Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Malaria Journal
Published in: Malaria Journal 1/2014

Open Access 01-12-2014 | Review

On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs

Authors: Nadira D Karunaweera, Gawrie NL Galappaththy, Dyann F Wirth

Published in: Malaria Journal | Issue 1/2014

Login to get access

Abstract

Malaria is one of the most important tropical diseases that has caused devastation throughout the history of mankind. Malaria eradication programmes in the past have had many positive effects but failed to wipe out malaria from most tropical countries, including Sri Lanka. Encouraged by the impressive levels of reduction in malaria case numbers during the past decade, Sri Lanka has launched a programme to eliminate malaria by year 2014. This article reviews the historical milestones associated with the malaria eradication programme that failed subsequently and the events that led to the launch of the ongoing malaria elimination plans at national-level and its strategies that are operational across the entire country. The existing gaps in knowledge are also discussed together with the priority areas for research to fill in these gaps that are posing as challenges to the envisaged goal of wiping out malaria from this island nation.
Appendix
Available only for authorised users
Literature
1.
WHO: World Malaria Report 2013. 2013, Geneva: World Health Organization
2.
Carter R, Mendis KN: Evolutionary and historical aspects of the burden of malaria. Clin Microbiol Rev. 2002, 15: 564-594. 10.1128/CMR.15.4.564-594.2002.PubMedCentralCrossRefPubMed
3.
WHO: Malaria. Handbook of resolutions and decisions of the World Health Assembly and the Executive Board. 1973, Geneva: World Health Organization
4.
Macdonald G: The epidemiology and control of malaria. 1957, London: Oxford University Press
5.
6.
Pampana E: A textbook of malaria eradication. 1963, Oxford: Oxford University Press
7.
Livadas GA, Belios G: Postwar malaria control in Greece and its results on basis of epidemiological data. WHO/Mal/27. 1948, Geneva: World Health Organization, WHO/Mal/27
8.
9.
WHO Expert Committee on Malaria: World Health Organization technical report series. Eighth Report. 1961, Geneva: World Health Organization
10.
Amerasinghe PH, Amerasinghe FP, Konradsen F, Fonseka KT, Wirtz RA: Malaria vectors in a traditional dry zone village in Sri Lanka. Am J Trop Med Hyg. 1999, 60: 421-429.PubMed
11.
Ramasamy R, Ramasamy MS, Wijesundera DA, Wijesundera AP, Dewit I, Ranasinghe C, Srikrishnaraj KA, Wickremaratne C: High seasonal malaria transmission rates in the intermediate rainfall zone of Sri Lanka. Ann Trop Med Parasitol. 1992, 86: 591-600.PubMed
12.
Amerasinghe PH, Amerasinghe FP, Wirtz RA, Indrajith NG, Somapala W, Pereira LR, Rathnayake AM: Malaria transmission by Anopheles subpictus (Diptera: Culicidae) in a new irrigation project in Sri Lanka. J Med Entomol. 1992, 29: 577-581.CrossRefPubMed
13.
De Silva BG, Gunasekera MB, Abeyewickreme W, Abhayawardana TA, Karunanayake EH: Screening of Anopheles culicifacies population of Sri Lanka for sibling species A. Indian J Malariol. 1998, 35: 1-7.PubMed
14.
Amerasinghe PH, Amerasinghe FP: Multiple host feeding in field populations of Anopheles culicifacies and An. subpictus in Sri Lanka. Med Vet Entomol. 1999, 13: 124-131. 10.1046/j.1365-2915.1999.00160.x.CrossRefPubMed
15.
Jude PJ, Dharshini S, Vinobaba M, Surendran SN, Ramasamy R: Anopheles culicifacies breeding in brackish waters in Sri Lanka and implications for malaria control. Malar J. 2010, 9: 106-10.1186/1475-2875-9-106.PubMedCentralCrossRefPubMed
16.
Surendran SN, Singh OP, Jude PJ, Ramasamy R: Genetic evidence for malaria vectors of the Anopheles sundaicus complex in Sri Lanka with morphological characteristics attributed to Anopheles subpictus species B. Malar J. 2010, 9: 343-PubMedCentralPubMed
