Abstract
Introduction
Cambodia has made significant progress in malaria control, reducing cases by more than 90% since 2010 and resulting in zero malaria-related deaths since 2018. In line with the Cambodia Malaria Elimination Action Framework 2021–2025, the country aims to achieve malaria-free status by 2025. According to World Health Organization (WHO) guidelines, certification of malaria elimination requires three consecutive years of zero indigenous cases, robust surveillance-response systems, and documented programmatic evidence. This study aimed to assess the readiness for malaria elimination certification in the Baray Santuk Operational District (OD) by evaluating epidemiological trends, health system performance, and surveillance capacity from 2021–2024.
Methods
A mixed-methods approach was used, including a review of malaria data from the National and OD-level Malaria Information Systems (ODMIS), key informant interviews, and health infrastructure assessments. The WHO’s “1-3-7 strategy” was applied as a benchmark for surveillance performance: (1) case notification within 1 day, (2) case classification within 3 days, and (3) foci investigation within 7 days. Descriptive analysis and data visualisations were employed to examine incidence trends, case classification, and system readiness indicators.
Results
Between 2021 and Quarter 1, 2024, malaria incidence declined to zero. P. falciparum transmission was interrupted by 2022, and the number of P. vivax cases decreased to zero by early 2024. The Baray Santuk OD consistently met 1-3-7 targets from 2023 to 2024, with 100% of confirmed cases reported within one day and classified in a timely manner, and 85% of foci investigated within 7 days. Moreover, community engagement and surveillance-response systems were ready, including the presence of actively trained village malaria workers (VMWs), G6PD testing capacity, radical cure availability, and effective supervision and reporting mechanisms. These components were in line with the required pillars for elimination readiness: strong leadership, a capable health workforce, and integrated vector and case management strategies.
Conclusion
These findings demonstrate that Baray Santuk OD has made significant strides in controlling and eliminating malaria, achieving the key milestones required for WHO certification. This indicates strong readiness for malaria elimination certification, fulfilling the WHO criteria for zero indigenous cases and providing effective surveillance-response systems. Furthermore, there is an operational capacity and engagement of VMWs, including maintenance of surveillance coverage and timely intervention. This pilot study underscores the feasibility of district-level certification in Cambodia and offers a replicable model for other provinces aiming to meet national and global malaria elimination goals.