14
IS 8
A1 Htike, Win
A1 Win Han Oo
A1 Aye Tun, Nilar
A1 Khamlome, Boualam
A1 Vilay, Phoutnalong
A1 Banouvong, Virasack
A1 Chindavongsa, Keobouphaphone
A1 Lynn, Thet
A1 Vathanakoune, Sanya
A1 Oo, May Chan
A1 Htwe, Ei Phyu
A1 Zaw, Aung Khine
A1 Thu, Kaung Myat
A1 Galau, Naw Hkawng
A1 Khant, Kaung Myat
A1 Cutts, Julia C
A1 Agius, Paul A
A1 Kearney, Ellen
A1 O’Flaherty, Katherine
A1 Fowkes, Freya J I
YR 2024
UL http://bmjopen.bmj.com/content/14/8/e083060.abstract
AB Objectives To achieve malaria elimination by 2030, the Lao People’s Democratic Republic (PDR) adopted a reactive surveillance and response (RASR) strategy of malaria case notification within 1 day, case investigation and classification within 3 days and foci investigation and response within 7 days. It is important to evaluate the performance and feasibility of RASR implementation in Lao PDR so that the strategy may be optimised and better contribute towards the goal of malaria elimination.Design A mixed-methods study comprising of secondary data analysis of routinely collected malaria surveillance data, quantitative surveys and qualitative consultations was conducted in 2022.Setting Primary data collections for quantitative surveys and qualitative consultations were conducted in Huaphan, Khammouane, Luangprabang and Savannakhet Provinces of Lao PDR.Participants Quantitative surveys were conducted among malaria programme stakeholders and service providers. Qualitative interviews were conducted with malaria programme stakeholders, and focus group discussions with malaria programme stakeholders, service providers and mobile and migrant populations (MMPs).Outcome measures Outcomes of interests were awareness and acceptability of current RASR activities by different group of participants, implementation, performance and feasibility of RASR activities including enablers and barriers.Results In Lao PDR, malaria programme stakeholders and service providers were aware of RASR; however, these activities were not well known in MMPs. Respectively, the timeliness of case notification and case investigation was 0.0% and 15.6% in 2018 but increased to 98.0% and 98.6% in 2022. Implementation of RASR was acceptable to the malaria programme stakeholders and service providers, and continued implementation was perceived as feasible. Nevertheless, issues such as low level of community awareness, high level of migration and limitations in health system capacity were identified.Conclusion Overall, the timeliness of case notification and investigation in Lao PDR was high, and malaria programme stakeholders and service providers had positive opinions on RASR. However, some operational and health system-related barriers were identified, which need to be addressed to improve the performance of RASR in Lao PDR.Data are available upon reasonable request. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.