17.
Kannathasan S, Antonyrajan A, Srikrishnaraj KA, Karunaratne SH, Karunaweera ND, Surendran SN: Studies on prevalence of anopheline species and community perception of malaria in Jaffna district, Sri Lanka. J Vector Borne Dis. 2008, 45: 231-239.PubMed
18.
Perera MD, Hemingway J, Karunaratne SP: Multiple insecticide resistance mechanisms involving metabolic changes and insensitive target sites selected in anopheline vectors of malaria in Sri Lanka. Malar J. 2008, 7: 168-10.1186/1475-2875-7-168.PubMedCentralCrossRefPubMed
19.
Kusumawathie PH, Wickremasinghe AR, Karunaweera ND, Wijeyaratne MJ, Yapabandara AM: Anopheline breeding in river bed pools below major dams in Sri Lanka. Acta Trop. 2006, 99: 30-33. 10.1016/j.actatropica.2006.06.007.CrossRefPubMed
20.
Premasiri DA, Wickremasinghe AR, Premasiri DS, Karunaweera N: Malarial vectors in an irrigated rice cultivation area in southern Sri Lanka. Trans R Soc Trop Med Hyg. 2005, 99: 106-114. 10.1016/j.trstmh.2004.02.009.CrossRefPubMed
21.
22.
Rawlings P, Curtis CF: Tests for the existence of genetic variability in the tendency of Anopheles culicifacies species B to rest in houses and to bite man. Bull World Health Organ. 1982, 60: 427-432.PubMedCentralPubMed
23.
24.
Wickramasinghe MB: Malaria and its control in Sri Lanka. Ceylon Med J. 1981, 26: 107-115.PubMed
25.
Visvalingam T: The laboratory organization and technical procedures for blood examination of the malaria eradication programme in Ceylon. WHO/Mal/419. 1963, 1-12.
26.
Jones M: The Ceylon malaria epidemic of 1934–35: a case study in colonial medicine. Soc Hist Med. 2000, 13: 87-109. 10.1093/shm/13.1.87.CrossRefPubMed
27.
Pinikahana J, Dixon RA: Trends in malaria morbidity and mortality in Sri Lanka. Indian J Malariol. 1993, 30: 51-55.PubMed
28.
29.
WHO: Development of the malaria eradication programme. Fourteenth World Health Assembly report. 1968, World Health Organization, Technical Report Series No. 382
30.
Sivaghanasundram C: MD thesis. Dynamics of malaria in Ceylon. 1971, London School of Hygiene and Tropical Medicine
31.
Antimalaria Campaign Ministry of Health, Sri Lanka: Administrative repot. 1963, Sri Lanka: Antimalaria Campaign, Ministry of Health
32.
Herath PR, Joshi GP: Pesticide selection pressure on Anopheles subpictus in Sri Lanka: comparison with two other Sri Lankan anophelines. Trans R Soc Trop Med Hyg. 1989, 83: 565-567. 10.1016/0035-9203(89)90298-8.CrossRefPubMed
33.
Ratnapala R, Subramaniam K, Yapabandara MG, Fernando WP: Chloroquine resistant Plasmodium falciparum in Sri Lanka. Ceylon Med J. 1984, 29: 135-145.PubMed
34.
Wijesundera Mde S: Malaria outbreaks in new foci in Sri Lanka. Parasitol Today. 1988, 4: 147-150. 10.1016/0169-4758(88)90193-7.CrossRefPubMed
35.
Feachem RGA: Shrinking the malaria map: a guide on malaria elimination for policy makers. 2009, San Francisco: University of California
36.
Feachem RG, Phillips AA, Targett GA, Snow RW: Call to action: priorities for malaria elimination. Lancet. 2010, 376: 1517-1521. 10.1016/S0140-6736(10)61500-0.PubMedCentralCrossRefPubMed
37.
Premaratna R, Galappaththy G, Chandrasena N, Fernando R, Nawasiwatte T, de Silva NR, de Silva HJ: What clinicians who practice in countries reaching malaria elimination should be aware of: lessons learnt from recent experience in Sri Lanka. Malar J. 2011, 10: 302-10.1186/1475-2875-10-302.PubMedCentralCrossRefPubMed
38.
Wickramage K, Galappaththy GN: Malaria burden in irregular migrants returning to Sri Lanka from human smuggling operations in West Africa and implications for a country reaching malaria elimination. Trans R Soc Trop Med Hyg. 2013, 107: 337-340. 10.1093/trstmh/trt009.CrossRefPubMed
39.
40.
