Epidemiology of malaria in the Papua New Guinean highlands

Betuela, I; Maraga, S; Hetzel, MW; Tandrapah, T; Sie, A; Yala, S; Kundi, J; Siba, P; Reeder, JC; Mueller, I

Author(s): Betuela, I; Maraga, S; Hetzel, MW; Tandrapah, T; Sie, A; Yala, S; Kundi, J; Siba, P; Reeder, JC; Mueller, I;
Details: Publication Year 2012-10,Volume 17,Issue #10,Page 1181-1191
Journal Title: TROPICAL MEDICINE & INTERNATIONAL HEALTH
Publication Type: Journal Article
Abstract: Objectives To conduct an in-depth investigation of the epidemiology of malaria in the Papua New Guinea (PNG) highlands and provide a basis for evidence-based planning and monitoring of intensified malaria control activities. Methods Between December 2000 and July 2005, 153 household-based, rapid malaria population surveys were conducted in 112 villages throughout the central PNG highlands. The presence of malaria infections was determined by light microscopy and risk factors assessed using a structured questionnaire. The combined dataset from all individually published surveys was reanalysed. Results The prevalence of malaria infections in the different surveys ranged from 0.0% to 41.8% (median 4.3%) in non-epidemic surveys and 6.6% to 63.2% (median 21.2%, P < 0.001) during epidemics. Plasmodium falciparum was the predominant infection below 1400 m and during epidemics, Plasmodium vivax at altitudes >1600 m. Outside epidemics, prevalence decreased significantly with altitude, was reduced in people using bed nets [odds ratio (OR) = 0.8, P < 0.001] but increased in those sleeping in garden houses (OR = 1.34, P < 0.001) and travelling to highly endemic lowlands (OR = 1.80, P < 0.001). Below 1400 m, malaria was a significant source of febrile illness. At higher altitudes, malaria was only a significant source of febrile illness during epidemic outbreaks, but asymptomatic malaria infections were common in non-epidemic times. Conclusions Malaria is once again endemic throughout the PNG highlands in areas below 14001500 m of altitude with a significant risk of seasonal malaria outbreaks in most area between 14001650 m. Ongoing control efforts are likely to result in a substantial reduction in malaria transmission and may even result in local elimination of malaria in higher lying areas.
Publisher: WILEY-BLACKWELL
Keywords: TROPICAL SPLENOMEGALY SYNDROME; PLASMODIUM-FALCIPARUM; POPULATION-STRUCTURE; MOROBE PROVINCE; ENGA PROVINCE; RISK-FACTORS; INFECTIONS; PREVALENCE; PROTECTION; CHILDREN
Research Division(s): Infection And Immunity
Publisher's Version: https://doi.org/10.1111/j.1365-3156.2012.03062.x

Creation Date: 2012-10-01 12:00:00