Syndromic surveillance in Vanuatu since Cyclone Pam: a descriptive study

In 2012, Vanuatu designed and implemented a syndromic surveillance system based on the guidelines developed by the Pacific Community and the World Health Organization to provide early warning of outbreaks and other important public health events. Four core syndromes were endorsed for surveillance: acute fever and rash, prolonged fever, influenza-like illness and acute watery diarrhoea. In March 2015, Vanuatu was struck by Cyclone Pam, after which several important changes and improvements to the country's syndromic surveillance were made. To date, there has been no formal evaluation of whether regular reports are occurring or that core syndromes are being documented. We therefore carried out a descriptive study in the 11 sentinel sites in Vanuatu conducting syndromic surveillance between July and December 2015. There was a total of 53 822 consultations which were higher in the first 13 weeks (n = 29 622) compared with the last 13 weeks (n = 24 200). During the six months, there were no cases of acute fever and rash or prolonged fever. There were cases with influenza-like illness from week 27 to 35, but no case was reported after week 35. Acute watery diarrhoea occurred in one or two cases per week during the whole study period. For these two core syndromes, there were generally more females than males, and about one third were children aged under 5 years. In conclusion, Vanuatu implemented changes to its new syndromic surveillance system from July to December 2015, although laboratory components had not yet been incorporated. The laboratory components are working in 2016 and will be the subject of a further report.

Improvement of diagnosis of malaria using an innovated LED Light box and microscopy in VanuatuA case report of the field trial and problems / 国際保健医療

 Malaria is a parasitic disease of major health significance that arrests the development of the tropical countries.We assembled an innovated LED light box for diagnosis of malaria, and examined for availability of the LED light box in the clinics of malaria endemic area in Solomon islands in the previous study. In the present study, we tried to use the LED light box for the practical use in the clinics with diagnostic service of malaria in Vanuatu (next country of Solomon Islands) for 1 year, and verified the availability and problems of the continual use of the LED light box.We identified the advantage of the use of LED light box in the diagnosis of malaria using microscopy. On the other hand, additional training of basic electricity is needed for microscopists who have little experience for electronics in the course of training of mictroscopists for the practical use of the LED light box.

Cross-sectional characterization of malaria in Sanma and Shefa Provinces, Republic of Vanuatu: malaria control implications

Endemic malaria still exists in the Republic of Vanuatu, an 80-island archipelago that sits astride the southeast margin of the Southeast Asian-Melanesian malaria band (Buxton Line 170 degrees E, 20 degrees S). The annual parasite incidence has decreased dramatically over the past decade, which has been attributed to an intensive insecticide-treated bednet distribution program and implementation of a revised Plasmodium falciparum treatment policy that employs combination chloroquine + sulfadoxinelpyrimethamine as a first-line therapy. Standard malariometric surveys were conducted at 10 locations in 2 provinces, screening 2351 adults and children towards the end of the peak transmission season. Spleen rates were consistent with mesoendemic malaria. Examination of blood slides revealed a mean slide-positive rate of 22% (range 4% to 33%). P. falciparum predominated, accounting for 73% of infections, followed by P. vivax (25%). Among 396 individuals with P. falciparum, the gametocyte rate was 54%, with 37% presenting gametocytes alone without asexual stages. Only 8% and 4% of persons with asexual stage P. falciparum and P. vivax parasitaemia, respectively, were symptomatic. These data suggest that malaria transmission has increased in some locations in Vanuatu over the past decade and this report underscores the importance of appropriate bednet use and vector control in this setting as well as the impact of adding sulfadoxine/pyrimethamine and removing primaquine from the national malaria treatment formulary.