Karunaweera ND, Ferreira MU, Hartl DL, Wirth DF: Fourteen polymorphic microsatellite DNA markers for the human malaria parasite Plasmodium vivax. Mol Ecol Notes. 2007, 7: 172-175.CrossRef
41.
Karunaweera ND, Ferreira MU, Munasinghe A, Barnwell JW, Collins WE, King CL, Kawamoto F, Hartl DL, Wirth DF: Extensive microsatellite diversity in the human malaria parasite Plasmodium vivax. Gene. 2008, 410: 105-112. 10.1016/j.gene.2007.11.022.CrossRefPubMed
42.
Gunawardena S, Karunaweera ND, Ferreira MU, Phone-Kyaw M, Pollack RJ, Alifrangis M, Rajakaruna RS, Konradsen F, Amerasinghe PH, Schousboe ML, Galappaththy GNL, Abeyasinghe RR, Hartl DL, Wirth DF: Geographic structure of Plasmodium vivax: microsatellite analysis of parasite populations from Sri Lanka, Myanmar, and Ethiopia. Am J Trop Med Hyg. 2010, 82: 235-242. 10.4269/ajtmh.2010.09-0588.PubMedCentralCrossRefPubMed
43.
Gunasekera AM, Wickramarachchi T, Neafsey DE, Ganguli I, Perera L, Premaratne PH, Hartl D, Handunnetti SM, Udagama-Randeniya PV, Wirth DF: Genetic diversity and selection at the Plasmodium vivax apical membrane antigen-1 (PvAMA-1) locus in a Sri Lankan population. Mol Biol Evol. 2007, 24: 939-947. 10.1093/molbev/msm013.CrossRefPubMed
44.
Dias S, Somarathna M, Manamperi A, Escalante AA, Gunasekera AM, Udagama PV: Evaluation of the genetic diversity of domain II of Plasmodium vivax Apical Membrane Antigen 1 (PvAMA-1) and the ensuing strain-specific immune responses in patients from Sri Lanka. Vaccine. 2011, 29: 7491-7504. 10.1016/j.vaccine.2011.07.029.CrossRefPubMed
45.
Premaratne PH, Aravinda BR, Escalante AA, Udagama PV: Genetic diversity of Plasmodium viva x Duffy Binding Protein II (PvDBPII) under unstable transmission and low intensity malaria in Sri Lanka. Infect Genet Evol. 2011, 11: 1327-1339. 10.1016/j.meegid.2011.04.023.CrossRefPubMed
46.
Dias S, Longacre S, Escalante AA, Udagama-Randeniya PV: Genetic diversity and recombination at the C-terminal fragment of the merozoite surface protein-1 of Plasmodium vivax (PvMSP-1) in Sri Lanka. Infect Genet Evol. 2011, 11: 145-156. 10.1016/j.meegid.2010.09.007.CrossRefPubMed
47.
Wickramarachchi T, Premaratne PH, Dias S, Handunnetti SM, Udagama-Randeniya PV: Genetic complexity of Plasmodium vivax infections in Sri Lanka, as reflected at the merozoite-surface-protein-3alpha locus. Ann Trop Med Parasitol. 2010, 104: 95-108. 10.1179/136485910X12607012374190.CrossRefPubMed
48.
Manamperi A, Mahawithanage S, Fernando D, Wickremasinghe R, Bandara A, Hapuarachchi C, Wickremasinghe R: Genotyping of Plasmodium vivax infections in Sri Lanka using Pvmsp-3α and Pvcs genes as markers: a preliminary report. Trop Biomed. 2008, 25: 100-106.
49.
Schousboe ML, Rajakaruna RS, Amerasinghe PH, Konradsen F, Ord R, Pearce R, Bygbjerg IC, Roper C, Alifrangis M: Analysis of polymorphisms in the merozoite surface protein-3alpha gene and two microsatellite loci in Sri Lankan Plasmodium vivax: evidence of population substructure in Sri Lanka. Am J Trop Med Hyg. 2011, 85: 994-1001. 10.4269/ajtmh.2011.11-0338.PubMedCentralCrossRefPubMed
50.
Escalante AA, Cornejo OE, Rojas A, Udhayakumar V, Lal AA: Assessing the effect of natural selection in malaria parasites. Trends Parasitol. 2004, 20: 388-395. 10.1016/j.pt.2004.06.002.CrossRefPubMed
51.
Gunawardena SG, Ferreira MU, Kapilananda GMG, Wirth DF, Karunaweera ND: The Sri Lankan paradox: high genetic diversity in Plasmodium vivax populations despite decreasing levels of malaria transmission. Parasitology. 2014, doi:10.1017/S0031182013002278
52.
Hapuarachchi HC, Dayanath MY, Bandara KB, Abeysundara S, Abeyewickreme W, de Silva NR, Hunt SY, Sibley CH: Point mutations in the dihydrofolate reductase and dihydropteroate synthase genes of Plasmodium falciparum and resistance to sulfadoxine-pyrimethamine in Sri Lanka. Am J Trop Med Hyg. 2006, 74: 198-204.PubMed
