Private Acces  

ECOnomic development,
ECOsystem MOdifications,
and emerging infectious diseases
Risk Evaluation

Republic of the Union of Myanmar

Improvement of diagnosis, early detection and surveillance of severe respiratory diseases

Background and rationale

In Myanmar the fast-paced development over the past few years is mainly due to the opening of the country resulting in a substantial increase in the number of visitors. The risk of circulation of emergent respiratory pathogens (H5N1, H7N9, SRAS, MERS, etc.) is a source of concern.

In addition, According To the Hospital Annual statistics report published by the Ministry of Health in 2009, respiratory diseases account for 16.5% of morbidity and mortality of 11.4% in the under 5 age group.

The need to enhance laboratory capacities to better identify causes of severe acute respiratory infections (SARI), and to develop a surveillance system has been pointed out during the preliminary mission of Institut Pasteur in Myanmar, by the Minister of Health. They also expressed a strong desire for a documented study on SARI, to help guide the implementation of an effective Public Health policy in order to implement better preventive and therapeutic measures, including vaccinations to minimize impact of SARI in children.

Objectives and Strategy of Intervention

The project aims to:

Reinforce the national capacity for diagnosis and laboratory surveillance of some infectious diseases that cause SARI. Specifically, the project aims at capacitating the National Health Laboratory for the diagnosis of viral and bacteriological pathogens;

Build a network for the diagnosis and surveillance of SARI in two Yangon pediatric hospitals including proper collection and handling of specimens and adequate recording of data on patient history and check-ups;

Supplying NHL to perform analyses with appropriate equipment and techniques in order to document viral and bacterial pathogens causing SARI in Yangon and to allow (if any) detection of emerging/new pathogens or significant outbreaks

The project will assist the NHL to:

Reinforce capacities including new equipment and required consumables which will be delivered to the NHL according the need assessment. Trainings will also be conducted in necessary areas including laboratory techniques, equipment maintenance, and bio-banking which are conducted at IPC and on-site.

Design a proof-of-concept sentinel surveillance for SARI in Yangon. An ICU-based sentinel surveillance model will be designed to allow early detection of emerging pathogens or outbreaks related to SARI in two paediatric hospitals in Yangon. About 600 SARI will be documented in children with sampling to test for 17 viruses, (including some that are atypical and all common bacteria causing severe respiratory diseases over a period of 18-24 months).

An in-house data manager will be trained at the Epidemiology & Public Health unit of Institut Pasteur in Cambodia.

Expected results

At the end of the project, the proper identification of germs Involved in SARI Will result in more Appropriate treatments and the sentinel monitoring model Will Provide an early warning tool for Detecting Outbreaks or emery pathogens.

Fostering a network for the diagnosis and monitoring of SARI in hospital ICUs Some Will Support the NHL in meeting operational Constraints to detect public health events of international concern (PHEIC) and consequently better match with IHR in Myanmar.

Ultimately this study Will Provide a proof-of-concept initiative to the Ministry of Health to guide the public health policy.

Beneficiaries of project ECOMORE

The NHL will receive new equipment and required training to improve its capacity to identify pathogens causing SARI.

The Paediatric Hospitals will be able to issue more advanced diagnosis of SARI.

The patients of Paediatric Hospitals participating in the study will receive more appropriate treatments.

In the near future, the population in general will have a better chance to obtain accurate diagnosis and subsequently, an improved treatment of SARI.

The Ministry of Health will better meet operational constraints to detect public health events of international concern (PHEIC) and consequently better match with IHR.


Implementing Team