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Title: Microgeography and molecular epidemiology of malaria at the Thailand-Myanmar border in the malaria pre-elimination phase
Authors: Daniel M. Parker
Stephen A. Matthews
Guiyun Yan
Guofa Zhou
Ming Chieh Lee
Jeeraphat Sirichaisinthop
Kirakorn Kiattibutr
Qi Fan
Peipei Li
Jetsumon Sattabongkot
Liwang Cui
Pennsylvania State University
University of California, Irvine
Bureau of Vector Borne Diseases
Mahidol University
Dalian Institute of Biotechnology
Keywords: Immunology and Microbiology;Medicine
Issue Date: 13-May-2015
Citation: Malaria Journal. Vol.14, No.1 (2015)
Abstract: © 2015 Parker et al.; licensee BioMed Central. Background: Endemic malaria in Thailand continues to only exist along international borders. This pattern is frequently attributed to importation of malaria from surrounding nations. A microgeographical approach was used to investigate malaria cases in a study village along the Thailand-Myanmar border. Methods: Three mass blood surveys were conducted during the study period (July and December 2011, and May 2012) and were matched to a cohort-based demographic surveillance system. Blood slides and filter papers were taken from each participant. Slides were cross-verified by an expert microscopist and filter papers were analysed using nested PCR. Cases were then mapped to households and analysed using spatial statistics. A risk factor analysis was done using mixed effects logistic regression. Results: In total, 55 Plasmodium vivax and 20 Plasmodium falciparum cases (out of 547 participants) were detected through PCR, compared to six and two (respectively) cases detected by field microscopy. The single largest risk factor for infection was citizenship. Many study participants were ethnic Karen people with no citizenship in either Thailand or Myanmar. This subpopulation had over eight times the odds of malaria infection when compared to Thai citizens. Cases also appeared to cluster near a major drainage system and year-round water source within the study village. Conclusion: This research indicates that many cases of malaria remain undiagnosed in the region. The spatial and demographic clustering of cases in a sub-group of the population indicates either transmission within the Thai village or shared exposure to malaria vectors outside of the village. While it is possible that malaria is imported to Thailand from Myanmar, the existence of undetected infections, coupled with an ecological setting that is conducive to malaria transmission, means that indigenous transmission could also occur on the Thai side of the border. Improved, timely, and active case detection is warranted.
ISSN: 14752875
Appears in Collections:Scopus 2011-2015

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