Supporting the National Malaria Control Programme of Papua New Guinea

Team in Papua New Guinea

Swiss TPH has a long history of collaborating with partners in Papua New Guinea (PNG), a country of almost 9 million people that contributes 80% of all malaria cases recorded in the Western Pacific Region.

Since 2004, the PNG National Malaria Control Program (NMCP) has been financially supported with grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The main strategies of the NMCP include vector control with long-lasting insecticidal nets (LLIN), and prompt diagnosis and treatment of malaria cases with artemisinin-based combination therapy.

In partnership with the Papua New Guinea Institute of Medical Research (PNGIMR)we support the 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 complementary approaches that can help accelerate PNG’s progress towards malaria elimination.

Evaluation of the PNG National Malaria Control Programme

Together with the PNG Institute of Medical Research, we assess the outcomes and impact of the Global Fund-supported NMCP. Major activities include national Malaria Indicator Surveys (5 MIS conducted to date), country-wide Health Facility Surveys, and analytical work to contribute to the stratification of malaria risk across PNG. Surveys provide a platform for additional studies, for example to evaluate the longevity of mosquito nets. Findings from these activities support the effective implementation of malaria control activities by the NMCP.

Link to Project 2021-2023

Link to Project 2018-2020

Link to Project 2015-2017

Malaria Indicator Surveys Document Changes in Malaria Prevalence

Five national Malaria Indicator Surveys (MIS) conducted since 2008 have documented a substantial decrease in the country-wide prevalence of malaria infections in the population following the scaling-up of vector control with insecticide-treated bednets. A resurgence was observed in 2016/17 and a renewed decrease in the last MIS in 2019/20. Coverage with mosquito nets has plateaued since 2011. The next MIS is scheduled for 2022/23.

All PNG MIS reports are available on https://www.malariasurveys.org/

School Malaria Survey in the Highlands of PNG

In the Highlands of PNG, the climate is generally unsuitable for stable malaria transmission, providing an opportunity for complete interruption of local transmission and sub-national elimination. We conducted a school malaria survey combined with reactive case detection in Highlands communities and found only 13 malaria infections among over 6600 participants. A history of recent travel to coastal provinces was a strong predictor of infection. The findings indicate a conducive epidemiological setting for pushing towards local malaria elimination, if operational capacities allow. 

Understanding Heterogeneities in Malaria in PNG

Data from sentinel surveillance sites provide a detailed picture of trends in clinical malaria cases over time complementing national routine statistics. We used sentinel site malaria data to evaluate species-specific morbidity trends and estimate the relative impact of malaria control interventions. We found that repeated mosquito net distributions, but not the introduction of more effective treatment, reduced the incidence of clinical malaria. Human and mosquito behavior may be important drivers of ongoing malaria transmission. Link to Project

Keven J.B et al. Vector composition, abundance, biting patterns and malaria transmission intensity in Madang, Papua New Guinea: assessment after 7 years of an LLIN-based malaria control programme. Malar J. 2022;21:7. DOI: 10.1186/s12936-021-04030-4

Cleary E, Hetzel M.W, Siba P, Lau C.L, Clements A.C.A. Spatial prediction of malaria prevalence in Papua New Guinea: a comparison of Bayesian decision network and multivariate regression modelling approaches for improved accuracy in prevalence prediction. Malar J. 2021;20:269. DOI: 10.1186/s12936-021-03804-0

Rodríguez-Rodríguez D et al. Human behavior, livelihood, and malaria transmission in two sites of Papua New Guinea. J Infect Dis. 2021;223(Suppl. 2):S171-S186. DOI: 10.1093/infdis/jiaa402

Rodriguez-Rodriguez D et al. Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea. Malar J. 2019;18:364. DOI: 10.1186/s12936-019-2993-6

Pulford J, Saweri O.P.M, Jeffery C, Siba P.M, Mueller I, Hetzel M.W. Does test-based prescription of evidence-based treatment for malaria improve treatment seeking and satisfaction? Findings of repeated cross-sectional surveys in Papua New Guinea. BMJ Glob Health. 2018;3(6):e000915. DOI: 10.1136/bmjgh-2018-000915

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

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