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MALARIA CONTROL
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PROGRAM
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COMMUNITY HEALTH MEDICINE
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Bicol Christian College of Medicine
Medicine II (Group 7 Team ocGenes)
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Abayon, Ronell Andrew
Ayyappan Nair, Akhil
Chereddy, Sairam Reddy
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Del Rosario, Paolo Dominique
Henry, Sydney Hoper
Shrestha, Sagun
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Vias, Mark Titus
Sacil, Janelle Eve
Tapit, Ma.Francia
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Tolentino, Gerly
Tolosa, Jonnahvee D.
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Villanueva, Mary Angeline
Vitualla, Jean Louise
Zoleta, Dawn
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INTRODUCTION
The Philippines is a heavily populated archipelago of more than seven thousand islands in
Southeast Asia. Malaria is produced by intraethrocytic parasites of the genus Plasmodium. Four
plasmodia produce malaria in humans: Plasmodium falciparum, P. vivax, P. ovale and P. malariae. In
2010, approximately 72 percent of cases were due to Plasmodium falciparum and 25 percent were due
to P. vivax. Transmission occurs year-round but is typically higher during the rainy season, which runs
from June to December. The primary vector is Anopheles flavirostris, which breeds in clear, slow-flowing
streams near foothills and forests.
Malaria can be transmitted in the following ways: (1) blood transfusion from an infected
individual; (2) sharing of IV needles; and (3) trans placenta (transfer of malaria parasites from an
infected mother to its unborn child). Signs and symptoms include: recurrent chills, fever, profuse
sweating, anemia, malaise, hepatomegaly and splenomegaly.
It is mainly associated with poverty and poses significant impediments to the socio-economic
development of affected communities. The nature of malaria as a public health problem requires
sustained and systemic efforts toward two major strategies, namely prevention of transmission through
vector control and the detection and early treatment of cases to reduce morbidity and prevent
mortality.

BRIEF HISTORY OF MALARIA CONTROL PROGRAM IN THE PHILIPPINES

Prior to 1900 - Malaria was documented with high mortality rates

1906 - Philippines Bureau of Health conducted malaria education and distributed free quinine
1955 - launch of nationwide malaria control program
1966 - Malaria Eradication Act assisted by WHO
1986 - Vector Control program at the provincial level
1987 - Department Circular No. 167 s. semi vertical malaria program

VISION
Malaria-free Philippines

MISSION
To empower health workers, the population at risk and all others concerned to eliminate
malaria in the country.
GOAL
To significantly reduce malaria burden so that it will no longer affect the socio-economic
development of individuals and families in endemic areas.

OBJECTIVES
Based on the 2011-2016 Malaria Program Medium Term Plan, it aims to:
1. Ensure universal access to reliable diagnosis, highly effective, and appropriate treatment and
preventive measures;
2. Capacitate local government units (LGUs) to own, manage, and sustain the Malaria Program
in their respective localities;
3. Sustain financing of anti-malaria efforts at all levels of operation; and
4. Ensure a functioning quality assurance system for malaria operations.

BENIFICIARIES
The Malaria Control Program targets
Meagre-resourced municipalities in endemic provinces
Rural poor residing near breeding areas
Farmers relying on forest products
Indigenous people with limited access to quality health care services
Communities affected by armed conflict
Pregnant women and children aged five years old and below.
PROGRAM STRATEGIES
EARLY DIAGNOSIS & PROMPT TREATMENT
Early diagnosis and prompt treatment is a core strategy for malaria control and is central to the
implementation of all the Global Fund Malaria Projects. The aim is to provide prompt diagnosis and
adequate treatment within 24 to 48 hours after consultation of the patient with fever in endemic
communities to prevent progression of uncomplicated malaria to severe cases and to avoid death.
Diagnosis

Microscopy (gold standard)

RDT (far-flung, hard-to- reach areas)
Treatment:
Malaria can be treated effectively early in the course of the disease, but delay of therapy can have
serious or even fatal consequences.
Treatment depends on the species..
P. falciparum:
Uncomplicated:
- Artemisinin Based Combination Therapy (Artemether-Lumefantrine) + Primaquine
Severe:
- Parenteral Quinine + Tetracycline/Doxycycline/Clindamycin
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 P. vivax/ovale/malariae:

Chloroquine + Primaquine
Mixed infection:

Pf plus other species: AL + PQ

Pv + Pm: CQ + PQ
Chemoprophylaxis Drugs
Atovaquone/Prognanil (Malarone)- good choice for shorter travel trips
Chloroquine- good choice for long trips; can be used in all trimesters of pregnancy
Doxycycline- least expensive antimalarial
Mefloquine (Lariam)- long trips & pregnancy
Primaquine- most effective medicine
VECTOR CONTROL
Sustainable preventive and vector control measures refer to the adaptation of measures for the
prevention and control against the malaria parasite and the mosquito vector. Such measures being
affordable, applicable, and appropriate are under our local conditions so that these measures can be
sustained throughout the duration of malaria control operations.
Objective of this measure is to reduce the source of infection in the human population; man vector
contact, and the density of the mosquito vector population.

