Proactive malaria case surveillance and management in Malaysia

Although Plasmodium vivax infections in Malaysia are usually imported, a significant autochthonous outbreak of vivax malaria was detected in a remote indigenous settlement located in northern peninsular Malaysia. Between November 2016 and April 2017, 164 cases of P. vivax infection were detected. Although 83.5% of the vivax cases were identified through passive case detection and contact screening during the first 7 weeks, subsequent mass blood screening (combination of rapid diagnostic tests, blood films, and nested polymerase chain reaction [nPCR]) of the entire settlement (N = 3,757) revealed another 27 P. vivax infections, 19 of which were asymptomatic.

The malaria outbreak operation was initiated on November 2016 after three confirmed P. vivax cases were detected during an active case detection (screening of febrile individuals at areas with high risk of malaria). After that, contact screening (reactive case detection) within 2 km radius from the suspected site of infection was carried out.
During the outbreak, positive cases were identified through contact screening and passive case detection (detection of malaria in patients that seek medical care), whereas most cases detected after the outbreak came from mass blood survey (MBS) also known as proactive case detection (screening of all individuals in an area).
Malaria parasite infections were diagnosed using a combination of rapid diagnostic tests, blood films, and nPCR.

Asymptomatic Reservoir
Indigenous Cases & Importation
P. vivax
Residual Transmission
Surveillance

Nov 2016 — Apr 2017

Malaysia

Mass Test and Treat (MTaT) strategies
Reactive strategies