On 30 June, Suriname became the first country in the Amazon region to receive malaria-free certification from the World Health Organization (WHO). Over the past five years, TDR has been one of several partners supporting the Malakit Project, which contributed to this historic milestone.
While Suriname had drastically reduced the burden of malaria across the country in the past 10 years, persistent transmission in the gold mining areas in the Amazon was a challenge to elimination. In Suriname, as well as in Brazil and French Guiana, this population is particularly vulnerable to malaria, given difficulties accessing healthcare from these remote mining sites. In addition, their reliance on informal drug markets raises the risk of antimalarial resistance. To reach these last pockets of malaria in Suriname and achieve malaria elimination, a new approach called Malakit was implemented.
The Malakit intervention includes self-testing and self-care kits distributed to the mining community, aiming to ensure early diagnosis and proper treatment adherence. The diagnostic kit includes three single-use rapid diagnostic tests and illustrated step-by-step instructions. If a test result is positive, the treatment kit offers an artemisinin combination therapy (ACT), a single dose of primaquine and paracetamol.
The Malakit intervention appears to have accelerated the decline in malaria incidence in the region by 43% between April 2018 and March 2020, the researchers reported in a paper published in Lancet Regional Health in 2021.
However, the last cases of malaria with the Plasmodium vivax parasite required some improvements to the kits themselves and their use and distribution. The testing of these changes was supported financially and technically by TDR through an implementation research project and the scale-up of the Malakit approach with the following objectives:
a) the re-assessment of tools and messages for community members and health workers (social study);
b) introducing and evaluating Point of Care G6PD testing (operational study) at the distribution sites to control P. vivax; and
c) engaging in global discussion about the prevention and control of malaria in mobile and hard-to-reach populations and exchange of experiences with innovative approaches (international symposium).
The improved Malakit strategy was integrated into the National Strategic Plan for Malaria Elimination Suriname 2023-2027, thereby contributing to the national elimination of malaria, including in remote sites.
“TDR played an important role in the
last mile to eliminating malaria in Suriname,” said Dr Stephen Vreden, Chair of the
Malaria Elimination Task Force in Suriname. “The research
results helped to fine-tune the Malakit strategy and reach the critical
hard-to-reach populations.”
For more information, please contact Dr Florence Fouque.