Investigator(s)
| Submitter |
Kinley Penjor Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan & Health Research Institute, University of Canberra, ACT, Australia. Kinley Penjor 
|
| Principal Investigator |
Kinley Penjor Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan & Health Research Institute, University of Canberra, ACT, Australia. Kinley Penjor
|
| Co-Investigator(s) |
Tobgyal None Vector-Borne Disease Control Program, Department of Public Health, Ministry of Health, Gelephu Bhutan. Tobgyal None
|
| Co-Investigator(s) |
Deki Yangzom Communicable Disease Control Division, Department of Public Health, Ministry of Health, Thimphu Bhutan Deki Yangzom
|
| Co-Investigator(s) |
Soumya Mazumdar HEAL Global Research Centre, Health Research Institute, University of Canberra, Bruce, Canberra, ACT 2617, Australia Soumya Mazumdar
|
| Co-Investigator(s) |
Nasser Bagheri HEAL Global Research Centre, Health Research Institute, University of Canberra, Bruce, Canberra, ACT 2617, Australia Nasser Bagheri
|
| Co-Investigator(s) |
Manas Kotepui Faculty of Science, Nakhon Phanom University, Thailand Manas Kotepui
|
| Co-Investigator(s) |
Kinley Wangdi HEAL Global Research Centre, Health Research Institute, University of Canberra, Bruce, Canberra, ACT 2617, Australia Kinley Wangdi
|
| Co-Investigator(s) |
Binay Thapa HEAL Global Research Centre, Health Research Institute, University of Canberra, Bruce, Canberra, ACT 2617, Australia Binay Thapa
|
Title(s) and abstract
| Scientific title | Risk assessment of imported malaria to Bhutan’s malaria elimination status: retrospective analysis (2013‑2024) |
| Public title | Imported malaria risk in Bhutan |
| Background | Despite major strides made in the 21st century, malaria continues to be a significant global health burden, with an estimated 263 million cases and 597,000 deaths in 2023. The World Health Organization (WHO) South-East Asia Region (SEAR) is the world’s second-most malarious region, with record 4 million cases in 2023 despite achieving an 87% reduction in incidence—from 17.7 to 2.3 per 1,000 at-risk population. Many countries have made impressive gains, with more than 35 nations adopting elimination goals and globally targeting a 90% reduction in malaria mortality and case incidence by 2030 (versus 2015). In SEAR, the 11 member states committed to zero malaria by 2030, a pledge reinforced through a 2017 ministerial platform. To date, three SEAR countries have received WHO certification as malaria-free (Maldives in 2015, Sri Lanka in 2016, and Timor‑Leste most recently), while Bhutan is aiming for certification in 2025. Bhutan’s malaria programme has achieved decline of cases by approximately 99% in two decades (from 5,935 in 2000 to just 54 in 2020), largely attributed to rolling out of ACTs, RDTs at community level, large-scale LLIN and IRS campaigns, and enhanced surveillance. Nonetheless, elimination targets for 2018, 2020 and 2023 were missed, largely due to persistent cross-border transmission with India, and disruptions during the COVID-19 pandemic. Bhutan has accordingly revised its national strategic plan to attain malaria-free status by 2025. A key remaining challenge is the growing volume of cross-border malaria importation, especially through migrant workers crossing Bhutan’s long porous border with India’s Assam and West Bengal states, which continues to threaten elimination gains. Moreover, in very low-transmission settings like Bhutan many cases are rare and highly clustered, which limit the conventional frequentist statistical methods; So a Bayesian analytical framework is proposed to robustly quantify importation risk and guide the strategic evidence base for prevention of malaria re-establishment. |
| Objectives | • Describe the epidemiological characteristics of cross-border imported malaria cases in Bhutan. • Quantify the risk factors associated with imported malaria transmission in Bhutan. • Generate evidence to inform the future strategic framework for preventing re-establishment of malaria in Bhutan as it enters elimination status. |
| Study Methods | This will be a retrospective analytical study using individual malaria confirmed cases from the secondary surveillance data maintained by the Bhutan Vector-Borne Disease Control Programme (VDCP). The dataset covers a 12‑year period, from 2013 to 2024. Since 2013, |
| Expected outcomes and use of results | • A detailed epidemiological profile of imported malaria cases in Bhutan • Identification and quantification of key risk-factors associated with imported malaria and potential local transmission • Evidence-based recommendations for strengthening surveillance, case detection, response and prevention strategies in Bhutan, particularly in border-areas and among mobile populations. |
| Keywords | imported malaria, Bhutan, epidemiology, Bayesian, cross border malaria, risk factors |
Research Details
| Student research | Yes |
| Institution: University of Canberra | |
| Academic degree: Ph.D. | |
| Supervisor of the student(s) | |
| Full Name and title: Dr Kinley Wangdi | |
| Email: kinley.wangdi@canberra.edu.au | |
| Start Date | 28-Jan-2025 |
| End Date | 01-Sep-2029 |
| Key Implementing Institution | Khesar Gyalpo University of Medical Sciences |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Malaria |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Secondary data |
| Proposal reviewed by other Committee | No |