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. 2019 Sep 12;18(1):309.
doi: 10.1186/s12936-019-2924-6.

Increasing trends of malaria in a border area of the Greater Mekong Subregion

Jinting Geng  1 , Pallavi Malla  2 , Jiaqi Zhang  1 , Shiling Xu  1 , Cuiying Li  1 , Yan Zhao  3 , Qinghui Wang  3 , Myat Phone Kyaw  4 , Yaming Cao  3 , Zhaoqing Yang  5 , Liwang Cui  6
Affiliations

Increasing trends of malaria in a border area of the Greater Mekong Subregion

Jinting Geng et al. Malar J. .

Abstract

Background: Intensive malaria transmission along international borders is a significant impediment to malaria elimination in the Greater Mekong Subregion (GMS) of Southeast Asia. Passive case detection (PCD) was used to study the dynamics and trends of malaria transmission at the China-Myanmar border to provide epidemiologic information for improved malaria control.

Methods: PCD was conducted in one hospital and 12 clinics near the Laiza town in northeast Myanmar from 2011 to 2016. Clinical malaria was diagnosed by microscopy and demographic information was captured using a structured questionnaire at the time of the patient's presentation for care.

Results: Over the study period, 6175 (19.7%) malaria cases were confirmed by microscopy from 31,326 suspected cases. The four human malaria parasite species were all identified, with Plasmodium vivax and Plasmodium falciparum accounting for 5607 (90.8%) and 481 (7.8%) of the confirmed cases, respectively. In contrast to the steady decline of malaria in the general GMS, the study site had an upward trend of malaria incidence with vivax malaria outbreaks in 2013 and 2016. Adult males, children under the age of 15, and those with occupations such as farming, being a soldier or student, had significantly higher risks of clinical malaria compared to having fevers from other aetiologies. A self-reported history of clinical malaria was also associated with a higher risk of confirmed malaria.

Conclusions: The China-Myanmar border area has experienced an overall upward trend of malaria incidence in recent years with P. vivax becoming the predominant species. Evidence-based control strategies need to focus on high-risk populations.

Keywords: China–Myanmar border; Elimination; Malaria; P. vivax; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trend and dynamics of malaria incidence in Laiza township at the China–Myanmar border during 2011–2016. a Dynamics of suspected malaria cases (blue bars) and annual parasite incidence (API, incidence number per 10,000 population, red dots). b Monthly confirmed malaria cases in different years (left y axis) and average seasonal index (right y axis) showing clear seasonality of malaria incidence. Note the major and minor peaks of malaria cases in June and November, respectively. Seasonal index = average number of cases for a respective month/monthly mean number of cases for all months during the 6-year study period. c Total monthly malaria cases (blue bars), precipitation in 2016 (black line) and average temperature (shadowed between the highest and lowest daily temperature)
Fig. 2
Fig. 2
Dynamics of confirmed P. vivax and P. falciparum cases (a) and percentages of individual parasite species (b)
See this image and copyright information in PMC

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