Malaria in Myanmar

Introduction
Myanmar is a country situated in South East Asia and in the recent years the country has
experienced an insurgence in the number of reported malaria cases with an estimated of thirty
thousand reported cases annually. This has being mainly attributed to the rise of resistance to
both chloroquine and artemisinin. This resistance is mainly because in the South Eastern Asian
region there is a lower level of natural immunity unlike other parts of the world. (World Health
Organization, 2010, pg 7)
Epidemiology
It has been shown that unlike the other malaria a prone region where plasmodium
falciparum is more prevalent, in Myanmar plasmodium vivax malaria is more prevalent. I think
this means that it easy to reduce the number of malaria cases and this is because vivax malaria is
known not to be as fatal (and it exhibits frequent lapses) as plasmodium malaria and it also has a
short incubation period. Although the malaria vivax is not as fatal I think this can easily lead us
to conclude that an enormous economic loss will be encountered. (Rollinson, Hay, Price &
Baird, 2013, pg 16)
It has been showed that the malaria containing parasites have shown degrees of
resistance in Myanmar that is Mefloquine resistant falciparum and chloroquine resistant vivax. I
think the best way to deal with such an issue is by conducting more researches so as to find more
efficient drugs which the parasites will not be able to resist against. (Blas & Sivasankara, 2010,
pg 60)

Malaria in Myanmar 3
In Myanmar, just like in other Asian countries, malaria is common among the hard to
reach population which mainly consists of the migrant population and the urban poor. In some
areas though, the risk of contracting this disease depends on human behaviors. Since the risk of
contracting malaria is not equal even in people in the same geographic region, I think there is the
need to identify such populations and clearly understand the epidemiology of malaria among
them so that the better interventions are sought. I think their behavioral risk factors also need to
be identified. I also think it is important for these groups to access health care and this can be
achieved through initiating control programmes. Although the prevalence of malaria in
pregnancy is not common, I still think there is need to pay attention since prevention is better
than cure.
Following the frequent malaria outbreaks that have been reported over the past decade I
think continuous eradication projects should be carried out so as to avoid resurgence of malaria
after the eradication project in Sri Lanka in 1967-1967
Social determinates
It has been shown that in Myanmar malaria is most at times transmitted during migration
times as people migrate from one place to the other for example during the times of epidemics
such as earthquakes and migrants moving into the country, people massively migrate from one
place to the other. Those travelling from malaria prone areas have usually being found to be the
main people transmitting this disease. I think the best way to curb this is by the government
restricting movements from the malaria prone areas and if the movement is necessary and
unavoidable then these people should be secluded to particular areas until all the necessary tests
have been done on them and it has being proved that they do not suffer from malaria. (Blas &
Sivasankara, 2010, pg 39)

Malaria in Myanmar 4

Illiteracy has also contributed to the spread of this disease and this is so because, with a
low level of illiteracy, the level of awareness concerning the disease is then definitely low. The
best way to curb this I think is by initiating programmes that will ensure people are educated on
malaria focusing on issues such as its spread, measures to curb its spread, the signs and
symptoms and the treatment. I also think this issue can be addressed through introducing malaria
related topics in school so as to increase the awareness level among the locals. (Blas &
Sivasankara, 2010, pg 36)
Poverty has also been shown to be a major malaria social determinant. Most of the poor
families in Myanmar cannot sustain the preventative measure such as use of mosquito nets and
repellants hence making the disease more prevalent among the poor population. Malaria
treatment also requires money and this has been difficult to seek among the poor families hence
retaining a high mortality rate among the poor due to malaria. If it was up to me, I think this can
be addressed through the government of Myanmar in association with other organizations such
as the World Health Organization carrying out programmes that will ensure that all the poor
families get all materials they require to prevent malaria such as nets for free. The same should
also be done when it comes to treatment. (Blas & Sivasankara, 2010, pg 45)
Poor health services in Myanmar which is indicated by the presence of very few hospitals
and health practitioners in general is another great and grave issue which has significantly
contributed to the spread of malaria in the region. I think this can be addressed by the
government through the ministry of health by allocating more funds which will aid building new

Malaria in Myanmar 5
health facilities, refurbishing the ones present, employing more practitioners and initiating
campaigns aimed at fighting malaria. (Jameson, 2013, pg 101)
The burden of the disease
The disease has had a major impact on the people of Myanmar. Malaria, HIV and TB ranked
the 5 th place in country’s burden of disease. The total years of life lost due to premature mortality by
malaria were 2000. The financial cost used in fighting malaria enormous for example in 2013
US$ 22.5 million was used. Usually, when the bread winners of a family are affected by the
disease for example when the bread winner succumbs to the death, the family social and
economic status suffers. (Martini & Chesworth, 2010, pg 360)
In my opinion I think the government should set aside funds that will cater for the
families who have lost their bread winners. I think the government should also source for more
funds that will enable them fight malaria from organizations such as the World Health
Organization
Conclusion
My contribution in the group presentation was on the epidemiology of malaria in
Myanmar. I focused on several issues as follows
Firstly, was the population of people in Myanmar affected by malaria and I was able to
find out that there is a high number of reported cases for example in 2013 there were 198 million
reported cases of malaria with an estimated 584,000 deaths reported with about 78% of these
death cases being of children under the age five years old. (World Health Organization, 2014, pg
56)

Malaria in Myanmar 6
Secondly, was the morbidity and mortality cases of malaria where I was able to conclude
that over the past years there has been a decrease both the morbidity and mortality rates. For
example in 1988 the morbidity rate was at 25 people per a thousand while the mortality was at
about 10 per a thousand people. In 2010 the morbidity rate had fallen to about 7 people per a
thousand people whilst the mortality was now at about 2 people per a thousand people. (World
Health Organization, 2014, pg 63)
Thirdly, was the distribution pattern of malaria cases in the country and was I was able to
discover that the North Western region of Myanmar was the most affected with over 75 reported
cases per a thousand people. This was followed by the Central and Eastern regions where
reported cases per a thousand people ranged from 1 to 10 people. I then found out that over the
years the male population was more affected by the disease compared to the female population.
(World Health Organization, 2014, pg 67)
Lastly, was and the epidemiologic triangle of malaria in the country where I was able to
generalize that the environment played a major role in the spread of the disease for example bush
land, lakes and ponds and that the most vulnerable population was comprised of; Children under
five, pregnant women, people living in swamps and coastal areas, the poor, people living in
remote areas, illiterate citizens and the IDPs. I also found out that the best way to reduce the
vulnerability of these people was through conducting educations on malaria related issues,
eliminating potential sources for mosquitos’ life cycles, using of protective clothes, insecticides
and mosquito nets and anti-malaria drugs. (World Health Organization, 2014, pg 70)
Epidemiology plays a major role in the global health education. I say this because
epidemiology provides critical information such as the pattern of the disease and its prevalence

Malaria in Myanmar 7
among the population. With such information we are able to determine the major determinates of
the disease and the vulnerable population. This provides a background that will enable us know
how to eradicate the disease and carry out the necessary preventative measures. (Rollinson et
al…, 2013, pg 87)
Epidemiology also helps us reduce the impact of a disease, for example it is through this
study that it can be determined that the disease has greatly affected the education system in the
country hence calling for the necessary actions such as initiating programmers that will ensure
that all the children who have been orphaned by this disease get the necessary required
education.
It is thus important for the society to help in the fighting of malaria in conjunction with
other organizations such as the World Health Organization.

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