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Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination

Malaria in Bhutan has fallen significantly over the last decade. As Bhutan attempts to eliminate malaria in 2022, this study aimed to characterize the space–time clustering of malaria from 2010 to 2019. Malaria data were obtained from the Bhutan Vector-Borne Disease Control Program data repository....

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Autores principales: Wangdi, Kinley, Penjor, Kinley, Tobgyal, Lawpoolsri, Saranath, Price, Ric N., Gething, Peter W., Gray, Darren J., Da Silva Fonseca, Elivelton, Clements, Archie C. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196969/
https://www.ncbi.nlm.nih.gov/pubmed/34067393
http://dx.doi.org/10.3390/ijerph18115553
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author Wangdi, Kinley
Penjor, Kinley
Tobgyal,
Lawpoolsri, Saranath
Price, Ric N.
Gething, Peter W.
Gray, Darren J.
Da Silva Fonseca, Elivelton
Clements, Archie C. A.
author_facet Wangdi, Kinley
Penjor, Kinley
Tobgyal,
Lawpoolsri, Saranath
Price, Ric N.
Gething, Peter W.
Gray, Darren J.
Da Silva Fonseca, Elivelton
Clements, Archie C. A.
author_sort Wangdi, Kinley
collection PubMed
description Malaria in Bhutan has fallen significantly over the last decade. As Bhutan attempts to eliminate malaria in 2022, this study aimed to characterize the space–time clustering of malaria from 2010 to 2019. Malaria data were obtained from the Bhutan Vector-Borne Disease Control Program data repository. Spatial and space–time cluster analyses of Plasmodium falciparum and Plasmodium vivax cases were conducted at the sub-district level from 2010 to 2019 using Kulldorff’s space–time scan statistic. A total of 768 confirmed malaria cases, including 454 (59%) P. vivax cases, were reported in Bhutan during the study period. Significant temporal clusters of cases caused by both species were identified between April and September. The most likely spatial clusters were detected in the central part of Bhutan throughout the study period. The most likely space–time cluster was in Sarpang District and neighboring districts between January 2010 to June 2012 for cases of infection with both species. The most likely cluster for P. falciparum infection had a radius of 50.4 km and included 26 sub-districts with a relative risk (RR) of 32.7. The most likely cluster for P. vivax infection had a radius of 33.6 km with 11 sub-districts and RR of 27.7. Three secondary space–time clusters were detected in other parts of Bhutan. Spatial and space–time cluster analysis identified high-risk areas and periods for both P. vivax and P. falciparum malaria. Both malaria types showed significant spatial and spatiotemporal variations. Operational research to understand the drivers of residual transmission in hotspot sub-districts will help to overcome the final challenges of malaria elimination in Bhutan.
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spelling pubmed-81969692021-06-13 Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination Wangdi, Kinley Penjor, Kinley Tobgyal, Lawpoolsri, Saranath Price, Ric N. Gething, Peter W. Gray, Darren J. Da Silva Fonseca, Elivelton Clements, Archie C. A. Int J Environ Res Public Health Article Malaria in Bhutan has fallen significantly over the last decade. As Bhutan attempts to eliminate malaria in 2022, this study aimed to characterize the space–time clustering of malaria from 2010 to 2019. Malaria data were obtained from the Bhutan Vector-Borne Disease Control Program data repository. Spatial and space–time cluster analyses of Plasmodium falciparum and Plasmodium vivax cases were conducted at the sub-district level from 2010 to 2019 using Kulldorff’s space–time scan statistic. A total of 768 confirmed malaria cases, including 454 (59%) P. vivax cases, were reported in Bhutan during the study period. Significant temporal clusters of cases caused by both species were identified between April and September. The most likely spatial clusters were detected in the central part of Bhutan throughout the study period. The most likely space–time cluster was in Sarpang District and neighboring districts between January 2010 to June 2012 for cases of infection with both species. The most likely cluster for P. falciparum infection had a radius of 50.4 km and included 26 sub-districts with a relative risk (RR) of 32.7. The most likely cluster for P. vivax infection had a radius of 33.6 km with 11 sub-districts and RR of 27.7. Three secondary space–time clusters were detected in other parts of Bhutan. Spatial and space–time cluster analysis identified high-risk areas and periods for both P. vivax and P. falciparum malaria. Both malaria types showed significant spatial and spatiotemporal variations. Operational research to understand the drivers of residual transmission in hotspot sub-districts will help to overcome the final challenges of malaria elimination in Bhutan. MDPI 2021-05-22 /pmc/articles/PMC8196969/ /pubmed/34067393 http://dx.doi.org/10.3390/ijerph18115553 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wangdi, Kinley
Penjor, Kinley
Tobgyal,
Lawpoolsri, Saranath
Price, Ric N.
Gething, Peter W.
Gray, Darren J.
Da Silva Fonseca, Elivelton
Clements, Archie C. A.
Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination
title Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination
title_full Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination
title_fullStr Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination
title_full_unstemmed Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination
title_short Space–Time Clustering Characteristics of Malaria in Bhutan at the End Stages of Elimination
title_sort space–time clustering characteristics of malaria in bhutan at the end stages of elimination
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196969/
https://www.ncbi.nlm.nih.gov/pubmed/34067393
http://dx.doi.org/10.3390/ijerph18115553
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