**Author details**

Asia with mixed results [110, 181–186]. Nevertheless, RACD provides an opportunity for public health workers to concurrently assess coverage of malaria interventions including LLINs, and should be advocated and practised. Another efficient way to evaluate the efficacy of vector control methods, also applied in Africa and Asia, is to estimate the human antibody response to

Diagnostic techniques used for testing blood during RACD will significantly impact the programme effectiveness. Estimating parasite prevalence using microscopy is time and labour intensive, and often inaccurate in operational settings [190]. Newly available rapid diagnostic tests (RDTs) offer on-the-spot results, but have limitations in specificity, sensitivity, quality, and cost [190–193]. Both methods (microscopy and RDTs) may fail to detect a substantial proportion of low-density parasitaemias [186, 194, 195]. Polymerase chain reaction (PCR) provides enhanced sensitivity but results are not available immediately [196], instead Real-time PCR may present a consistent, accurate, and efficient tool for surveillance to assist malaria

Cross-border movement of populations impacts the maintenance of 'hotspots' of high transmission along international borders [77, 94, 97, 108, 137, 197–200], and spread of drug-resistance seen along the international border of Thailand and Cambodia [201]. Then, cross-border initiatives should be initiated through sharing of programme data including insecticide resistance, blood testing at the border areas, and treatment of symptomatic cases [177, 202–208]. Such successful cross-border case studies in the region have led to significant reduction in malaria bur-

Successful malaria elimination in the APMEN member States will greatly enhance the global drive to eliminate malaria. Malaria transmission in these States is complex. APMEN member States include the largest populations living in areas of malaria transmission risk outside Africa. They are a global source of ACT resistance, highest burden of *P. vivax* and zoonotic malaria, and face many geopolitical and socioeconomic factors that will challenge malaria elimination efforts. These challenges can be addressed in part through operational research to identify country specific solutions, making better use of operational data such as through implement-

ing SDSS approaches, and strengthening surveillance and cross-border collaborations.

ACT artemisinin-based combination therapy

APMEN Asia Pacific Malaria Elimination Network

DDT dichlorodiphenyltrichloroethane

AIM action and investment to defeat malaria 2016–2030

*Anopheles* saliva in human populations [187–189].

elimination in the future [196].

214 Towards Malaria Elimination - A Leap Forward

den in the study areas [209].

**4. Conclusions**

**Abbreviations**

Kinley Wangdi\* and Archie CA Clements

\*Address all correspondence to: kinley.wangdi@anu.edu.au

Department of Global Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
