Poster Presentation First Malaria World Congress 2018

Risk factors associated with malaria infection among patients who seek health care through the public and community sectors in malaria endemic townships of ayeyarwady region myanmar (#427)

Dr. Myat Min Tun 1 , Dr, Aung Thi 1 , Dr. May Thin Ko 1 , Christopher Lourenco 2 , Nang Aung 2 , Moe Moe Aye 2 , Jillian Dunning 2
  1. National Malaria Control Programme (NMCP), Yangon, Myanmar
  2. Clinton Health Access Initiative, Boston, MA, United States

Malaria cases in Ayeyarwady, a delta region in the southwest of Myanmar, have decreased by 86% from 2011 to 2016, but exposure to forested areas may pose an obstacle to continued decline. Out of 26 total townships in the region, Ngaputaw, Pathein, and Thabaung represent 74.4% of the total confirmed cases in 2017(n=2,024). Despite this geographic concentration of cases and perceived link between forest exposure and malaria, limitations of surveillance data prevent a thorough understanding of the risks for contracting malaria in this region. A case control study was conducted to ascertain forest travel patterns and use of preventive methods and to evaluate the influence of these behavioral and occupational patterns on risk of malaria infection. Patients consulting for fever > 38 C and tested with a rapid diagnostic test (RDT) for malaria were recruited from September 2017 to April 2018 by staff at 17 health facilities and by 24 village health volunteers in the three highest endemic townships. Information was collected including demographics, geolocation of participant home villages, forest travel patterns, and use of preventive methods. A total of 1,465 individuals were sampled with 98 positive cases. The  relationship  between  sleeping in forested areas  overnight and  confirmed  malaria  was observed to be a significant risk factor for malaria infection, with an OR of 3.18 (95% CI 1.71, 6.37). Reported ownership of bednets was high but use in the forest was not significantly different between cases and controls, with an OR of 0.96 (95% CI 0.57, 1.69). This study identified critical areas of high malaria burden and provided evidence that extended time in forested areas contributes to malaria risk. Further exploration of risk around forest worksites should include a focus on extended stays, specific occupations, and travel patterns to optimize interventions.