Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Retrospective analysis of risk factors of slide positivity among febrile patients in the Salween river valley of Shan Special Region II, northern Myanmar

Authors: Hui Liu, Jian-Wei Xu, Qi-Zhang Xu, Yi-Rou Zeng

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

In Myanmar, epidemiological conditions have been unclear due to a lack of accurate data. In 2014 and 2016, malaria outbreaks occurred in the Shan Special Region II (SSR2). It was reported that these outbreaks were caused by malaria patients from the Salween River Valley (SRV), but further research is needed to confirm these reports. To examine the risks of malaria infection in the SSR2 section of the SRV, this paper offers a retrospective analysis based on the data we collected in 2009.

Methods

A multivariate logistic model was utilized to analyze risk factors associated with the slide positivity of 2009. Results of the investigation in 2009 were compared with updated data.

Results

The number of slide positivity was 91 (24.7%, 95% confidence interval [CI], 20.3–29.4%) among 369 people who had fever 2 weeks ago of the survey, including 74 (20.1%; 95%CI, 16.1–24.5%) cases of P. falciparum, 13 (3.5%; 95%CI, 1.9–5.9%) of P.vivax and 4 (1.1%, 95%CI, 0.3–2.8%) of P. malariae. The adjusted odds ratio (OR) was 99.8 (95% CI, 24.7–887.7) for patients’ age < 15 years, 6.61 (95%CI, 3.57–10.49) for people living at an altitude of < 800 m, 6.35 (95%CI, 2.45–23.27) for people lacking knowledge on malaria transmission and knowledge on symptoms, 2.10 (95%CI, 1.22–5.11) for people taking no measures against mosquito bites and 5.55 (95%CI, 2.65–13.05) for people delaying treatment. Compared with annual parasitic incidences 13.80 per 10,000 person-years (422/305733) in 2014, 2.36 per 10,000 person-years (73/309004) in 2015 and 5.25 per 10,000 person-years (164/312310) in 2015, malaria burden is reduced.

Conclusion

Age, lower altitude, a lack of knowledge about malaria transmission and symptoms, inaction of measures against mosquito bites and delayed treatment-seeking were independent risk factors for slide positivity. These results indicate that malaria transmission was likely within housing settlements in the SRV, and that the transmission rates within the SRV are higher than in other areas. In order to eliminate malaria, it is important for people to obtain qualified treatment to contain artemisinin resistance.

