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Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014

BACKGROUND: Internally displaced persons (IDP) represent vulnerable populations whose public health conditions merit special attention. In the China–Myanmar border area, human movement and resettlements of IDP can influence malaria transmission. Comparison of disease incidence and vector densities b...

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Autores principales: Zhou, Guofa, Lo, Eugenia, Zhong, Daibin, Wang, Xiaoming, Wang, Ying, Malla, Sameer, Lee, Ming-chieh, Yang, Zhaoqing, Cui, Liwang, Yan, Guiyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024476/
https://www.ncbi.nlm.nih.gov/pubmed/27628040
http://dx.doi.org/10.1186/s12936-016-1512-2
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author Zhou, Guofa
Lo, Eugenia
Zhong, Daibin
Wang, Xiaoming
Wang, Ying
Malla, Sameer
Lee, Ming-chieh
Yang, Zhaoqing
Cui, Liwang
Yan, Guiyun
author_facet Zhou, Guofa
Lo, Eugenia
Zhong, Daibin
Wang, Xiaoming
Wang, Ying
Malla, Sameer
Lee, Ming-chieh
Yang, Zhaoqing
Cui, Liwang
Yan, Guiyun
author_sort Zhou, Guofa
collection PubMed
description BACKGROUND: Internally displaced persons (IDP) represent vulnerable populations whose public health conditions merit special attention. In the China–Myanmar border area, human movement and resettlements of IDP can influence malaria transmission. Comparison of disease incidence and vector densities between IDP camps and surrounding local villages allows for better understanding of current epidemiology and to evaluate the effectiveness of interventions in the region. METHODS: Malaria and vector surveillance was conducted in three IDP camps and three local villages neighbouring the camps along the China–Myanmar border in Myanmar. Clinical malaria cases were collected from seven hospitals/clinics from April 2011 to December 2014. Malaria vector population dynamics were monitored using CDC light traps. The use of malaria preventive measures and information on aid agencies and their activities was obtained through questionnaire surveys. RESULTS: Malaria was confirmed in 1832 patients. Of these cases, 85.4 % were Plasmodium vivax and 11.4 % were Plasmodium falciparum malaria. Annual malaria incidence rates were 38.8 and 127.0 cases/1000 person year in IDP camps and local villages, respectively. Older children of 5–14 years had the highest incidence rate in the camps regardless of gender, while male adults had significantly higher incidence rates than females in local villages and females child-bearing age had significantly lower risk to malaria in IDP camps compare to local villages. Seasonal malaria outbreaks were observed both in the IDP camps and in the local villages from May to August 2013. The proportion of P. vivax remained unchanged in local villages but increased by approximately tenfold in IDP camps from 2011 to 2014. Anopheles vector density was tenfold higher in local villages compared to IDP camps (2.0:0.2 females/trap/night). Over 99 % of households in both communities owned bed nets. While long-lasting insecticidal nets accounted for 61 % of nets used in IDPs, nearly all residents of local villages owned regular nets without insecticide-impregnation. There were more active aid agencies in the camps than in local villages. CONCLUSION: Malaria in IDP camps was significantly lower than the surrounding villages through effective control management. The observation of P. vivax outbreaks in the study area highlights the need for increased control efforts. Expansion of malaria intervention strategies in IDP camps to local surrounding villages is critical to malaria control in the border area. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-016-1512-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-50244762016-09-20 Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014 Zhou, Guofa Lo, Eugenia Zhong, Daibin Wang, Xiaoming Wang, Ying Malla, Sameer Lee, Ming-chieh Yang, Zhaoqing Cui, Liwang Yan, Guiyun Malar J Research BACKGROUND: Internally displaced persons (IDP) represent vulnerable populations whose public health conditions merit special attention. In the China–Myanmar border area, human movement and resettlements of IDP can influence malaria transmission. Comparison of disease incidence and vector densities between IDP camps and surrounding local villages allows for better understanding of current epidemiology and to evaluate the effectiveness of interventions in the region. METHODS: Malaria and vector surveillance was conducted in three IDP camps and three local villages neighbouring the camps along the China–Myanmar border in Myanmar. Clinical malaria cases were collected from seven hospitals/clinics from April 2011 to December 2014. Malaria vector population dynamics were monitored using CDC light traps. The use of malaria preventive measures and information on aid agencies and their activities was obtained through questionnaire surveys. RESULTS: Malaria was confirmed in 1832 patients. Of these cases, 85.4 % were Plasmodium vivax and 11.4 % were Plasmodium falciparum malaria. Annual malaria incidence rates were 38.8 and 127.0 cases/1000 person year in IDP camps and local villages, respectively. Older children of 5–14 years had the highest incidence rate in the camps regardless of gender, while male adults had significantly higher incidence rates than females in local villages and females child-bearing age had significantly lower risk to malaria in IDP camps compare to local villages. Seasonal malaria outbreaks were observed both in the IDP camps and in the local villages from May to August 2013. The proportion of P. vivax remained unchanged in local villages but increased by approximately tenfold in IDP camps from 2011 to 2014. Anopheles vector density was tenfold higher in local villages compared to IDP camps (2.0:0.2 females/trap/night). Over 99 % of households in both communities owned bed nets. While long-lasting insecticidal nets accounted for 61 % of nets used in IDPs, nearly all residents of local villages owned regular nets without insecticide-impregnation. There were more active aid agencies in the camps than in local villages. CONCLUSION: Malaria in IDP camps was significantly lower than the surrounding villages through effective control management. The observation of P. vivax outbreaks in the study area highlights the need for increased control efforts. Expansion of malaria intervention strategies in IDP camps to local surrounding villages is critical to malaria control in the border area. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-016-1512-2) contains supplementary material, which is available to authorized users. BioMed Central 2016-09-15 /pmc/articles/PMC5024476/ /pubmed/27628040 http://dx.doi.org/10.1186/s12936-016-1512-2 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Zhou, Guofa
Lo, Eugenia
Zhong, Daibin
Wang, Xiaoming
Wang, Ying
Malla, Sameer
Lee, Ming-chieh
Yang, Zhaoqing
Cui, Liwang
Yan, Guiyun
Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014
title Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014
title_full Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014
title_fullStr Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014
title_full_unstemmed Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014
title_short Impact of interventions on malaria in internally displaced persons along the China–Myanmar border: 2011–2014
title_sort impact of interventions on malaria in internally displaced persons along the china–myanmar border: 2011–2014
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024476/
https://www.ncbi.nlm.nih.gov/pubmed/27628040
http://dx.doi.org/10.1186/s12936-016-1512-2
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