Abstract
Malaria in Asia is thought to be grossly under-reported and this is evident from previously published statistics from Bangladesh. Malaria screening data from four Upazillas was analysed alongside census data to assess the trends in malaria incidence over time and distribution of malaria by age and gender. Malaria incidence in this area has decreased by around two thirds since 2003, although control measures were not significantly increased until 2005. Malaria occurred in people of all ages with the highest incidence being in young adults. This is consistent with higher occupational exposure in this group. The probability of being screened for malaria decreased with age suggesting significant numbers of adults with malaria may be being missed.
Highlights
Much of the morbidity and 90% of deaths due to malaria are thought to be in Africa, mostly in young children, malaria remains a major cause of morbidity and mortality in Asia
From 1999-2006, there were 307,803 blood samples screened for malaria in the Upazillas and, of these, 11.6% of samples were positive for Plasmodium falciparum and 4.9% for Plasmodium vivax i.e. 70.3% of all malaria cases were caused by P. falciparum
In the 4 Upazillas included in this study, the annual parasite incidence rates (API) for malaria was 8.4/1,000/year
Summary
Much of the morbidity and 90% of deaths due to malaria are thought to be in Africa, mostly in young children, malaria remains a major cause of morbidity and mortality in Asia. It has been argued that the disease burden due to malaria in Asia is grossly underestimated, partly due to the use of passively collected disease notification data[1]. In Bangladesh, 10 out of its 64 districts (around 17.9 million people) are thought to be highly endemic (>1 case per year per 1,000 population) malaria with highly seasonal transmission. All of these districts are in the east and southeast of the country near to the borders with India and Myanmar (Figure 1). There are wide fluctuations in the annual malaria rates and there has been no evidence of a systematic decline in the national figures from 2001 to the most recent data collected in 20062. There were no reported cases in 2006 in 48 districts, this is likely to be due to under-reporting[2]
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