Table 1 Operational definitions for malaria case notification, investigation, classification, and response strategy implemented in low-endemic settings of Myanmar, 2016 [3, 10, 11, 14]
Malaria stratum | The malaria stratum are classified as high (> 5/1000 population), moderate (1–5 case per 1000 population), low (< 1 case per 1000 population), and potential transmission and malaria free areas based on the annual parasite incidence, presence, or absence of indigenous cases, presence or absence of main vectors of malaria, and ecology. Each village is classified as malarious (stratum 3), potentially malarious (stratum 2), or malaria-free area (stratum 1). The malarious villages are further stratified into high risk (3a), moderate risk (3b), and low risk (3c). |
Case notification | Compulsory reporting of detected cases of malaria by all medical units and medical practitioners, to either the health department or the malaria elimination service. |
Case investigation | Collection of information to allow classification of a malaria case by origin of infection, i.e., whether it was imported, introduced, indigenous, or induced. Case investigation includes administration of a standardized questionnaire to a person in whom a malaria infection is diagnosed. |
Response to control | Response to control refers to the response following the case investigation which consists of (a) active case detection through blood examination/symptom screening of the febrile cases in and around 10 households of the index cases and (b) vector control measures are IRS, distribution of LLINs (for positive cases), larval source management, and IEC/BCC activities. |
Malaria case classification | |
Indigenous case | A case contracted locally with no evidence of importation and no direct link to transmission from an imported case. |
Imported case | Malaria case or infection in which the infection was acquired outside the area (outside region or state or country) in which it is diagnosed. |
Introduced case | A case contracted locally, with strong epidemiological evidence linking it directly to a known imported case (first-generation local transmission). |