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Spatio-temporal patterns of malaria infection in Bhutan: a country embarking on malaria elimination.

Wangdi K, Kaewkungwal J, Singhasivanon P, Silawan T, Lawpoolsri S, White NJ - Malar. J. (2011)

Bottom Line: Trend of the overall districts and most of the endemic districts have decreased except Pemagatshel, which has an increase in the trend.Clusters extended to the non-transmission areas in the eastern Bhutan.The decrease in the trend can be attributed to the success of the control and preventive measures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. dockinley@gmail.com

ABSTRACT

Background: At the verge of elimination of malaria in Bhutan, this study was carried out to analyse the trend of malaria in the endemic districts of Bhutan and to identify malaria clusters at the sub-districts. The findings would aid in implementing the control activities. Poisson regression was performed to study the trend of malaria incidences at district level from 1994 to 2008. Spatial Empirical Bayesian smoothing was deployed to identify clusters of malaria at the sub-district level from 2004 to 2008.

Results: Trend of the overall districts and most of the endemic districts have decreased except Pemagatshel, which has an increase in the trend. Spatial cluster-outlier analysis showed that malaria clusters were mostly concentrated in the central and eastern Bhutan in three districts of Dagana, Samdrup Jongkhar and Sarpang. The disease clusters were reported throughout the year. Clusters extended to the non-transmission areas in the eastern Bhutan.

Conclusions: There is significant decrease in the trend of malaria with the elimination at the sight. The decrease in the trend can be attributed to the success of the control and preventive measures. In order to realize the target of elimination of malaria, the control measure needs to be prioritized in these high-risk clusters of malaria.

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Related in: MedlinePlus

Malaria clusters of the sub-districts of the endemic districts of Bhutan from 2004 to 2008. Colour codes: Red = high-high, Dark blue = low-low, Light blue = low-high, Pink = high-low
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Figure 2: Malaria clusters of the sub-districts of the endemic districts of Bhutan from 2004 to 2008. Colour codes: Red = high-high, Dark blue = low-low, Light blue = low-high, Pink = high-low

Mentions: Mapping of malaria clusters at the sub-districts of the seven endemic districts showed that the clusters of malaria were confined to the central and eastern part of Bhutan (Figure 2). For the month of January, clusters were reported from different sub-districts of the country for 2004, but malaria clusters started to be confided to the central and eastern part for the rest of the study period. In February and March, clusters for 2004 and 2006 occurred in the central part while malaria clusters for 2007 and 2008 occurred in the eastern sub-districts. From 2006 to 2008, clusters were located at the central and eastern Bhutan for April month. In May and June, malaria clusters became more pronounced in eastern Bhutan. Malaria clusters for July remained same as the previous month and extended to the central region. The clusters for August of the eastern region decreased while in the central region increased over the five years. In September, malaria clusters returned to the eastern sub-districts with further increase to the neighbouring sub-districts and into the central region for the rest of the months (Figure 2).


Spatio-temporal patterns of malaria infection in Bhutan: a country embarking on malaria elimination.

Wangdi K, Kaewkungwal J, Singhasivanon P, Silawan T, Lawpoolsri S, White NJ - Malar. J. (2011)

Malaria clusters of the sub-districts of the endemic districts of Bhutan from 2004 to 2008. Colour codes: Red = high-high, Dark blue = low-low, Light blue = low-high, Pink = high-low
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3094227&req=5

Figure 2: Malaria clusters of the sub-districts of the endemic districts of Bhutan from 2004 to 2008. Colour codes: Red = high-high, Dark blue = low-low, Light blue = low-high, Pink = high-low
Mentions: Mapping of malaria clusters at the sub-districts of the seven endemic districts showed that the clusters of malaria were confined to the central and eastern part of Bhutan (Figure 2). For the month of January, clusters were reported from different sub-districts of the country for 2004, but malaria clusters started to be confided to the central and eastern part for the rest of the study period. In February and March, clusters for 2004 and 2006 occurred in the central part while malaria clusters for 2007 and 2008 occurred in the eastern sub-districts. From 2006 to 2008, clusters were located at the central and eastern Bhutan for April month. In May and June, malaria clusters became more pronounced in eastern Bhutan. Malaria clusters for July remained same as the previous month and extended to the central region. The clusters for August of the eastern region decreased while in the central region increased over the five years. In September, malaria clusters returned to the eastern sub-districts with further increase to the neighbouring sub-districts and into the central region for the rest of the months (Figure 2).

Bottom Line: Trend of the overall districts and most of the endemic districts have decreased except Pemagatshel, which has an increase in the trend.Clusters extended to the non-transmission areas in the eastern Bhutan.The decrease in the trend can be attributed to the success of the control and preventive measures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. dockinley@gmail.com

ABSTRACT

Background: At the verge of elimination of malaria in Bhutan, this study was carried out to analyse the trend of malaria in the endemic districts of Bhutan and to identify malaria clusters at the sub-districts. The findings would aid in implementing the control activities. Poisson regression was performed to study the trend of malaria incidences at district level from 1994 to 2008. Spatial Empirical Bayesian smoothing was deployed to identify clusters of malaria at the sub-district level from 2004 to 2008.

Results: Trend of the overall districts and most of the endemic districts have decreased except Pemagatshel, which has an increase in the trend. Spatial cluster-outlier analysis showed that malaria clusters were mostly concentrated in the central and eastern Bhutan in three districts of Dagana, Samdrup Jongkhar and Sarpang. The disease clusters were reported throughout the year. Clusters extended to the non-transmission areas in the eastern Bhutan.

Conclusions: There is significant decrease in the trend of malaria with the elimination at the sight. The decrease in the trend can be attributed to the success of the control and preventive measures. In order to realize the target of elimination of malaria, the control measure needs to be prioritized in these high-risk clusters of malaria.

Show MeSH
Related in: MedlinePlus