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The Changing Nature of Disease Management

As conditions in Southeast Asia continue to evolve, public health officials are constantly monitoring the transmission of multiple vector borne diseases and adjusting their strategies to protect the populations they serve.

MALARIA

While the risk for contracting malaria still exists in some areas of Southeast Asia, public health officials have made significant progress toward eradicating the disease throughout the region. According to the World Health Organization, the number of malaria cases and deaths has been steadily declining since 2000.1 Malaysia has set a target of eliminating malaria transmission by the year 2020, and the goal for all of Asia is 2030.

In addition to integrated vector management programs and public education, the efforts of public health officials have been aided by an unintended consequence of industrialization—deforestation and the pollution of their larval habitats have reduced Anopheles mosquitoes’ ability to thrive in increasingly populated areas.

CHIKUNGUNYA

The chikungunya virus has been present in Southeast Asia for decades, but recent outbreaks in Malaysia, Singapore, and Thailand have brought the disease to the attention of public health officials once again.

DENGUE

Dengue continues to be a prime concern for Southeast Asia. Cases of dengue fever have risen in recent years, particularly in Vietnam, Thailand, and Malaysia.2 A particularly strong El Niño pattern in 2015 created conditions conducive for breeding Aedes aegypti and Aedes albopictus, which may lead to further increases in disease transmission.

Although an experimental vaccine has been developed, it was rejected by the Singapore government because it offers no protection against one of the four dengue serotypes.3 The government of Malaysia has requested additional trials, but the manufacturer of the vaccine has been unwilling so far.

Along with integrated vector control strategies, public health officials have been implementing Communication for Behavioral Impact (COMBI) programs in response to outbreaks. These toolkits provided by the World Health Organization provide a seven-step approach with corresponding tools, checklists, and templates for developing culturally appropriate prevention and control measures.

ZIKA VIRUS

Ministries of Health throughout Southeast Asia are on alert for signs of Zika virus transmission since virus reservoirs in mosquito and human populations have been reported in Malaysia. Carried by Aedes aegypti, the Zika virus can cause fever and rash, but it has been associated with cases of microcephaly in Latin America.