title: Artemisinin resistance containment project in Thailand. (I): Implementation of electronic-based malaria information system for early case detection and individual case management in provinces along the Thai-Cambodian border.
abstract: BACKGROUND
  The Bureau of Vector-borne Diseases, Ministry of Public Health, Thailand, has implemented an electronic Malaria Information System (eMIS) as part of a strategy to contain artemisinin resistance. The attempt corresponds to the WHO initiative, funded by the Bill & Melinda Gates Foundation, to contain anti-malarial drug resistance in Southeast Asia. The main objective of this study was to demonstrate the eMIS' functionality and outputs after implementation for use in the Thailand artemisinin-resistance containment project.
  
  
  METHODS
  The eMIS had been functioning since 2009 in seven Thai-Cambodian border provinces. The eMIS has covered 61 malaria posts/clinics, 27 Vector-borne Disease Units covering 12,508 hamlets at risk of malaria infections. The eMIS was designed as an evidence-based and near real-time system to capture data for early case detection, intensive case investigation, monitoring drug compliance and on/off-site tracking of malarial patients, as well as collecting data indicating potential drug resistance among patients. Data captured by the eMIS in 2008-2011 were extracted and presented.
  
  
  RESULTS
  The core functionalities of the eMIS have been utilized by malaria staff at all levels, from local operational units to ministerial management. The eMIS case detection module suggested decreasing trends during 2009-2011; the number of malaria cases detected in the project areas over the years studied were 3818, 2695, and 2566, with sero-positive rates of 1.24, 0.98, and 1.16%, respectively. The eMIS case investigation module revealed different trends in weekly Plasmodium falciparum case numbers, when classified by responsible operational unit, local and migrant status, and case-detection type. It was shown that most Thai patients were infected within their own residential district, while migrants were infected either at their working village or from across the border. The data mapped in the system suggested that P. falciparum-infected cases and potential drug-resistant cases were scattered mostly along the border villages. The mobile technology application has detected different follow-up rates, with particularly low rates among seasonal and cross-border migrants.
  
  
  CONCLUSIONS
  The eMIS demonstrated that it could capture essential data from individual malaria cases at local operational units, while effectively being used for situation and trend analysis at upper-management levels. The system provides evidence-based information that could contribute to the control and containment of resistant parasites. Currently, the eMIS is expanding beyond the Thai-Cambodian project areas to the provinces that lie along the Thai-Myanmar border.
authors: Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors: Amnat
authors: A
authors: Khamsiriwatchara
authors: Prayuth
authors: P
authors: Sudathip
authors: Surasak
authors: S
authors: Sawang
authors: Saowanit
authors: S
authors: Vijakadge
authors: Thanapon
authors: T
authors: Potithavoranan
authors: Aumnuyphan
authors: A
authors: Sangvichean
authors: Wichai
authors: W
authors: Satimai
authors: Charles
authors: C
authors: Delacollette
authors: Pratap
authors: P
authors: Singhasivanon
authors: Saranath
authors: S
authors: Lawpoolsri
authors: Jaranit
authors: J
authors: Kaewkungwal
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000494:pharmacology*; D037621:Artemisinins / Q000494:pharmacology*; D003140:Communicable Disease Control / Q000379:methods; D004351:Drug Resistance; D001330:Electronic Data Processing / Q000379:methods; D006801:Humans; D007256:Information Systems; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000453:epidemiology* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects*; D013785:Thailand / Q000453:epidemiology
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin