• Mass survey campaign, with annual re-surveys.

• When the incidence rates declined, modified school surveys were deployed

• every 6 months. If infectious cases were found, the entire area would be studied.

• Incidence rate declined from 140.85 per 100,000 population in 1958 to <2 in 1974.

• Yaws control activities were integrated into the general health services in 1974. All health workers were trained to recognise yaws cases.

• Peninsular Malaysia: Control team (medical assistant, public health auxiliary, junior laboratory technician, driver and vehicle).

• Sabah and Sarawak: Ad hoc team to conduct surveys and treatment in specific areas.

• 1988–90: There appeared to be a decreasing trend in the number of filariasis cases detected countrywide.

• 1983: incorporated into the Vector-Borne Disease Control Programme.

• National TB Control Programme, 1961 –

• monitored and co-ordinated by the Division of TB and National TB Control Centre

• National health education campaigns: To increase public awareness of TB signs and symptoms and early diagnosis.

• BCG vaccination programme: Between 1961 and 1974, at least 75% of the susceptible population had been vaccinated (total BCG vaccinations performed: 4,965,982).

• Treatment programme: 20-month standard treatment regimen (streptomycin with isoniazid or isoniazid with para-aminosalicylic acid or thiacetazone) for patients to render them non-infective (at least 95%).

• The National TB Control Centre served as the national referral hospital for patients with complicated TB.

• Countrywide training programme conducted by the National TB Centre, supported by hospitals, for different categories of personnel (doctors, nurses, hospital assistants, health inspectors, medical students and lab technicians).

• Formation of State TB Control/Managerial Teams in 1973 to supervise and monitor the treatment programme and contact tracing.

• TB is no longer the major cause of death.

• The National TB Control Programme was integrated with public health and general medical services in 1995.

Vector control:

Residual insecticide spraying using DDT (started with DDT wettable powder and replaced by DDT emulsion)

1. - Abate 500 E was applied in drains and canals

2. - Automatic siphons, tidal gates and sluice gates were constructed to manage water movement.

Health education for the community.

• Active case detection in high-risk areas.

• Passive case detection in patients seeking medical and health services.

• Mass blood screenings

• every 6 months in areas with increase of cases, influx of foreign workers, interior Orang Asli settlements and where there were cases in non-endemic areas.

• Presumptive treatment (Darachlor (chloroquine/pyrimethamine)) was given to suspected cases, especially those from malarious areas before blood examination.

• Radical and follow-up treatment (sulfadoxine/pyrimethamine, chloroquine and primaquine) was given for all reported cases.

Vertical organisational structure:

1. - Director and deputy director

2. - Administration bureau

3. - Spraying bureau

4. - Health education and training bureau

5. - Epidemiology bureau

6. - Entomology bureau

7. - Malariologist

8. - District chief and multi-purpose/special team

Specially trained personnel deployed to map and spray all houses and structures, perform

census counts, perform mass blood surveys and general

surveillance activities.

• Case registries

• Entomological surveillance activities to study vector habits.

• Substantial decline in reported cases in West Malaysia and Sarawak, from 150,000 at the start of the programme to <50,000 a year in the late 1970s.

• Did not succeed in eliminating malaria, re-orientated strategy to malaria control.

• 1985: Incorporated into the Vector-Borne Disease Control Programme.

• Introduction of multiple drug therapy (MDT) and decentralisation of treatment:

• patients were hospitalised only during the intensive phase of treatment, and follow-up treatment was available at 23 skin clinics throughout the country.

• Institutional treatment only for infectious cases and non-infectious cases with severe reactions from drug cases requiring reconstructive surgery.

• National Immunisation Programme – Expanded Immunisation Programme was adopted as part of the National Immunisation Programme in the late 1980s.

• Smallpox (early 1950s)

• DPT (1958)

• BCG (1961)

• Poliomyelitis (1972)

• Measles (1984)

• Rubella (1988)

• Hepatitis B (1989)

• Immunisation campaigns jointly organised with NGOs.

• Dissemination of health education messages through mass media.

• Delivered through the rural health units or the MCH clinics in urban areas as part of MCH services.

• Focus on low-coverage groups:

• Estate population

• Indigenous people

• Religious subgroups

• Urban poor

• Defaulter tracing

• Missed opportunities

• Strengthening of the cold chain:

• Provision of suitable refrigerators, ice packs and vaccine carriers

• Training on the management, maintenance and monitoring of the cold chain

• Almost 90% childhood immunisation coverage for BCG, DPT, polio and MMR in 1990

• Decline of the infant and children mortality rate.