Risk Factors for Border Malaria in a Malaria Elimination Setting: a Retrospective Case-control Study in Yunnan, China

Overview

Journal Am J Trop Med Hyg

Specialty Tropical Medicine

Date 2015 Jan 21

PMID 25601994

Citations 26

Authors

Jian-Wei Xu

Hui Liu

Yu Zhang

Xiang-Rui Guo

Jia-Zhi Wang

Affiliations

Soon will be listed here.

Abstract

A retrospective case-control study was conducted to identify risk factors for border malaria in a malaria elimination setting of Yunnan Province, China. The study comprised 214 cases and 428 controls. The controls were individually matched to the cases on the basis of residence, age, and gender. In addition, statistical associations are based on matched analyses. The frequencies of imported, male, adult, and vivax malaria cases were respectively 201 (93.9%), 194 (90.7%), 210 (98.1%), and 176 (82.2%). Overnight stay in Myanmar within the prior month was independently associated with malaria infection (odds ratio [OR] 159.5, 95% confidence interval [CI] 75.1-338.9). In particular, stays in lowland and foothill (OR 5.5, 95% CI 2.5-11.8) or mid-hill (OR 42.8, 95% CI 5.1-319.8) areas, or near streamlets (OR 15.3, 95% CI 4.3-55.2) or paddy field or pools (OR10.1, 95% CI 4.4-55.8) were found to be independently associated with malaria. Neither forest exposure nor use of vector control measures was associated with malaria. In conclusion, travel to lowland and foothill or mid-hill hyperendemic areas, especially along the waterside in Myanmar, was found to be the highest risk factor for malaria. In considering the limitations of the study, further investigations are needed to identify the major determinants of malaria risk and develop new strategies for malaria elimination on China-Myanmar border.

Citing Articles

Factors associated with contracting border malaria: A systematic and meta-analysis.

Fambirai T, Chimbari M, Mhindu T PLoS One. 2025; 20(1):e0310063.

PMID: 39752437 PMC: 11698403. DOI: 10.1371/journal.pone.0310063.

Assessment of malaria risk in Southeast Asia: a systematic review.

Sa-Ngamuang C, Lawpoolsri S, Yin M, Barkowsky T, Cui L, Prachumsri J Malar J. 2023; 22(1):339.

PMID: 37940923 PMC: 10631000. DOI: 10.1186/s12936-023-04772-3.

Risk of imported malaria infections in Zanzibar: a cross-sectional study.

Fakih B, Holzschuh A, Ross A, Stuck L, Abdul R, Al-Mafazy A Infect Dis Poverty. 2023; 12(1):80.

PMID: 37641152 PMC: 10464242. DOI: 10.1186/s40249-023-01129-5.

The public health response to an outbreak of border-spill malaria along China-Myanmar border.

Lin Z, Yin S, Yang J, Guo X, Dong C, Lin Y PLoS One. 2022; 17(12):e0275932.

PMID: 36525438 PMC: 9757579. DOI: 10.1371/journal.pone.0275932.

Risk factors associated with malaria infection along China-Myanmar border: a case-control study.

Xu J, Deng D, Wei C, Zhou X, Li J Malar J. 2022; 21(1):288.

PMID: 36210453 PMC: 9548336. DOI: 10.1186/s12936-022-04312-5.

References

Xu J, Liu H . Border malaria in Yunnan, China. Southeast Asian J Trop Med Public Health. 1998; 28(3):456-9. View

Bermejo A, Veeken H . Insecticide-impregnated bed nets for malaria control: a review of the field trials. Bull World Health Organ. 1992; 70(3):293-6. PMC: 2393280. View

Erhart A, Ngo D, Phan V, Ta T, Van Overmeir C, Speybroeck N . Epidemiology of forest malaria in central Vietnam: a large scale cross-sectional survey. Malar J. 2005; 4:58. PMC: 1325238. DOI: 10.1186/1475-2875-4-58. View

Guerra C, Snow R, Hay S . A global assessment of closed forests, deforestation and malaria risk. Ann Trop Med Parasitol. 2006; 100(3):189-204. PMC: 3204444. DOI: 10.1179/136485906X91512. View

