The National Malaria Control Programme Republic of Yemen

1
The National Malaria Control Programme Republic
of Yemen

• The Situation of Drug Resistance and Monitoring
  Activities
• Inter-Country Workshop On Monitoring Therapeutic
  Efficacy Of Antimalarial Drugs
• Sanaa, Yemen, 21-25 April 2002

2
Introduction

• Population 18,261,000
• Area 550,000 sq.km
• Malaria comes on top of the priority list of
  health problems in Yemen
• 60 of the Yemeni population are at risk
• An estimate of 3 million cases a year
• Mortality rate estimated to be 1 of cases
• Predominant species P.falciparum
• Predominant vector An. arabiensis

3
History of Malaria Control in Yemen

• 1940 Malaria unit in Abyan
• 1969 Malaria control programme in Aden
• 1978 Malaria control programme HQ in
• Hodeida (Tihama coast)
• 1991 Malaria control programme HQ in
• Sanaa

  -        .
4

• The programme faced serious problems during the
  nineties until the year 2000
• January 2000 Statement of Intent committing
  Yemen to ROLL BACK MALARIA

5

• November 2000 A prime ministerial decree to
  establish the HQ of the national malaria control
  programme in the capital Sanaa
• March 2001 The prime ministerial decree
  announcing the year 2001 as the year of Malaria
  Control in Yemen

6

• POLITICAL
• COMMITMENT

7
The 8 Strategic Directions

• Human resource development to have competent
  national cadres in all the areas of malariology
• Early and correct diagnosis followed by prompt
  and effective treatment of malaria cases
  including severe cases of malaria through a
  national anti-malaria drug policy which should be
  standardized and adhered to in all the health
  institutions country-wide
• Selective integrated vector control through
  multiple and sustainable preventive measures

8

• 4. Prevention of malaria in pregnancy to ensure
  safer pregnancy
• 5. Epidemic preparedness and response efficient
  forecasting and controlling malaria outbreaks
• 6. Strengthening the information system and
  surveillance

9

• 7. Increasing the capability of the community to
  recognize, prevent and control malaria. This
  includes the initiation of Home management in
  selective remote areas where there is a problem
  with accessibility to disease management
• 8. Developing the capacity to plan and implement
  operational field research and to utilize results
  in programme intervention

10
The National Anti-malarial Drug Policy

• 1st line treatment Chloroquine
• 2nd line treatment Sulphadoxine/Pyrimethamine
• 3rd line treatment Mefloquine
• Treatment of Severe and complicated malaria
• IV Quinine
• N.B
• Posters and flow charts have been prepared to be
  fixed on the walls of every clinic in the country
• Manuals are being prepared

11

• Training is a very important component to
  strengthen the national capacity building
• Training of medical doctors
• Training of laboratory technicians with special
  emphasis on establishing the Quality Control
  system
• Training of sanitary inspectors

12
(No Transcript)
13
Monitoring the efficacy of antimalarial drugs

• Several limited studies were done in the eighties
  and nineties
• A plan to assess the Pf susceptibility to
  Anti-malarial Drugs has been formulated and is
  about to be implemented in some sentinel sites
  starting in the pilot areas in Tihama and Ibb
  governorate

14

• Objective of the plan
• To monitor the practical efficacy of chloroquine
  in wider and representative areas with an
  ultimate goal of ascertaining its continued
  usefulness or the need of replacing it in the
  routine treatment of acute uncomplicated
  falciparum malaria in Yemen

15
Monitoring Sites
16
Review of some studies on Monitoring the
Therapeutic Efficacy of Chloroquine in the
Republic of Yemen