Subnational Elimination Malaria
Subnational Elimination Malaria
ELIMINATION
VERIFICATION
Oleh:
Dr. Khairul Rafizah binti Hairodin,
Unit Kawalan Penyakit Bawaan Vektor,
JKN Terengganu
Isi kandungan
1) Gannt Chart Ke Arah Eliminasi Malaria KKM
Reorientation Reorientation
Programme 1 Programme 2
Certification of malaria elimination is
granted by WHO to a country, further to a
request from its government,
after it has been proven beyond
reasonable doubt that human malaria
transmission has been interrupted in
the country,
resulting in zero indigenous malaria cases
for at least the past 3 consecutive years,
and a programme for the prevention of re-
establishment of transmission is in place.
Between 2000
and 2020,
no country
that was certified
malaria free has
been found to
have malaria
transmission
re-established.
Map of malaria endemic countries (including the territory of French Guiana) showing progress towards the
GTS 2020 malaria case incidence milestone of at least 40% reduction from a 2015 baseline
GTS: Global technical strategy for malaria 2016–2030; WHO: World Health Organization. Malaysia also on track (zero malaria deaths) Source: WHO estimates.
PREVENTION OF RE-ESTABLISHMENT (POR)
• Once countries have eliminated malaria, prevention of re-establishment of
transmission through :
- vigilance to identify suspected malaria cases in the health system,
- quality assured diagnosis and treatment, and
- follow-up to ensure complete cure and no onward transmission
- continued preventive measures in areas with malariogenic potential (i.e. risk of
importation in areas receptive to transmission),
• After elimination, imported cases of malaria are expected; however, any introduced or indigenous
cases signify local transmission and indicate possible deficiencies in prevention and surveillance
strategies that must be addressed.
PSEMK
Capacity Case
building Management
Inter Vector
agencies Control
Collaboration
ANNEX 1
REQUIRED DOCUMENTS STATED IN ANNEX 1
3.Diagnosis 3.10 Microscopists and laboratory technicians follow SOPs, as evidenced by good-quality stained blood
slides and accurate readings.
3.11 Laboratory consumables and reagents are supplied continuously, with no stock-outs.
3.12 Rapid diagnostic tests, if used in the country, are WHO_x0002_prequalified and appropriately target
the malaria species most common in the country or likely to be imported.
3.13 Written SOPs and bench aids for use of rapid diagnostic tests for malaria are available and used
according to the manufacturer’s guidance.
3.15 When applicable, health facility staff are trained and proficient in using and interpreting rapid
diagnostic tests.h
3.16 Outreach training and supportive supervision are provided to support use of rapid diagnostic tests in
peripheral health facilities.
CHECKLIST AUDIT YANG DIHASILKAN TASKFORCE
PERINGKAT NEGERI TERENGGANU
Bil. standard/elemen
Bagi PKD : 27 + 9 komponen makmal + 7 komponen entomologi = 43
Bagi Hospital : 9 + 9 komponen makmal = 18
Anggota yang wajib dengar taklimat
• Anggota Unit Vektor dan Unit Ento & Pest daerah
• PKE
• Pakar Perubatan Keluarga
• MOIC Klinik
• Penyelia Jururawat Daerah
• Ketua PPP Daerah
• Ketua JTMP dan semua JTMP
• Pegawai Farmasi
CHECKLIST
AUDIT PKD
ANNEX 7. METHODS FOR VERIFICATION OF MALARIA - FREE STATUS IN A COUNTRY
In China, the methods used for subnational verification differ slightly in counties, prefectures and provinces. While the methods used for subnational
verification in a province are similar to those for national certification, the methods used to verify malaria-free status in a county or a prefecture are
simplified, illustrated in the table below.
