Abstract
Malaria infections remain an important public health problem for the Thai–Myanmar border population, despite a plan for the elimination by the end of 2026 (Thailand) and 2030 (Myanmar). This study aimed to explore spatiotemporal patterns in Plasmodium falciparum and Plasmodium vivax incidence along the Thai–Myanmar border. Malaria cases among Thai citizens in 161 sub-districts in Thailand’s Kanchanaburi and Tak Provinces (2012–2017) were analyzed to assess the cluster areas and temporal trends. Based on reported incidence, 65.22% and 40.99% of the areas studied were seen to be at elimination levels for P. falciparum and P. vivax already, respectively. There were two clear clusters of malaria in the region: One in the northern part (Cluster I), and the other in the central part (Cluster II). In Cluster I, the malaria season exhibited two peaks, while there was only one peak seen for Cluster II. Malaria incidence decreased at a faster rate in Cluster I, with 5% and 4% reductions compared with 4% and 3% reductions in P. falciparum and P. vivax incidence per month, respectively, in Cluster II. The decreasing trends reflect the achievements of malaria control efforts on both sides of the Thai–Myanmar border. However, these clusters could act as reservoirs. Perhaps one of the main challenges facing elimination programs in this low transmission setting is maintaining a strong system for early diagnosis and treatment, even when malaria cases are very close to zero, whilst preventing re-importation of cases.
Highlights
Malaria infections threaten more than 3.2 billion of the world’s population, with approximately 216 million cases globally each year, of which 6.76% occur in Southeast Asia [1]
Our analysis predominantly focused on Thai citizens, with an assumption that the malaria situation among Thai citizens was likely to be indicative of indigenous malaria
Summary Statistics In Tak Province (Figure 1), total P. falciparum and P. vivax cases decreased by 98.10% and 86.41%, respectively, from 2012 to 2017
Summary
Malaria infections threaten more than 3.2 billion of the world’s population, with approximately 216 million cases globally each year, of which 6.76% occur in Southeast Asia [1]. In the Greater Mekong Sub-region (GMS), which includes Cambodia, China (Yunnan Province), Lao PDR, Myanmar, Thailand, and Vietnam, malaria has been in general decline over the last several decades. All nations of the GMS have committed to eliminating malaria by the year 2030 [2,3]. Thailand has already made huge strides in reducing its malaria burden, with the disease persisting only along its international borders with Myanmar, Laos, and Cambodia. Resistance to artemisinin combination therapies (ACT) has spread across the GMS [4,8], presenting a widespread threat of untreatable malaria. The current threat has put pressure on nations within the GMS to rapidly eliminate malaria before it becomes completely untreatable, and before these strains spread to other parts of the world
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