The Myanmar Malaria Burden Reduction Assessment documented the reduction of malaria burden between 2006 and 2017 in three areas of Myanmar: 34 townships of Kayin State, Tanintharyi Region, and Rakhine State. The assessment reviewed all cross-sectional surveys, routine malaria surveillance data, and interventions supported by all partners. Surveys demonstrated little change nationally in malaria knowledge, treatment-seeking or impregnated net use between 2011 and 2016. Health Management Information System data demonstrated a decline in reported incidence of confirmed malaria with 91% reported in Kayin, 97% in Tanintharyi, and 95% in Rakhine since 2012. The decline started in Rakhine before 2012, followed by steep decline in Tanintharyi and a slower decrease in Kayin, where cases are severely underestimated at government facilities. Training expanded markedly in 2009; a dramatic increase in insecticidal nets distribution and village health workers occurred after 2011. Reduction of cases in areas supported by the President's Malaria Initiative was of similar magnitude to overall reduction.
Cross-sectional time-series regression analysis demonstrated significant association between an annual decline in reported Health Management Information System cases by township and the number of impregnated nets provided, number of village health workers, person-days of malaria training provided, and socioeconomic status assessed as vulnerability. There was no evidence of association between the decline in cases and annual rainfall or deforestation. Thus, a decline in malaria can be attributed to the interventions delivered, which have had additional impact in townships classed as less vulnerable. Improved collaboration between the National Malaria Control Programme and partners at township level to share and use intervention and surveillance information is needed to accelerate progress towards elimination.