Semak
Semak :
Dokumen perlu ada dalam fail
siasatan kes termasuk :
• Hasil analisa kes malaria i. Borang Siasatan Kes (lengkap
mengikut tahun disemak & disahkan oleh pegawai)
(direkodkan dan tren menggunakan Borang PEM9
dalam bentuk graf ii. Borang daftar kes (diambil dari
didokumenkan/ vekpro online)
5.8 Case-based dipamerkan) bagi setiap iii. Borang Notifikasi Kes dari Hospital
data are reported daerah iv. Salinan QC Makmal Vektor Negeri
Prevention of Surveillance v. Salinan PCR MKAK/IMR
to provincial,
Re- and vi. Peta kedudukan rumah kes
district and • Linelisting kes (dalam Unit Vektor vii. Salinan follow up bfmp (Hari ke -
establishment response
national levels bentuk softcopy & PKD 3,7,14,21,28,42)
of Malaria system
according to hardcopy) viii. Salinan Ringkasan kes/wabak yang
Transmission
protocol. *softcopy dari dihantar melalui aplikasi Whatsapp
tahun 2010 (jika ada)
hingga kini ix. Borang Pemantauan Drug Response
Surveillance (DRS)
x. Salinan borang Kajian UM
• Buku daftar kes/case
registration book
(Nota: untuk senarai semak, rujuk
LAMPIRAN 2)
• Fail siasatan kes (setiap
kes ada 1 fail)
ANNEX 7. METHODS FOR VERIFICATION OF MALARIA - FREE STATUS IN A COUNTRY
In China, the methods used for subnational verification differ slightly in counties, prefectures and provinces. While the methods used for subnational
verification in a province are similar to those for national certification, the methods used to verify
malaria-free status in a county or a prefecture are simplified, illustrated in the table below.
Prevention of Surveillance
Re- and
establishment response 5.14 Contingency plans Review plan for Sektor KPB Vektor,
Of Malaria system for rapid deployment of contingency plans for JKNT
Transmission supplies malaria outbreak
(diagnostic tests,
antimalarial treatments
and vector control)
are in place in case of
outbreaks.
ANNEX 7. METHODS FOR VERIFICATION OF MALARIA - FREE STATUS IN A COUNTRY
In China, the methods used for subnational verification differ slightly in counties, prefectures and provinces. While the methods used for subnational
verification in a province are similar to those for national certification, the methods used to verify
malaria-free status in a county or a prefecture are simplified, illustrated in the table below.
Laporan Tahunan
Menyemak data kes sepanjang tempoh 5 tahun
ke belakang direkodkan di dalam bentuk graf.
8. Malaria Case Case registration Semua kes malaria perlu Melawat PKD dan menyemak notifikasi kes di Unit Vektor
Database dilaporkan dan didaftarkan dalam enotifikasi atau data notifikasi PKD
To demonstrate that
Documentation health education and
Enabling Review Senarai
of health community engagement
environment to Aktiviti Pendidikan
education and were used to achieve
support elimination Kesihatan Penyakit Unit Vektor
community elimination and will
and prevention of Demam Malaria PKD
awareness- support the country's
re-establishment of (Bulanan / Tahunan)
raising plan to preventre-
transmission
establishment
Annex 5
COMPONENT ELEMENTS STANDARD METHODS SITE NOTES
Case 4.1 National treatment • All health facilities i. Management Guideline PKD/ KK / KD/
Management guidelines which must ensure Malaria in Malaysia Hospital
according to WHO guidelines are ii. Garispanduan Pencegahan
guidance available Malaria Re-Introduction di
Malaysia
iii.Buku Pelan Pengurusan
Wabak Malaria 2016
iv. A Framework for Malaria
Elimination (WHO)
17. Annual reports of Entomological and Annual reports are Check the availability of the Unit Vektor PKD
entomological and vector control available in hard copy annual reports in the
vector control activities report or soft copy epidemiological bulletin 2022
activities onwards.
18. Reports of multi- Multi-sectoral Reports are available List of duta malaria Unit Vektor PKD
sectoral collaboration collaboration report in hard copy or soft PKD/ Vektor JKNT
copy Check the availability of the
reports
CHECKLIST
AUDIT
HOSPITAL
ANNEX 7. METHODS FOR VERIFICATION OF MALARIA - FREE STATUS IN A COUNTRY
In China, the methods used for subnational verification differ slightly in counties, prefectures and provinces. While the methods used for subnational
verification in a province are similar to those for national certification, the methods used to verify malaria-free status in a county or a prefecture are
simplified, illustrated in the table below.
