Supporting the National Malaria Control Programme of Papua New Guinea

Team in Papua New Guinea

Papua New Guinea (PNG) is a malaria endemic country in the South-West Pacific with a population of approximately 8 million people. Since 2004, the National Malaria Control Program (NMCP), a multi-stakeholder partnership of the PNG government, non-governmental organizations and the private sector, has been financed largely with grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The main interventions that are implemented by the NMCP include long-lasting insecticidal nets (LLIN), rapid diagnostic tests for the diagnosis and artemisinin-based combination therapy for the treatment of malaria.
In partnership with the Papua New Guinea Institute of Medical Research (PNGIMR) we support the PNG NMCP by generating evidence of the outcomes and impact of the malaria control interventions implemented across PNG.
We conduct operational research studies to identify and validate approaches that can improve the performance of the NMCP and further reduce the malaria burden in PNG.

Evaluation of the PNG National Malaria Control Programme

This project aims to assess outcomes and impacts of the Global Fund supported NMCP. Results from this continued independent evaluation and accompanying operational research will support the scaling-up of interventions and provide evidence required to adjust programme strategies. The project activities focus on stratification of the malaria risk across PNG, and cross-sectional surveys to assess intervention progress, quality of care, and malaria trends.

Link to Project 2021-2023

Link to Project 2018-2020

Link to Project 2015-2017


Understanding Heterogeneities in the Epidemiology of Malaria in Papua New Guinea

Data from sentinel surveillance sites provide a detailed picture of trends in clinical malaria cases over time complementing national routine statistics. We use sentinel site malaria data to evaluate species-specific morbidity trends and estimate the relative impact of malaria control interventions and underlying secular trends. Drivers of change and reasons for differences in malaria trends between sites are investigated. Link to Project

Malaria Prevalence Decreases Following Mosquito Net Scale-up

Three subsequent national Malaria Indicator Surveys (MIS) covering almost 30,000 individuals in 218 villages found that between 2008 and 2014, malaria prevalence across PNG decreased from 11% to less than 1%. This decrease was linked to repeated rounds of country-wide insecticide-treated net distributions and the introduction of artemisinin-based combination therapies. The decline was accompanied by broader health benefits, such as decreased morbidity. In light of the continuing transmission potential, maintaining a high level of intervention coverage is crucial for avoiding malaria resurgence.  Research into drivers of residual transmission is crucial for better targeting of interventions. Link to Survey

Insecticide-treated Wall-lining

Insecticide-treated plastic sheeting (ITPS) targets mosquitoes resting on the inside walls of houses. A study by PNGIMR and collaborators found ITPS installation to be feasible and acceptable in a diverse range of PNG contexts. However, ITPS had been removed from over 50% of the original study homes 3 years post-installation, largely due to deteriorating housing infrastructure. The presence of the ITPS appeared to reduce mosquito net use among many participating householders, suggesting that large-scale implementation of ITPS in the contemporary PNG malaria control programme may be counter-productive. ITPS should be considered in very specific settings only. Link to Study

Poor Quality Antimalarials

A survey of the formal health facility supply chain found poor-quality antimalarial drugs across Papua New Guinea in 2011. While 90% of tested medicines were of good quality, most primaquine tablets (an antimalarial used to treat Plasmodium vivax malaria) found on the shelves contained insufficient active ingredient, rendering the drugs useless. The study concluded that system, facilities and trained staff are required within PNG to identify poor quality products. A regulatory framework and is needed to ensure that only quality-assured drugs from certified providers are purchased, poor quality products can be removed from the market, and suppliers of such products can be prosecuted.  Link to Survey

Koimbu G et al. Status of insecticide resistance in Papua New Guinea: an update from nation-wide monitoring of anopheles mosquitoes. Am J Trop Med Hyg. 2018;98(1):162-165. DOI: 10.4269/ajtmh.17-0454

Pulford J, Kurumop S, Mueller I, Siba P.M, Hetzel M.W. The impact of the scale-up of malaria rapid diagnostic tests on the routine clinical diagnosis procedures for febrile illness: a series of repeated cross-sectional studies in Papua New Guinea. Malar J. 2018;17:202. DOI: 10.1186/s12936-018-2351-0

Hetzel M.W et al. Insecticide-treated nets and malaria prevalence, Papua New Guinea, 2008–2014. Bull World Health Organ. 2017;95:695-705. DOI: 10.2471/BLT.16.189902

Ménard D et al. A worldwide map of Plasmodium falciparum K13-propeller polymorphisms. N Engl J Med. 2016;374(25):2453-2464. DOI: 10.1056/NEJMoa1513137

Pulford J, Smith I, Mueller I, Siba P.M, Hetzel M.W. Health worker compliance with a 'test and treat' malaria case management protocol in Papua New Guinea. PLoS One. 2016;11(7):e0158780. DOI: 10.1371/journal.pone.0158780

Reimer L.J et al. Malaria transmission dynamics surrounding the first nationwide long-lasting insecticidal net distribution in Papua New Guinea. Malar J. 2016;15:25. DOI: 10.1186/s12936-015-1067-7

Hetzel M.W et al. Evaluation of the Global Fund-supported National Malaria Control Program in Papua New Guinea, 2009-2014. PNG Med J. 2014;57(1-4):7-29

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