53.
Schousboe ML, Rajakaruna RS, Salanti A, Hapuarachchi HC, Galappaththy GN, Bygbjerg IC, Amerasinghe PH, Konradsen F, Alifrangis M: Island-wide diversity in single nucleotide polymorphisms of the Plasmodium vivax dihydrofolate reductase and dihydropteroate synthetase genes in Sri Lanka. Malar J. 2007, 6: 28-10.1186/1475-2875-6-28.PubMedCentralCrossRefPubMed
54.
Hawkins VN, Auliff A, Prajapati SK, Rungsihirunrat K, Hapuarachchi HC, Maestre A, O’Neil MT, Cheng Q, Joshi H, Na-Bangchang K, Sibley CH: Multiple origins of resistance-conferring mutations in Plasmodium vivax dihydrofolate reductase. Malar J. 2008, 7: 72-10.1186/1475-2875-7-72.PubMedCentralCrossRefPubMed
55.
Hapuarachchi HC, Abeysundara S, Dayanath MY, Manamperi A, Abeyewickreme W, de Silva NR: Molecular markers of chloroquine resistance in Plasmodium falciparum in Sri Lanka: frequency before revision of the antimalarial drug policy. Ann Trop Med Parasitol. 2009, 103: 351-356. 10.1179/136485909X435067.CrossRefPubMed
56.
Zhang JJ, Senaratne TN, Daniels R, Valim C, Alifrangis M, Amerasinghe P, Konradsen F, Rajakaruna R, Wirth DF, Karunaweera ND: Distribution pattern of Plasmodium falciparum chloroquine transporter (pfcrt) gene haplotypes in Sri Lanka 1996–2006. Am J Trop Med Hyg. 2011, 85: 811-814. 10.4269/ajtmh.2011.11-0167.PubMedCentralCrossRefPubMed
57.
Rawlings P, Herath PR, Kelly S: Anopheles culicifacies (Diptera: Culicidae): DDT resistance in Sri Lanka prior to and after cessation of DDT spraying. J Med Entomol. 1985, 22: 361-365.CrossRefPubMed
58.
Surendran SN, Ramasamy R: Some characteristics of the larval breeding sites of Anopheles culicifacies species B and E in Sri Lanka. J Vector Borne Dis. 2005, 42: 39-44.PubMed
59.
Surendran SN, Ramasamy MS, De Silva BG, Ramasamy R: Anopheles culicifacies sibling species B and E in Sri Lanka differ in longevity and in their susceptibility to malaria parasite infection and common insecticides. Med Vet Entomol. 2006, 20: 153-156. 10.1111/j.1365-2915.2006.00601.x.CrossRefPubMed
60.
Surendran SN, Jude PJ, Ramasamy R: Variations in salinity tolerance of malaria vectors of the Anopheles subpictus complex in Sri Lanka and the implications for malaria transmission. Parasit Vectors. 2011, 4: 117-10.1186/1756-3305-4-117.PubMedCentralCrossRefPubMed
61.
Surendran SN, Gajapathy K, Kumaran V, Tharmatha T, Jude PJ, Ramasamy R: Molecular evidence for the presence of malaria vector species a of the Anopheles annularis complex in Sri Lanka. Parasit Vectors. 2011, 4: 239-10.1186/1756-3305-4-239.PubMedCentralCrossRefPubMed
62.
Van Der Hoek W, Konradsen F, Amerasinghe PH, Perera D, Piyaratne MK, Amerasinghe FP: Towards a risk map of malaria for Sri Lanka: the importance of house location relative to vector breeding sites. Int J Epidemiol. 2003, 32: 280-285. 10.1093/ije/dyg055.CrossRefPubMed
63.
Gunathilaka N, Fernando T, Hapugoda M, Wickremasinghe R, Wijeyerathne P, Abeyewickreme W: Anopheles culicifacies breeding in polluted water bodies in Trincomalee District of Sri Lanka. Malar J. 2013, 12: 285-10.1186/1475-2875-12-285.PubMedCentralCrossRefPubMed
64.
Surendran SN, Jude PJ, Weerarathne TC, Parakrama Karunaratne SH, Ramasamy R: Variations in susceptibility to common insecticides and resistance mechanisms among morphologically identified sibling species of the malaria vector Anopheles subpictus in Sri Lanka. Parasit Vectors. 2012, 5: 34-10.1186/1756-3305-5-34.PubMedCentralCrossRefPubMed
65.
Anderson TJ, Haubold B, Williams JT, Estrada-Franco JG, Richardson L, Mollinedo R, Bockarie M, Mokili J, Mharakurwa S, French N, Whitworth J, Velez ID, Brockman AH, Nosten F, Ferreira MU, Day KP: Microsatellite markers reveal a spectrum of population structures in the malaria parasite Plasmodium falciparum. Mol Biol Evol. 2000, 17: 1467-1482. 10.1093/oxfordjournals.molbev.a026247.CrossRefPubMed
