TY - JOUR
T1 - Malaria Hotspots Drive Hypoendemic Transmission in the Chittagong Hill Districts of Bangladesh
AU - Ahmed, Sabeena
AU - Galagan, Sean
AU - Scobie, Heather
AU - Khyang, Jacob
AU - Prue, Chai Shwai
AU - Khan, Wasif Ali
AU - Ram, Malathi
AU - Alam, Mohammad Shafiul
AU - Haq, M. Zahirul
AU - Akter, Jasmin
AU - Glass, Gregory
AU - Norris, Douglas E.
AU - Nyunt, Myaing Myaing
AU - Shields, Timothy
AU - Sullivan, David J.
AU - Sack, David A.
N1 - Funding Information:
Starting in 2007, the Government of Bangladesh received funding from the Global Fund to fight Malaria, AIDS and Tuberculosis to implement a national malaria control program. The program works with various non-governmental organizations but most importantly BRAC, which provides long-lasting insecticide treated bed nets at the village level at no cost and supports treating old nets with deltamethrine in the insecticide-treated nets program . The nets distributed include Net Protect (Bestnet, UK), Olyset (Sumitomo Co. Ltd., Japan), and Permanet (Verstergaard Fradsen, Switzerland) and are believed to be effective for 3–5 years .
PY - 2013/8/6
Y1 - 2013/8/6
N2 - Background: Malaria is endemic in 13 of 64 districts of Bangladesh, representing a population at risk of about 27 million people. The highest rates of malaria in Bangladesh occur in the Chittagong Hill Districts, and Plasmodium falciparum (predominately chloroquine resistant) is the most prevalent species. Methods: The objective of this research was to describe the epidemiology of symptomatic P. falciparum malaria in an area of Bangladesh following the introduction of a national malaria control program. We carried out surveillance for symptomatic malaria due to P. falciparum in two demographically defined unions of the Chittagong Hill Districts in Bangladesh, bordering western Myanmar, between October 2009 and May 2012. The association between sociodemographics and temporal and climate factors with symptomatic P. falciparum infection over two years of surveillance data was assessed. Risk factors for infection were determined using a multivariate regression model. Results: 472 cases of symptomatic P. falciparum malaria cases were identified among 23,372 residents during the study period. Greater than 85% of cases occurred during the rainy season from May to October, and cases were highly clustered geographically within these two unions with more than 80% of infections occurring in areas that contain approximately one-third of the total population. Risk factors statistically associated with infection in a multivariate logistic regression model were living in the areas of high incidence, young age, and having an occupation including jhum cultivation and/or daily labor. Use of long lasting insecticide-treated bed nets was high (89.3%), but its use was not associated with decreased incidence of infection. Conclusion: Here we show that P. falciparum malaria continues to be hypoendemic in the Chittagong Hill Districts of Bangladesh, is highly seasonal, and is much more common in certain geographically limited hot spots and among certain occupations.
AB - Background: Malaria is endemic in 13 of 64 districts of Bangladesh, representing a population at risk of about 27 million people. The highest rates of malaria in Bangladesh occur in the Chittagong Hill Districts, and Plasmodium falciparum (predominately chloroquine resistant) is the most prevalent species. Methods: The objective of this research was to describe the epidemiology of symptomatic P. falciparum malaria in an area of Bangladesh following the introduction of a national malaria control program. We carried out surveillance for symptomatic malaria due to P. falciparum in two demographically defined unions of the Chittagong Hill Districts in Bangladesh, bordering western Myanmar, between October 2009 and May 2012. The association between sociodemographics and temporal and climate factors with symptomatic P. falciparum infection over two years of surveillance data was assessed. Risk factors for infection were determined using a multivariate regression model. Results: 472 cases of symptomatic P. falciparum malaria cases were identified among 23,372 residents during the study period. Greater than 85% of cases occurred during the rainy season from May to October, and cases were highly clustered geographically within these two unions with more than 80% of infections occurring in areas that contain approximately one-third of the total population. Risk factors statistically associated with infection in a multivariate logistic regression model were living in the areas of high incidence, young age, and having an occupation including jhum cultivation and/or daily labor. Use of long lasting insecticide-treated bed nets was high (89.3%), but its use was not associated with decreased incidence of infection. Conclusion: Here we show that P. falciparum malaria continues to be hypoendemic in the Chittagong Hill Districts of Bangladesh, is highly seasonal, and is much more common in certain geographically limited hot spots and among certain occupations.
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U2 - 10.1371/journal.pone.0069713
DO - 10.1371/journal.pone.0069713
M3 - Article
C2 - 23936345
AN - SCOPUS:84881126357
SN - 1932-6203
VL - 8
JO - PloS one
JF - PloS one
IS - 8
M1 - e69713
ER -