Tropical Medicine and International Health
volume 10 no 4 pp 357–365 april 2005
Objective:
The National Malaria Control Program (NMCP) in Vietnam is based on application of
insecticide-treated bed nets (ITNs), spraying of insecticides and early microscopic diagnosis of malaria
and treatment (EDTM) with artemisinin drugs. This study explores the implementation of the NMCP at
provincial level and its impact on malaria incidence (mi) and prevalence in Binh Thuan in southern
Vietnam.
Methods
Data on implementation of EDTM, distribution of ITNs, annual mi and Plasmodium index
(pi) were derived from intervention logbooks and surveillance records kept by the provincial Malaria
Station since 1988. The relation between interventions and the change of pi over time was analysed with
Generalized Estimating Equations.
Results
Control activities focused on the highly endemic zones where ITNs were distributed free of
charge to ethnic minority groups, including twice yearly re-impregnation, from 1992 onwards. This
almost completely replaced insecticide spraying. Complete ITN coverage of these groups was achieved in
1995, constituting 40% of the entire population. In all malaria endemic communes, primary health care
posts were consecutively upgraded or installed, mainly between 1992 and 1995, offering EDTM with
artemisinin drugs free of charge. Before 1994, mi peaked to over 50/1000, pi to over 16% in the highly
endemic zones. In 1998, these had decreased to below 9/1000 and 4% respectively. The effects of the
interventions could not be discerned with statistical significance.
Conclusion
Malaria incidence and prevalence declined significantly in Vietnam, possibly due to the
malaria control efforts, but coinciding with rapid socioeconomic changes