Long-Lasting Insecticidal Nets (LLIN)

o Insecticide treatment of mosquito net
This involves the soaking of the mosquito net in an insecticide solution and allowed to dry. Such
treated net is used as a protective measure against the vector mosquito during sleeping time at night.
Insecticide treated curtains may be used in areas where they are more culturally acceptable
than mosquito nets.

House spraying - this is the application of insecticide on the indoor surfaces of the
house through spraying.
On stream seeding - this involves the construction of bio-ponds for fish propagation
which shall be the responsibility of the LGUs and their corresponding communities. The
number of bio-ponds to be constructed as sources of larvivorous fish, for each malariaendemic municipality, will depend on the number of streams to be seeded with the
3

propagated larvivorous fish. To be effective, about 2-4 fish per sq.m. is needed for an
immediate impact and about 200-400 fish per ha. Is needed for a delayed effect.
On steaming clearing this is the cutting of the vegetation overhanging along stream
banks to expose the breeding stream to sunlight, rendering it unsuitable for mosquito
vector habituation.
Other preventive measures
Wearing of clothing that covers arms and legs in the evening.
Avoiding outdoor night activities, particularly during the vectors peak biting hours from 9pm to 3am
Using mosquito repellents such as mosquito coils, soap lotion or other personal protection measures
advocated by the DOH/MCS Malaria Control Service.
Planting of Neem tree or other herbal plants which are (potential) mosquito repellents as advocated by
the DOH/MCS Malaria Control Service.
Zooprophylaxis - typing of domestic animals like the carabao, cow, etc., near human dwelling to
deviate mosquito bites from man to these animals.

ENHANCEMENT OF LOCAL CAPACITY/ ADVOCACY

LGUs are capacitated to manage and implement community-based malaria control through social
mobilization.

Building a healthy public policy

Creation of a supportive environment
Strengthening community action (behavior-change activities)
Development health personnel communication skills (capacity-building activities)
Development and adaptation of key messages conveyed through appropriate channels and
fitting to target audiences.

ENHANCED SURVEILLANCE & EPIDEMIC MANAGEMENT

Philippine Malaria Information System (PhilMIS)

Aims to provide information in a computerized form needed for planning,
implementation, monitoring and evaluation of malaria control program.
Philippine Integrated Disease Surveillance and Response (PIDSR)
Established to improve the current disease surveillance systems in the Philippines and
to comply with the 2005 IHR call for an urgent need to adopt an integrated approach for

strengthening the epidemiologic surveillance and response system of each member

nation.
Field Health Services Information System (FHSIS)
To update indicators based on the current needs of the health program managers
and all local government units.
Updates in surveillance:
Harmonized PhilMIS-PIDSR System
(HARPPS)
Malaria Text Report System (MTRS)

QUALITY ASSURANCE SYSTEMS IN PLACE

For diagnosis:
Microscopy validation of slides
For treatment:
Therapeutic Efficacy Surveillance (RITM)
Vector control:
Insecticide resistance monitoring through bioassay and susceptibility tests (RITM)
EARLY RECOGNITION PREVENTION AND CONTROL OF MALARIA EPIDEMICS
Early Recognition Prevention and Control of Malaria Epidemics refer to the establishment of a
system that will immediately recognize an impending malaria epidemic
Malaria Epidemic is a situation where there is an incidence of new malaria cases in excess of the
expected. The application of such definition of actual situation is not always straight-forward.
Any transmission in a previously malaria-free are is obviously in excess of the excepted and
constitutes and epidemic by the above definition, with the premise that, traditionally, small
epidemics are usually called outbreaks
Epidemic potential is a situation where in an area is vulnerable to malaria case upsurge due to
causal factors such as climatic changes, ecological changes or socio-economic changes.
PREVENTION OF THE EPIDEMIC
1. The following should be done in the event that an imminent epidemic occurs:
Mass blood smear (MBS) collection
Immediate confirmation and follow up cases
Insecticide treatment of mosquito nets
Focal spraying
Stream clearing
Intensive IEC campaign
2. All cases should be given drug treatment and followed-up until clinically and/or microscopically
found negative.
3. Continuous surveillance measures should be implemented for three years.
4. The Local Government Units in collaboration with the Nongovernment Organization and with
the technical assistance from the Provincial Malaria Coordinator should contribute in terms of
IEC campaign and logistics support.
5

1.

