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Title: Mapping the travel patterns of people with malaria in Bangladesh
Authors: Ipsita Sinha
Abdullah Abu Sayeed
Didar Uddin
Amy Wesolowski
Sazid Ibna Zaman
M. Abul Faiz
Aniruddha Ghose
M. Ridwanur Rahman
Akramul Islam
Mohammad Jahirul Karim
Anjan Saha
M. Kamar Rezwan
Abul Khair Mohammad Shamsuzzaman
Sanya Tahmina Jhora
M. M. Aktaruzzaman
Hsiao Han Chang
Olivo Miotto
Dominic Kwiatkowski
Arjen M. Dondorp
Nicholas P.J. Day
M. Amir Hossain
Caroline Buckee
Richard J. Maude
Harvard T.H. Chan School of Public Health
Organisation Mondiale de la Santé
University of Oxford
Mahidol University
Chittagong Medical College Hospital
Nuffield Department of Clinical Medicine
Johns Hopkins Bloomberg School of Public Health
Wellcome Sanger Institute
Filariasis Elimination
National Malaria Elimination Programme
Dev Care Foundation
Shaheed Suhrawardy Medical College
BRAC Centre
Directorate General of Health Services
Keywords: Medicine
Issue Date: 4-Mar-2020
Citation: BMC Medicine. Vol.18, No.1 (2020)
Abstract: © 2020 The Author(s). Background: Spread of malaria and antimalarial resistance through human movement present major threats to current goals to eliminate the disease. Bordering the Greater Mekong Subregion, southeast Bangladesh is a potentially important route of spread to India and beyond, but information on travel patterns in this area are lacking. Methods: Using a standardised short survey tool, 2090 patients with malaria were interviewed at 57 study sites in 2015-2016 about their demographics and travel patterns in the preceding 2 months. Results: Most travel was in the south of the study region between Cox's Bazar district (coastal region) to forested areas in Bandarban (31% by days and 45% by nights), forming a source-sink route. Less than 1% of travel reported was between the north and south forested areas of the study area. Farmers (21%) and students (19%) were the top two occupations recorded, with 67 and 47% reporting travel to the forest respectively. Males aged 25-49 years accounted for 43% of cases visiting forests but only 24% of the study population. Children did not travel. Women, forest dwellers and farmers did not travel beyond union boundaries. Military personnel travelled the furthest especially to remote forested areas. Conclusions: The approach demonstrated here provides a framework for identifying key traveller groups and their origins and destinations of travel in combination with knowledge of local epidemiology to inform malaria control and elimination efforts. Working with the NMEP, the findings were used to derive a set of policy recommendations to guide targeting of interventions for elimination.
ISSN: 17417015
Appears in Collections:Scopus 2020

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