title: Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific.
abstract: Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission.
  
  
  
  A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN).
  
  
  
  All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure.
  
  
  
  Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.
authors.affiliation: Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA.
authors.forename: Shawn
authors.initials: S
authors.lastname: Wen
authors.affiliation: Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA. kelly.harvard@ucsf.edu.
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Harvard
authors.affiliation: Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA.
authors.forename: Cara Smith
authors.initials: CS
authors.lastname: Gueye
authors.affiliation: Centre for Biomedical Research, Burnet Institute, 85 Commercial Road, Melbourne, VIC, Australia.|Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Canavati
authors.affiliation: University of Queensland School of Public Health, Level 1, Public Health Building (887), Herston Rd, Herston, QLD, 4006, Australia.
authors.forename: Arna
authors.initials: A
authors.lastname: Chancellor
authors.affiliation: Department of Microbiology, National Institute of Preventive and Social Medicine, Ministry of Health and Family Welfare, Mohakhali, Dhaka, Bangladesh.
authors.forename: Be-Nazir
authors.initials: BN
authors.lastname: Ahmed
authors.affiliation: National Vector Borne Disease Control Programme, Ministry of Health and Medical Services, Honiara, Solomon Islands.
authors.forename: John
authors.initials: J
authors.lastname: Leaburi
authors.affiliation: The National Center For Parasitology, Entomology and Malaria Control, Ministry of Health, Corner street 92, Trapaing Svay village, Sankat Phnom Penh Thmey, Khan Sensok, Phnom Penh, Cambodia.
authors.forename: Dysoley
authors.initials: D
authors.lastname: Lek
authors.affiliation: Vector-borne Disease Control Programme, Ministry of Health, Gelephu, Royal Government of Bhutan.
authors.forename: Rinzin
authors.initials: R
authors.lastname: Namgay
authors.affiliation: National Malaria Control Programme, Directorate General of Disease Control and Environment Health, Ministry of Health, Jakarta, Republic of Indonesia.
authors.forename: Asik
authors.initials: A
authors.lastname: Surya
authors.affiliation: Monitoring and Evaluation Division, Ministry of Health and Population, Kathmandu, Nepal.
authors.forename: Garib D
authors.initials: GD
authors.lastname: Thakur
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia.
authors.forename: Maxine Anne
authors.initials: MA
authors.lastname: Whittaker
authors.affiliation: Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA.
authors.forename: Roly D
authors.initials: RD
authors.lastname: Gosling
mesh_terms: D001208:Asia / Q000453:epidemiology; D003140:Communicable Disease Control / Q000458:organization & administration*; D060740:Disease Eradication; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D010139:Pacific Islands / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Asia Pacific; Hard-to-reach populations; High-risk populations; Malaria elimination; Migrant populations; Mobile populations; Populations at higher risk