This article is part of a series on Health care in Burma, edited by Dr. Chris Beyrer.Prevalence of plasmodium falciparum in active conflict areas of eastern Burma: a summary of cross-sectional data1Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 305 East 161st Street, Bronx, USA 10451 2Global Health Access Program, Mae Sot, Thailand 3Planet Care/Global Health Access Program, 801 Cedar Street Suite 200, Berkeley, CA, USA 94710 4Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, USA 21205 5The MENTOR Initiative-Liberia, Monrovia, Liberia 615806 East Saratoga Place Aurora, CO 80015 USA 7Backpack Health Worker Team, 659, Moo 1 – Thasailuad, Mae Sot, Tak, Thailand, 63110 8Karen Department of Health and Welfare, No. 663 Moo 1 – Thasailuad, Asia High Way, Mae Sot, Tak, Thailand 63110 9Department of Medicine, University of California at Los Angeles, 924 Westwood Blvd. Suite 300, Los Angeles, CA, USA 90024
Conflict and Health 2007, 1:9doi:10.1186/1752-1505-1-9
AbstractBackgroundBurma records the highest number of malaria deaths in southeast Asia and may represent a reservoir of infection for its neighbors, but the burden of disease and magnitude of transmission among border populations of Burma remains unknown. MethodsPlasmodium falciparum (Pf) parasitemia was detected using a HRP-II antigen based rapid test (Paracheck-Pf®). Pf prevalence was estimated from screenings conducted in 49 villages participating in a malaria control program, and four retrospective mortality cluster surveys encompassing a sampling frame of more than 220,000. Crude odds ratios were calculated to evaluate Pf prevalence by age, sex, and dry vs. rainy season. Results9,796 rapid tests were performed among 28,410 villagers in malaria program areas through four years (2003: 8.4%, 95% CI: 8.3 – 8.6; 2004: 7.1%, 95% CI: 6.9 – 7.3; 2005:10.5%, 95% CI: 9.3 – 11.8 and 2006: 9.3%, 95% CI: 8.2 – 10.6). Children under 5 (OR = 1.99; 95% CI: 1.93 – 2.06) and those 5 to 14 years (OR = 2.24, 95% CI: 2.18 – 2.29) were more likely to be positive than adults. Prevalence was slightly higher among females (OR = 1.04, 95% CI: 1.02 – 1.06) and in the rainy season (OR = 1.48, 95% CI: 1.16 – 1.88). Among 5,538 rapid tests conducted in four cluster surveys, 10.2% were positive (range 6.3%, 95% CI: 3.9 – 8.8; to 12.4%, 95% CI: 9.4 – 15.4). ConclusionPrevalence of plasmodium falciparum in conflict areas of eastern Burma is higher than rates reported among populations in neighboring Thailand, particularly among children. This population serves as a large reservoir of infection that contributes to a high disease burden within Burma and likely constitutes a source of infection for neighboring regions. |



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