2.
3.

4.

PUBLIC HEALTH CARE RESPONSIBILITIES

Participates in the implementation of the following:
Treatment policies
Provision of drugs
Laboratory confirmation of diagnosis
Training of Barangay Health workers and volunteers on the diagnosis and treatment of
malaria
Supervision of malaria control activities of all health personnel in the area
Collection, analysis and submission of required reports
Recognition of early signs and symptoms for management and further referrals
Educate the individual/families/community of the importance of the following:
Taking of chemoprophylaxis
Wearing of long-sleeved clothing and trousers when going out at night.
Application of insect repellant to skin
Use of mosquito nets
Use of screen in doors and windows. If no screen, close windows and doors during night
time.
Use of insecticide aerosols and pyrethroid mosquito coils
Clearing of hanging branches of trees along the stream
Availability of anti-malarial drugs and chemoprophylaxis drugs

PROGRAM ACCOMPLISHMENTS:
Malaria cases in the country declined since the mid-2000s, and have resulted in an 83%
reduction from 2005 to 2013.
There was a 92% reduction in the number of deaths within the same period.
Deaths were 150 in 2005 to 12 in 2013. The Philippines has achieved the Millennium
Development Goal target for 2015 as early as 2008.
Of 53 known provinces that are endemic for the disease, 27 have already been declared
malaria-free. These were:
Cavite
Masbate
MArinduque
Camarines Sur
Albay
Alkan
Sorsogon
Guimaras
Iloilo
Cebu
Capiz
Western Samar
Bohol
Nortern Samar
Siqujior
Southern Leyte
Eastern Samar
Camiguin
Northern Leyte
Surigao Del Norte
Biliran
Benguet
Batangas
Catanduanes
Romblon

 The top five provinces having the highest number of malaria cases are:
Palawan
Tawi-tawi
Sulu
Maguindanao
Zambales

PARTNER ORGANIZATION/AGENCIES:
The following organizations/agencies take part in achieving the goals of Malaria Control Program:

Pilipinas Shell Foundation, Inc, (PSFI)

Roll Back Malaria (RBM)
World Health Organization (WHO)
Act Malaria Foundation, Inc
Field Epidemiology Training Program Alumni Foundation, Inc. (FETPAFI)
Research Institute of Tropical Medicine (RITM)
University of the Philippines-College of Public Health (UP-CPH)
Philippine Malaria Network
Australian Agency for International Development (AusAID)
Asia Pacific Malaria Elimination Network (APMEN)
Malaria Elimination Group (MEG)
Local Government Units (LGUs)
WORLD MALARIA DAY

April 25

OUTLOOK FOR THE FUTURE

Malaria elimination program in progress for a malaria-free Philippines by 2020.

CONCLUSION
The malaria control program is one of the priorities for the Philippines Department of Health;
however, malaria is no longer a leading cause of morbidity and mortality.
Factors behind malaria reduction since mid-2000; the malaria stratification system at the
barangay level facilitates a targeted and focused approach for interventions; early detection and prompt
treatment of cases; strengthened vector control, surveillance and epidemic management; quality
assurance systems for interventions in place; sustained social mobilization and advocacy; building local
capacities to manage and sustain the program; public-private partnerships; and intra- and intersectorial collaborations
Mainstreaming the Malaria Control Program (MCP) through the formal health structure of the
LGU, RHU, and BLGU has been the backbone of the community based malaria control program since the
beginning of the project.
In 2010, all existing Global Fund malaria grants were consolidated into a single grant covering 40
malaria-endemic provinces. In 2012, US$24 million was earmarked for phase two of the grant to sustain
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the Philippines malaria control and elimination efforts through 2014 and improve its chances of moving
closer to its 2020 elimination goal.
The Philippines has successfully controlled malaria over the past two decades, and malaria there
is currently at its lowest level in more than 40 years.

REFERENCES

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

pinoymalaria.press.wordcom/cases/
cprmfm.com/malaria-to-be-eradicated-in-the-philippines-by-2015/
www.gov.ph/2014/03/11/philippines-on-verge-of-attaining-malaria-free-status/
www.mb.com.ph/malaria-free-philippines-eyed-in-2020/
static1.1.sqspcdn.com/static/CP+UpdatePhilippines

Book of Communicable Diseases

The Global Fund Program: Malaria: Annual Report
Eliminating Malaria in the Philippines, August 2013 report
nec.doh.gov.ph/index.php
www.cdc.gov.ph