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. 2007 Sep 5:1:9.
doi: 10.1186/1752-1505-1-9.

Prevalence of Plasmodium falciparum in active conflict areas of eastern Burma: a summary of cross-sectional data

Adam K Richards  1 , Linda Smith, Luke C Mullany, Catherine I Lee, Emily Whichard, Kristin Banek, Mahn Mahn, Eh Kalu Shwe Oo, Thomas J Lee
Affiliations

Prevalence of Plasmodium falciparum in active conflict areas of eastern Burma: a summary of cross-sectional data

Adam K Richards et al. Confl Health. .

Abstract

Background: Burma records the highest number of malaria deaths in southeast Asia and may represent a reservoir of infection for its neighbors, but the burden of disease and magnitude of transmission among border populations of Burma remains unknown.

Methods: Plasmodium falciparum (Pf) parasitemia was detected using a HRP-II antigen based rapid test (Paracheck-Pf(R)). Pf prevalence was estimated from screenings conducted in 49 villages participating in a malaria control program, and four retrospective mortality cluster surveys encompassing a sampling frame of more than 220,000. Crude odds ratios were calculated to evaluate Pf prevalence by age, sex, and dry vs. rainy season.

Results: 9,796 rapid tests were performed among 28,410 villagers in malaria program areas through four years (2003: 8.4%, 95% CI: 8.3 - 8.6; 2004: 7.1%, 95% CI: 6.9 - 7.3; 2005:10.5%, 95% CI: 9.3 - 11.8 and 2006: 9.3%, 95% CI: 8.2 - 10.6). Children under 5 (OR = 1.99; 95% CI: 1.93 - 2.06) and those 5 to 14 years (OR = 2.24, 95% CI: 2.18 - 2.29) were more likely to be positive than adults. Prevalence was slightly higher among females (OR = 1.04, 95% CI: 1.02 - 1.06) and in the rainy season (OR = 1.48, 95% CI: 1.16 - 1.88). Among 5,538 rapid tests conducted in four cluster surveys, 10.2% were positive (range 6.3%, 95% CI: 3.9 - 8.8; to 12.4%, 95% CI: 9.4 - 15.4).

Conclusion: Prevalence of plasmodium falciparum in conflict areas of eastern Burma is higher than rates reported among populations in neighboring Thailand, particularly among children. This population serves as a large reservoir of infection that contributes to a high disease burden within Burma and likely constitutes a source of infection for neighboring regions.

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Figures

Figure 1
Figure 1
Target area of the KDHW and BPHWT. BPHWT: Backpack Health Worker Team; KDHW: Karen Department of Health & Welfare.
Figure 2
Figure 2
Estimates of Plasmodium falciparum prevalence from malaria program screenings and retrospective cluster surveys 2003 – 2006, by season. BPHWT: Backpack Health Worker Team; KDHW: Karen Department of Health & Welfare. Limited program screenings targeted female heads of household. Rainy season defined as the months from June – October.
See this image and copyright information in PMC

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