Kiriwina is now almost malaria-free

By JASON DOM
ARLY this month, the Guangzhou University of Chinese Medicine presented an annual report on the Fast Elimination of Malaria by Source Eradication (FEMSE) programme in a malaria-endemic region of Papua New Guinea at Airways Hotel, Port Moresby.
The occasion brought together officials from both China and Papua New Guinea to witness what is deemed the game changer in efforts to eliminate malaria in the country.
In 2015, the Guangzhou University of Chinese Medicine (GUCM) team to Papua New Guinea discussed the implementation of the FEMSE project. The Health Department of Papua New Guinea, in collaboration with the Guangdong government implemented the project on Kiriwina Island in Milne Bay.
The report surprised all the participants who were told that the 18 per cent of malaria infection rate among the Kiriwina Island population was reduced to 0.31 per cent after the mass drug administration (MDA) by the team of health workers and volunteers.
Multi-drug administration
Three rounds of MDA were administered from March to May 2018 to the 45,000 inhabitants in the area and that gave a great result by reducing the prevalence of malaria to less than 1 per cent within three months.
Following the result, today surveillance and monitoring are carried out in Kiriwina Island. The anti-malaria team has also helped PNG to set up the Sino-PNG Anti-Malaria Centre in Hohola, Port Moresby, with the aim to help the Department of Health in the long-term to train more local technicians for the fight against malaria.
Director of the Institute of Tropical Medicine at GUCM, Song Jianping said at the presentation of the report on April 3 that the university was the best traditional medicine institution in China.
He said after almost two years of negotiations between both countries the project eventuated and there were great results after one year.
Speaking on behalf of the Kiriwina project, Milne Bay provincial health authority director, Dr Jacob Morewaya, said the joint partnership between China, PNG health authorities, health workers of Kiriwina and the local people was a success.
He said about 95 per cent of the population at Kiriwina were treated, thanks to the Chinese medical team for training 234 locals and health workers to coordinate and distribution of drugs.
“Community education compliance was fundamental at that time. During the drug distribution, pregnant mothers, children under six months old and patients with chronic liver or kidney diseases were not treated.
“The team travelled by boat to all the smaller Islands in Kiriwina to provide treatment. Only 1.42 per cent of those treated experienced side effects like vomiting and diarrhoea while 95 per cent showed positive cure,” Dr Morewaya said.
The importance of MDA is the comprehensive treatment of asymptomatic parasite carriers who silently sustain transmission in endemic populations. MDA regimens have therefore included Primaquine (PMQ) to kill the Plasmodium Falciparum gametocytes that infect mosquitoes. A single dose of PMQ (0.25 mg base /kg) may clear Plasmodium Falciparum gametocytes without serious complications.
Success in other countries
The Chinese institution has also worked with 32 other countries throughout the world to eradicate malaria through FEMSE. One of their highlights was in the Union of Comoros in Africa which had 90 per cent of malaria deaths every year due to a high rate of infection.
In 2016, FEMSE was introduced in Comoros, located in the eastern coast of Africa, where plasmodium falciparum infections have historically accounted for 15-30 per cent of hospitalisations and 15-20 per cent deaths in the paediatric services. To eliminate this burden, the Comoros national health development plan for 2010-2014 aimed to reduce parasite carriage rates to 5 per cent.
The objectives included access for all to long-lasting insecticide-treated nets, indoor residual spraying, intermittent presumptive treatment for pregnant women, medical care for malaria, and implementations of MDA.
GUCM initiated the FEMSE putting together an antimalarial research team. The FEMSE strategy through the MDA with Artemisinin-based combination therapy (ACT) to eliminate malaria is by far an effective, quick acting and low-side effect short course treatment.
The team achieved great success through carrying out three rounds of MDA with Artequick within 60 days. The success of the FEMSE pilot project in Cambodia has equipped the team to endeavour into malaria endemic countries. Comoros to date is in its pre-elimination phase with no malaria.
Director Song Jianping, during the question-and-answer session told the audience that “MDA with or without low-dose primaquine (PMQ), was being considered for malaria elimination programmes. The potential of PMQ is to block malaria transmission by mosquitoes.”
He added that Artemisinin-piperaquine (AP), with or without PMQ was administered in three monthly rounds across Kiriwina Island to stop three generations of mosquitoes to transfer malaria parasites.
Chinese invention and patent
The antimalarial drug Artequick used in the programme was invented by the GUCM team and it is the fourth generation of ACT that owns proprietary intellectual property rights and has achieved patent protection in 38 countries. It has gone on sale in 18 malaria-epidemic countries. The team has been working for more than 40 years on the fight against malaria.
Minister for Health, Sir Puka Temu, who was the main speaker at the occasion, thanked the GUCM team, the PNG Department of Health and the Milne Bay provincial health authority for their efforts in the anti-malaria pilot project in Kiriwina .
He said there was a strong understanding between research institutions in China and PNG particularly for the eradication of malaria.
“What I am thinking now after hearing this successful report is, this would be the highest policy I would bring forth to the Government of PNG to amend, so that in the long term people are treated with anti-malaria dosages,” the minister said.
He said the success of the FEMSE pilot project in Milne Bay was the beginning of their next project.
Sir Puka has made a commitment to work with concerned parties in both China and PNG as well as United Nations and Australia to eradicate malaria in PNG by 2030.