66.
Daniels R, Volkman SK, Milner DA, Mahesh N, Neafsey DE, Park DJ, Rosen D, Angelino E, Sabeti PC, Wirth DF, Wiegand RC: A general SNP-based molecular barcode for Plasmodium falciparum identification and tracking. Malar J. 2008, 7: 223-10.1186/1475-2875-7-223.PubMedCentralCrossRefPubMed
67.
Fernando SD, Abeyasinghe RR, Galappaththy GN, Rajapaksa LC: Absence of asymptomatic malaria infections in previously high endemic areas of Sri Lanka. Am J Trop Med Hyg. 2009, 81: 763-767. 10.4269/ajtmh.2009.09-0042.CrossRefPubMed
68.
Rajakaruna RS, Alifrangis M, Amerasinghe PH, Konradsen F: Pre-elimination stage of malaria in Sri Lanka: assessing the level of hidden parasites in the population. Malar J. 2010, 9: 25-10.1186/1475-2875-9-25.PubMedCentralCrossRefPubMed
69.
Drakeley CJ, Corran PH, Coleman PG, Tongren JE, McDonald SL, Carneiro I, Malima R, Lusingu J, Manjurano A, Nkya WM, Lemnge MM, Cox J, Reyburn H, Riley EM: Estimating medium- and long-term trends in malaria transmission by using serological markers of malaria exposure. Proc Natl Acad Sci U S A. 2005, 102: 5108-5113. 10.1073/pnas.0408725102.PubMedCentralCrossRefPubMed
70.
Corran P, Coleman P, Riley E, Drakeley C: Serology: a robust indicator of malaria transmission intensity?. Trends Parasitol. 2007, 23: 575-582. 10.1016/j.pt.2007.08.023.CrossRefPubMed
71.
Dewasurendra RL, Suriyaphol P, Fernando SD, Carter R, Rockett K, Corran P, Kwiatkowski D, Karunaweera ND: Genetic polymorphisms associated with anti-malarial antibody levels in a low and unstable malaria transmission area in southern Sri Lanka. Malar J. 2012, 11: 281-10.1186/1475-2875-11-281.PubMedCentralCrossRefPubMed
72.
Abeyaratne KP, Halpe NL: Sensitivity to primaquine in Ceylonese children due to deficiency of erythrocytic glucose-6-phosphate dehydrogenase. Ceylon Med J. 1968, 13: 134-138.PubMed
73.
Abeyaratne KP, Premawansa S, Rajapakse L, Roberts DF, Pipiha SS: A survey of glucose-6-phosphate-dehydrogenase deficiency in the North Central Province of Sri Lanka (formerly Ceylon). Am J Phys Anthropol. 1976, 44: 135-138. 10.1002/ajpa.1330440119.CrossRefPubMed
74.
Nagaratnam N, Leelawathie PK, Weerasinghe WM: Enzyme glucose-6 phosphate dehydrogenase (G6PD) deficiency among Sinhalese in Ceylon as revealed by the methaemoglobin reduction test. Indian J Med Res. 1969, 57: 569-572.PubMed
Metadata
Title
On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs
Authors
Nadira D Karunaweera
Gawrie NL Galappaththy
Dyann F Wirth
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2014
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-13-59

Other articles of this Issue 1/2014

Malaria Journal 1/2014 Go to the issue

Methodology

Estimating the annual entomological inoculation rate for Plasmodium falciparum transmitted by Anopheles gambiae s.l. using three sampling methods in three sites in Uganda

Methodology

Standardization of blood smears prepared in transparent acetate: an alternative method for the microscopic diagnosis of malaria

Research

Chitinase 3-like 1 is induced by Plasmodium falciparum malaria and predicts outcome of cerebral malaria and severe malarial anaemia in a case–control study of African children

Research

Remotely-sensed, nocturnal, dew point correlates with malaria transmission in Southern Province, Zambia: a time-series study

Research

Determinants of delay in care seeking among children under five with fever in Dodoma region, central Tanzania: a cross-sectional study

Research

Submicroscopic infection of placenta by Plasmodium produces Th1/Th2 cytokine imbalance, inflammation and hypoxia in women from north-west Colombia
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits