Myanmar has one of the largest malaria burdens in the Greater Mekong Subregion (GMS). Throughout the GMS, Plasmodium falciparum parasites are increasingly resistant to artemisinin combination therapies. Given the lack of current alternative treatment options, one proposed solution is to eliminate P. falciparum from the region. Because of promising results, several small-scale elimination projects have been piloted in the GMS, including along the Myanmar-Thailand border. Encouraged by the pilot elimination project's success in reducing malaria cases along the Myanmar-Thailand border, the project was scaled up to encompass a large region of Eastern Kayin State, Myanmar.

Elimination of Plasmodium vivax imposes multiple challenges, including the prevalence of the G6PD deficiency, adherence to the long-course primaquine, and the presence of asymptomatic reservoirs among the communities living in the Kayin State.

To address these problems, METF was initiated in 2014 with Karen Community-Based Organizations (CBOs) and SMRU to eliminate artemisinin-resistant Plasmodium falciparum and relapsing Plasmodium vivax in Kayin State, Myanmar.

The overall strategies of METF are:
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1. Geographic mapping of the communities residing in malaria risk area
2. Community engagement to increase awareness of early case detection and prevention
3. Generalize access to the early diagnosis and treatment
4. Epidemiological surveillance
5. Malaria prevalence surveys using highly sensitive diagnostic tools
6. Targeted accelerated interventions (mass drug administration)
7. Glucose-6-phosphate-deficiency testing and safe radical regimen for P.vivax
8. Vector control interventions
9. Environmental Surveillance and Malaria Risk Assessment
10. Trans-border malaria surveillance (along the Thai-Myanmar border)

This  program has been co-funded by:
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1. The Global Fund to fight against Malaria, Aids and Tuberculosis
2. The Bill and Melinda Gates Foundation
3. Wellcome

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9. Landier J, Haohankhunnatham W, Das S, Konghahong K, Christensen P, Raksuansak J, et al. Operational Performance of a Plasmodium falciparum Ultrasensitive Rapid Diagnostic Test for Detection of Asymptomatic Infections in Eastern Myanmar. J Clin Microbiol. 2018;56(8):e00565-18.

10. Jacob CG, Thuy-Nhien N, Mayxay M, Maude RJ, Quang HH, Hongvanthong B, et al. Genetic surveillance in the Greater Mekong subregion and South Asia to support malaria control and elimination. Elife. 2021;10:e62997.

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