Malaria Prevalence in Endemic Districts of Bangladesh

Ubydul Haque,Rashidul Haque,Shahed Hossain,Mohammod Khalequzzaman,Syed Masud Ahmed,Mohammad Shafiul Alam,Awlad Hossain,Dinesh Mondal,Mamun Huda,Wasif Ali Khan,Simon I Hay

doi:10.1371/journal.pone.0006737

Abstract

BackgroundFollowing the 1971 ban of DDT in Bangladesh, malaria cases have increased steadily. Malaria persists as a major health problem in the thirteen south-eastern and north-eastern districts of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), provides interventions including advocacy at community level, Insecticide Treated Net (ITN) distribution, introduction of Rapid Diagnostic Tests (RDT) and combination therapy with Coartem. It is imperative, therefore, that baseline data on malaria prevalence and other malaria indicators are collected to assess the effectiveness of the interventions and rationalize the prevention and control efforts. The objective of this study was to obtain this baseline on the prevalence of malaria and bed net use in the thirteen malaria endemic districts of Bangladesh.Methods and Principal FindingsIn 2007, BRAC and ICDDR,B carried out a malaria prevalence survey in thirteen malaria endemic districts of Bangladesh. A multi-stage cluster sampling technique was used and 9750 blood samples were collected. Rapid Diagnostic Tests (RDT) were used for the diagnosis of malaria. The weighted average malaria prevalence in the thirteen endemic districts was 3.97%. In five south-eastern districts weighted average malaria prevalence rate was 6.00% and in the eight north-eastern districts weighted average malaria prevalence rate was (0.40%). The highest malaria prevalence was observed in Khagrachari district. The majority of the cases (90.18%) were P. falciparum infections. Malaria morbidity rates in five south-eastern districts was 2.94%. In eight north-eastern districts, morbidity was 0.07%.Conclusion and SignificanceBangladesh has hypoendemic malaria with P. falciparum the dominant parasite species. The malaria situation in the five north-eastern districts of Bangladesh in particular warrants urgent attention. Detailed maps of the baseline malaria prevalence and summaries of the data collected are provided along with the survey results in full, in a supplemental information

Highlights

Malaria is estimated to be directly responsible for around one million deaths annually worldwide [1]
Since the incidence of malaria in the eastern regions was low and there was a lack of adequate funds and programs, no control efforts maintained in the malaria endemic areas of Bangladesh
Five south-eastern districts situated in the south-eastern part of Bangladesh. Three of these districts share the common border with India and Myanmar and are known as Chittagong Hill Tracts (CHT) Districts

Summary

Introduction

Malaria is estimated to be directly responsible for around one million deaths annually worldwide [1]. Since the incidence of malaria in the eastern regions was low and there was a lack of adequate funds and programs, no control efforts maintained in the malaria endemic areas of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), provides interventions including advocacy at community level, Insecticide Treated Net (ITN) distribution, introduction of Rapid Diagnostic Tests (RDT) and combination therapy with Coartem. It is imperative, that baseline data on malaria prevalence and other malaria indicators are collected to assess the effectiveness of the interventions and rationalize the prevention and control efforts.

Objectives

Methods

Results

Discussion

Conclusion