Semak
Enabling Documentation To demonstrate that Menyediakan UKA Hospital To create awareness among
environment to of health health education and laporan Hari health care provider
support education and community Sambutan Malaria
elimination community engagement were peringkat Hospital Data dari 2018 hingga kini
and prevention awareness- used to achieve
of re- raising elimination and will Semak aktiviti
establishment support the country's promosi/
of plan to prevent pendidikan
transmission reestablishment kesihatan tahunan
yang telah
dijalankan
Annex 5
COMPONENT ELEMENTS STANDARD METHODS SITE NOTES
Case 4.3 Training in Training in malaria diagnosis • To provide CME UKA Hospital Senarai Latihan
Management malaria diagnosis and case management, record from dijalankan secara
and case including updated malaria healthcare provider tahunan dari
management information, is provided to 2018-sekarang
health practitioners who
provide malaria diagnosis and
treatment.
4.4 A functional A functional referral system is - To review case notes UKA District Referral from
referral system is in place to refer patients with Hospital district to tertiary
in place to refer severe malaria to hospitals. hospital according
patients with severe to CPG (page 28)
malaria to hospitals
4.5 Sufficient Sufficient treatment courses • To review Treatment Hospital Rujuk Surat
treatment courses are available when and where Response Monitoring• UKA, Pekeliling
are available when needed; stock-outs of (DRS_Annex 1) • Pharmacy Pemantauan Stok
and where needed; antimalarial drugs are • Rekod (BHT) Ubat Anti Malaria
stock-outs of prevented. • To review stock and di Fasiliti
antimalarial drugs indent anti malaria Kesihatan
are prevented. drug in Pharmacy Kerajaan (Ruj.
Department JKNTR 702-07-
05-03-JLD8(40))
Annex 5
COMPONENT ELEMENTS STANDARD METHODS SITE NOTES
Case 14. All guidelines are To check the UKA, ED, CPG dan garis panduan
Management National aligned with current availability of the latest Medical, (rujuk lampiran)
malaria WHO recommendations guidelines are aligned Paeds, Patho
treatment with current WHO Hospital
guidelines recommendations
(soft copy guideline)
15. Patient The completeness and To check linelisting of Hospital Di rekod hospital/HIS, perlu semak
log or quality of malaria malaria case from - UKA salinan notifikasi, nota kes, borang
register treatment and to 2013-present - Unit ujian makmal, rekod DRS (bagi
assess the rekod/wad kes yang penuhi kriteria untuk
consistency of To review Treatment DRS)
surveillance data Response Monitoring
(DRS_Annex 1) Rawatan ubat yang diberikan
mengikut garispanduan CPG KKM
Rujuk rekod BHT kes bagi jenis jangkitan malaria kes.
malaria/HIS
Pesakit hanya didiscaj selepas 3
kali bacaan bfmp negatif
CHECKLIST
AUDIT
MAKMAL
(Hospital
& PKD)
Annex 5
COMPONENT ELEMENTS STANDARD METHODS SITE CATATAN
11. SOPs and bench All laboratories SOPs or guidelines List of guidelines • All laboratories at Refer Guidelines list by
aids for malaria have correct are available in and availability of it KK, hospitals and Makmal JKNT
diagnosis guidance, aligned hard copy or soft (MOH and WHO Vector lab at PKD
with that of WHO copy guidelines) i. Basic Malaria
Microscopy Part 1.