Vyas S, Kumaranayake L . Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006; 21(6):459-68. DOI: 10.1093/heapol/czl029. View

Incardona S, Vong S, Chiv L, Lim P, Nhem S, Sem R . Large-scale malaria survey in Cambodia: novel insights on species distribution and risk factors. Malar J. 2007; 6:37. PMC: 1847522. DOI: 10.1186/1475-2875-6-37. View

Gikandi P, Noor A, Gitonga C, Ajanga A, Snow R . Access and barriers to measures targeted to prevent malaria in pregnancy in rural Kenya. Trop Med Int Health. 2008; 13(2):208-17. PMC: 2607535. DOI: 10.1111/j.1365-3156.2007.01992.x. View

Chalwe V, Van Geertruyden J, Mukwamataba D, Menten J, Kamalamba J, Mulenga M . Increased risk for severe malaria in HIV-1-infected adults, Zambia. Emerg Infect Dis. 2009; 15(5):749. PMC: 2687012. DOI: 10.3201/eid1505.081009. View

Delacollette C, Dsouza C, Christophel E, Thimasarn K, Abdur R, Bell D . Malaria trends and challenges in the Greater Mekong Subregion. Southeast Asian J Trop Med Public Health. 2009; 40(4):674-91. View

10.

Tatem A, Smith D, Gething P, Kabaria C, Snow R, Hay S . Ranking of elimination feasibility between malaria-endemic countries. Lancet. 2010; 376(9752):1579-91. PMC: 3044847. DOI: 10.1016/S0140-6736(10)61301-3. View

11.

Feachem R, Phillips A, Hwang J, Cotter C, Wielgosz B, Greenwood B . Shrinking the malaria map: progress and prospects. Lancet. 2010; 376(9752):1566-78. PMC: 3044848. DOI: 10.1016/S0140-6736(10)61270-6. View

12.

Smith L, Bruce J, Gueye L, Helou A, Diallo R, Gueye B . From fever to anti-malarial: the treatment-seeking process in rural Senegal. Malar J. 2010; 9:333. PMC: 3000420. DOI: 10.1186/1475-2875-9-333. View

13.

Ward K, Spokes P, McAnulty J . Case-control study of risk factors for hospitalization caused by pandemic (H1N1) 2009. Emerg Infect Dis. 2011; 17(8):1409-16. PMC: 3381572. DOI: 10.3201/eid1708.100842. View

14.

Chen G, Wei C, Li H, Yang L, Huang Q, Yan H . [Malaria epidemic trend and characteristics at monitoring sites in Yunnan province in 2008]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2011; 29(1):55-7. View

15.

Hsiang M, Hwang J, Kunene S, Drakeley C, Kandula D, Novotny J . Surveillance for malaria elimination in Swaziland: a national cross-sectional study using pooled PCR and serology. PLoS One. 2012; 7(1):e29550. PMC: 3253098. DOI: 10.1371/journal.pone.0029550. View

16.

Bousema T, Griffin J, Sauerwein R, Smith D, Churcher T, Takken W . Hitting hotspots: spatial targeting of malaria for control and elimination. PLoS Med. 2012; 9(1):e1001165. PMC: 3269430. DOI: 10.1371/journal.pmed.1001165. View

17.

Cui L, Yan G, Sattabongkot J, Cao Y, Chen B, Chen X . Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop. 2011; 121(3):227-39. PMC: 3132579. DOI: 10.1016/j.actatropica.2011.02.016. View

18.

Xu J, Liu H . The challenges of malaria elimination in Yunnan Province, People's Republic of China. Southeast Asian J Trop Med Public Health. 2012; 43(4):819-24. View

19.

Gosling R, Whittaker M, Gueye C, Fullman N, Baquilod M, Kusriastuti R . Malaria elimination gaining ground in the Asia Pacific. Malar J. 2012; 11:346. PMC: 3504559. DOI: 10.1186/1475-2875-11-346. View

20.

Trung H, Van Bortel W, Sochantha T, Keokenchanh K, Quang N, Cong L . Malaria transmission and major malaria vectors in different geographical areas of Southeast Asia. Trop Med Int Health. 2004; 9(2):230-7. DOI: 10.1046/j.1365-3156.2003.01179.x. View