Trial registration

Trial registration number: ChiCTR-COC-17012522.
Retrospectively registered 31 August 2017.
Literature
1.
WHO. Global technical strategy for malaria 2016–2030. Geneva: World Health Organization; 2015. Accessed 27 Feb 2016
2.
WHO. World malaria report 2015. Geneva: World Health Organization; 2015. Accessed 24 May 2016
3.
Cui L, Yan G, Sattabongkot J, Cao Y, Chen B, Chen X, et al. Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop. 2012;121:227–39.CrossRefPubMed
4.
Delacollette C, Souza C, Christophel E, Thimasarn K, Abdur R, Bell D, et al. Malaria trends and challenges in the Greater Mekong Subregion. Southeast Asian J Trop Med Public Health. 2009;40:674–91.PubMed
5.
Li N, Parker D, Yang Z, Fan Q, Zhou G, Ai G, Duan H, Lee M, Yan G, Matthews S, Cui L, Wang Y. Risk factors associated with slide positivity among febrile patients in a conflict zone of north-eastern Myanmar along the China-Myanmar border. Malar J. 2013;12:361.CrossRefPubMedPubMedCentral
6.
WHO. Strategy for malaria elimination in the Greater Mekong Subregion: 2015–2030. Geneva: World Health Organization; 2015. Accessed 27 Feb 2016
7.
Wang RB, Zhang J, Zhang QF. Malaria baseline survey in four special regions of northern Myanmar near China: a cross-sectional study. Malar J. 2014;13:302.CrossRefPubMedPubMedCentral
8.
Xu JW, Li Y, Yang HL, Zhang J, Zhang ZX, Yang YM, et al. Malaria control along China-Myanmar border during 2007-2013: an integrated impact evaluation. Inf Dis Poverty. 2016;5:75.CrossRef
9.
Xu JW, Liu H. The relationship of malaria between Chinese side and Myanmar’s five special regions along China–Myanmar border: a linear regression analysis. Malar J. 2016;15:368.CrossRefPubMedPubMedCentral
10.
Liu H, Xu JW, Yang HL, Mei L, Sun CD, Yin YJ, et al. Investigation and control of a Plasmodium falciparum malaria outbreak in Shan Special Region II of Myanmar along the China-Myanmar border from June to December 2014. Inf Dis Poverty. 2016;5:32.CrossRef
11.
Dong XS. The malaria vectors and their ecology in Yunnan Province. Chin J Parasit D is. 2000;13:144–7. (in Chinese)
12.
Xu JW, Xu QZ, Liu H, Zeng YR. Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study. Malar J. 2012;11:417.CrossRefPubMedPubMedCentral
13.
Bureau for Disease control and prevention, Ministry of Health, People’s Republic of China. Malaria control manual. Beijing: People’s Health Publishing Company; 2007. p. 33–42. (in Chinese)
14.
Liu H, Yang HL, Xu JW, Wang JZ, Nie RH, Li CF. Artemisinin-naphthoquine combination versus chloroquine-primaquine to treat vivax malaria: an open-label randomized and non-inferiority trial in Yunnan Province, China. Malar J. 2013;12:409.CrossRefPubMedPubMedCentral
15.
Liu H, Xu J-W, Bi Y. Malaria burden and treatment targets in Kachin Special Region II, Myanmar from 2008 to 2016: A retrospective analysis. PLoS ONE. 2018;13:4.
16.
Xu JW, Liu H. The challenges of malaria elimination in Yunnan Province, People’s Republic of China. Southeast Asian J Trop Med Public Health. 2012;43:819–24.PubMed
17.
Xu JW, Li JJ, Guo HP, Pu SW, Li SM, Wang RH, Liu H, Wang WJ. Malaria from hyperendemicity to elimination in Hekou County on China–Vietnam border: an ecological study. Malar J. 2017;16:66.CrossRefPubMedPubMedCentral
18.
Liu H, Nie RH, Li CF, Sun YH, Li GS. Active detection of malaria cases in Myanmar Wa ethnical villages of China-Myanmar border. Para Inf Dis. 2009;12:6–8. (in Chinese)
19.
Xu JW, Liu H, Zhang Y, Guo XR, Wang JZ. Risk factors for border malaria in a malaria elimination setting: a retrospective case-control study in Yunnan. China Am J Trop Med Hyg. 2015;92:546–51.CrossRefPubMed
20.
Cotter C, Sturrock HJ, Hsiang MS, Liu J, Phillips AA, Hwang J, et al. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet. 2013;382:900–16.CrossRefPubMed
21.
Yuan LL, Zhao H, Lanou Wu L, Li XM, Parkerd D, Xu SH, et al. Plasmodium falciparum populations from northeastern Myanmar display high levels of genetic diversity at multiple antigenic loci. Acta Trop. 2013;125:53–9.CrossRefPubMed
22.
Liu H, Yang HL, Tang LH, Li XL, Huang F, Wang JZ, et al. In vivo monitoring of dihydroartemisinin-piperaquine sensitivity in Plasmodium falciparum along the China-Myanmar border of Yunnan Province, China during 2007–2013. Malar J. 2015;14:47.CrossRefPubMedPubMedCentral
23.
Liu H, Yang HL, Zhang J, Li CF, Nie RH, Wang HY. Clinical trial on efficacy of compound dihydroartemisinin-piperaquine for treatment of uncomplicated falciparum malaria in Myanmar. Chin J Parasit Parasitic Dis. 2011;29:296–8. (in Chinese)
Metadata
Title
Retrospective analysis of risk factors of slide positivity among febrile patients in the Salween river valley of Shan Special Region II, northern Myanmar
Authors
Hui Liu
Jian-Wei Xu
Qi-Zhang Xu
Yi-Rou Zeng
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5469-7

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Early rigorous control interventions can largely reduce dengue outbreak magnitude: experience from Chaozhou, China

Research article

Health care-seeking patterns for female genital mutilation/cutting among young Somalis in Norway

Research article

Year-round effects of a four-week randomized controlled trial using different types of feedback on employees’ physical activity

Research article

Perceived effectiveness of pictorial health warnings on changes in smoking behaviour in Asia: a literature review

Research article

Movement behaviours are associated with lung function in middle-aged and older adults: a cross-sectional analysis of the Canadian longitudinal study on aging

Research article

Association between successful smoking cessation and changes in marital and job status and health behaviours: evidence from a 10-wave nationwide survey in Japan