Leaner's Guide
Second Edition
ii. Bench Aids For The
Diagnosis of Malaria
Infections Plate 1-
plate 12
iii. Basic Malaria
Microscopy Part 2,
Tutor's Guide Second
Edition
iv. Malaria Microscopy
Quality Assurance
Manual Version 1
v. Malaria Microscopy
Quality Assurance
Manual Version 2
COMPONENT ELEMENT STANDARD METHODS SITE CATATAN
Implementation of Testing of Sample logs are available in Visit laboratories in Laboratories at Buku Rekod PCD
elimination blood laboratories. health facilities, and KK/Vector PKD Malaria (Urgent
strategy and samples from Sample logs are complete review sample logs. and Hospital dan Survelan) -
quality of patients with and up to date. PKD
implementation fever
Number of blood samples LIS/HIS (hospital)
tested for malaria is Case positive
appropriate and comparable inform to requestor
to that defined in a the work –noted in system
plans.
Case All detected cases are Review sample logs Laboratories at Hospital (LIS),
notification reported. and patient logs. KK/Vector PKD PKD (buku rekod
and Hospital urgent dan
Cross check the survelan PCD
number of positive Malaria)
cases detected in the
laboratory and the
number of complete
case notifications,
and match the data
with those in the
national malaria
database.
COMPONENT ELEMENT STANDARD METHODS SITE CATATAN
Implementation Quality- Slides are cross- Review the record and feedback Laboratories Borang PBV
of elimination assured checked monthly, received on cross checking of Hospital/PKD/ (MK ) 302
strategy and diagnosis and the results of slides. Vektor Negeri Pindaan - 04
quality of cross-checking of
implementation slides are
available.
Internal quality assurance - Laboratories Fail Blinded
Diagnosis is Blinded cross checking of slides Hospital/PKD/ Rechecking/
quality assured. by laboratory at different levels Vektor Negeri Fail IQC
- Randomly select 10% negative
slides
Diagnostic SOP Microscopist and Review SOP by staff laboratory Laboratories Buku SOP /
laboratory Hospital/PKD/ soft copy
technicians follow Vektor Negeri Bench aids
SOP’s
1. Focus register, Entomological Entomological Review record registry case Unit Entomology & • Kena pastikan
including focus investigation; investigation (E-vekpro) and Pest PKD /Vektor juga Maps ada
investigation i. Adult study done within 2 weeks after entomological investigation PKD dimasukkan
forms and maps (Human case registration report dalam laporan EI
Landing catch)
ii. Environment
and habitat
study
iii. Effectiveness
control study
(wall & ITN
bioassay)
COMPONENT ELEMENTS STANDARD METHODS SITE NOTE
2. Guidelines or i. Effectiveness control Follow Guidelines or SOPs for Review the entomology Unit Entomology
SOPs for study (wall & ITN entomological surveillance activities (EI reports) to & Pest District /
entomological bioassay) and vector control; ensure it follow the State
surveillance i. Test Procedures for insecticide guidelines or SOPs
and vector resistance monitoring in
control malaria vector mosquitoes
(2nd Edition, WHO 2016) Review annual work plans
ii. Guidelines for laboratory and and annual reports
field testing of long-lasting
insecticidal nets (2013)
ii. Entomological study Panduan menjalankan kajian Review the entomology Unit Entomology & Surat arahan
entomologi (2015) investigation reports, Pest District / dari KKM
Ensure the study was State arahan 144
conducted according to jam
SOPs
iii. Training on All entomology staff to be train Reviews HRMIS/ Surat Unit Entomology & Include
Entomology related to malaria monitoring and Panggilan latihan/ training Pest District / myCPD
evaluation (every 3 years). report State
iv. Equipment for vector Yearly calibration Review microscope Unit Entomology & Record servis
identification - calibration record Pest District /
microscope calibration State
v. Monitoring Yearly report Review sentinel site reports Unit Entomology & Sentinel site at
entomological activities Pest District / Belukar Bukit
(Sentinel site) State Seasonal
Sentinel
lentang juga
masuk sekali
COMPONENT ELEMENTS STANDARD METHODS SITE NOTE
3. Annual Entomological Collect and record all Review annual reports Unit Entomology & Pencapaian SO
reports of reports malaria entomological Status RV Pest District / State Pelan Tindakan
entomological activities as future tahunan JKNT
and vector reference.
control activities Rekod RV kena ada
Std R dan V review every semua daerah
year (Ento pon kena ada
jugak data V)