III. Financing
II. Intervention policies and strategies
IV. Coverage
Co
n
tri
b
u
ti
o
n
($US
m)
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 0.5 1 1.5 2
Gov. expend. Global Fund World Bank USAID/PMI WHO/UNICEF Others
Bhutan
Sources of financing Government expenditure by intervention in 2015
Coverage of ITN and IRS Cases tested
V. Impact
Cases treated Cases tracked
Confirmed malaria cases per 1000 and ABER Number of malaria cases
P
o
p
u
lati
o
n
(%)
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 20 40 60 80 100
At high risk protected with ITNs All ages who slept under an ITN (survey) Households with at least one ITN (survey) At high risk protected with IRS
S
u
p
ected
cases
(%)
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 20 40 60 80 100
Case
(%)
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 20 40 60 80 100
Antimalarials distributed vs reported cases ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases ACTs as % of all antimalarials received by <5 (survey)
(%)
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 20 40 60 80 100
Reporting completenes Cases investigated Foci investigated
P
o
si
ti
vi
ty
rate
(%)
ABE
R
(%)
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 1 2 3 4
0 5 10 15
ABER (microscopy & RDT) Slide positivity rate RDT positivity rate
Cases
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
0 500 1,000 1,500 2,000
Total cases Imported cases Indigenous case (P.falciparum)
Indigenous case (P.vivax) I. Epidemiological profile
Population (UN) %
Plasmodium species:
Major anopheles species: An. culicifacies, An. maculatus, An. philippiensis, An. annularis
P. falciparum (40%), P.vivax (60%) Parasites and vectors
2015
Number of active foci
Number of people living within active foci
Malaria-free (0 cases)
Total
770,000
770,000
Estimated cases: Reported confirmed cases (health facility):
Reported deaths: Estimated deaths:
104
0
<50
<50[-;-] Confirmed cases at community level:
-Insecticides & spray materials ITNs
Diagnostic testing Antimalarial medicines Monitoring and Evaluation
Human Resources & Technical Assistance Management and other costs
36,000 4
96 10
Therapeutic efficacy tests (clinical and parasitological failure, %)
Medicine Year Min Median Max Follow-up No of studies Species
AL 2005-2011 0 0 0 28 days 23 P. falciparum
CQ 2005-2015 0 0 0 28 days 23 P. vivax
Insecticide susceptibility bioassays (reported resistance to at least one insecticide for any vector at any locality)
Year Pyrethroid DDT Carbamate Organophosphate Species/complex tested
2010–2012 No An. pseudowillori
South-East Asia Region
Notes:
Reported confirmed cases and reported deaths are indigenous only IPT used to prevent malaria during pregnancy
Intervention Policies/strategies Yes/No Adopted
ITN ITNs/ LLINs distributed free of charge
ITNs/ LLINs distributed to all age groups
Yes
Yes
2006 2006
IRS is recommended
IRS
DDT is authorized for IRS
Larval control
IPT
Diagnosis
Treatment
Use of larval control recommended
Patients of all ages should receive diagnostic test
Malaria diagnosis is free of charge in the public sector
ACT is free of charge for all ages in public sector
The sale of oral artemisinin-based monotherapies (oAMTs)
Single dose of primaquine is used as gametocidal medicine for P. falciparum
Primaquine is used for radical treatment of P. vivax
G6PD test is a requirement before treatment with primaquine
Directly observed treatment with primaquine is undertaken
System for monitoring adverse reactions to antimalarials exists
ACD for case investigation (reactive)
ACD of febrile cases at community level (pro-active)
Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted
Yes 1964
No
-No
-N/A
1964
-Yes
Yes 1964
Yes 2006
Never allowed
-Yes 2012
Yes
-No
-No
-No 2012
Yes 2013
No
-No 2011
Yes 2012
Yes 2012
Surveillance
Foci and case investigation undertaken
Case reporting from private sector is mandatory
Yes
Yes
2012
-Antimalarial treatment policy Medicine Year adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Type pf RDT used
-
-2006
2006
2006
2006 AL
QN
AM; QN
CQ+PQ(14d)
0.25 mg/Kg (14 days)
