Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection.
Malaria incidence in Myanmar has significantly reduced over recent years, however, completeness and timeliness of incidence data remain a challenge. The first ever nationwide malaria infection and seroprevalence survey was conducted in Myanmar in 2015 to better understand malaria epidemiology and hi...
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2021
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oai:doaj.org-article:cccb5186ce5f49678c589d5b4dd580332021-12-02T20:10:51ZPrevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection.1932-620310.1371/journal.pone.0252957https://doaj.org/article/cccb5186ce5f49678c589d5b4dd580332021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252957https://doaj.org/toc/1932-6203Malaria incidence in Myanmar has significantly reduced over recent years, however, completeness and timeliness of incidence data remain a challenge. The first ever nationwide malaria infection and seroprevalence survey was conducted in Myanmar in 2015 to better understand malaria epidemiology and highlight gaps in Annual Parasite Index (API) data. The survey was a cross-sectional two-stage stratified cluster-randomised household survey conducted from July-October 2015. Blood samples were collected from household members for ultra-sensitive PCR and serology testing for P. falciparum and P. vivax. Data was gathered on demography and a priori risk factors of participants. Data was analysed nationally and within each of four domains defined by API data. Prevalence and seroprevalence of malaria were 0.74% and 16.01% nationwide, respectively. Prevalent infection was primarily asymptomatic P. vivax, while P. falciparum was predominant in serology. There was large heterogeneity between villages and by domain. At the township level, API showed moderate correlation with P. falciparum seroprevalence. Risk factors for infection included socioeconomic status, domain, and household ownership of nets. Three K13 P. falciparum mutants were found in highly prevalent villages. There results highlight high heterogeneity of both P. falciparum and P. vivax transmission between villages, accentuated by a large hidden reservoir of asymptomatic P. vivax infection not captured by incidence data, and representing challenges for malaria elimination. Village-level surveillance and stratification to guide interventions to suit local context and targeting of transmission foci with evidence of drug resistance would aid elimination efforts.Hannah M EdwardsRuth DixonCeline Zegers de BeylOlivier CelhayMousumi RahmanMoe Myint OoThandar LwinZaw LinThiri SanKay Thwe HanMyaing Myaing NyuntChristopher PloweGillian StresmanTom HallChris DrakeleyPrudence HamadeSiddhi AryalArantxa Roca-FeltrerThaung HlaingAung ThiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252957 (2021) |
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EN |
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Medicine R Science Q |
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Medicine R Science Q Hannah M Edwards Ruth Dixon Celine Zegers de Beyl Olivier Celhay Mousumi Rahman Moe Myint Oo Thandar Lwin Zaw Lin Thiri San Kay Thwe Han Myaing Myaing Nyunt Christopher Plowe Gillian Stresman Tom Hall Chris Drakeley Prudence Hamade Siddhi Aryal Arantxa Roca-Feltrer Thaung Hlaing Aung Thi Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| description |
Malaria incidence in Myanmar has significantly reduced over recent years, however, completeness and timeliness of incidence data remain a challenge. The first ever nationwide malaria infection and seroprevalence survey was conducted in Myanmar in 2015 to better understand malaria epidemiology and highlight gaps in Annual Parasite Index (API) data. The survey was a cross-sectional two-stage stratified cluster-randomised household survey conducted from July-October 2015. Blood samples were collected from household members for ultra-sensitive PCR and serology testing for P. falciparum and P. vivax. Data was gathered on demography and a priori risk factors of participants. Data was analysed nationally and within each of four domains defined by API data. Prevalence and seroprevalence of malaria were 0.74% and 16.01% nationwide, respectively. Prevalent infection was primarily asymptomatic P. vivax, while P. falciparum was predominant in serology. There was large heterogeneity between villages and by domain. At the township level, API showed moderate correlation with P. falciparum seroprevalence. Risk factors for infection included socioeconomic status, domain, and household ownership of nets. Three K13 P. falciparum mutants were found in highly prevalent villages. There results highlight high heterogeneity of both P. falciparum and P. vivax transmission between villages, accentuated by a large hidden reservoir of asymptomatic P. vivax infection not captured by incidence data, and representing challenges for malaria elimination. Village-level surveillance and stratification to guide interventions to suit local context and targeting of transmission foci with evidence of drug resistance would aid elimination efforts. |
| format |
article |
| author |
Hannah M Edwards Ruth Dixon Celine Zegers de Beyl Olivier Celhay Mousumi Rahman Moe Myint Oo Thandar Lwin Zaw Lin Thiri San Kay Thwe Han Myaing Myaing Nyunt Christopher Plowe Gillian Stresman Tom Hall Chris Drakeley Prudence Hamade Siddhi Aryal Arantxa Roca-Feltrer Thaung Hlaing Aung Thi |
| author_facet |
Hannah M Edwards Ruth Dixon Celine Zegers de Beyl Olivier Celhay Mousumi Rahman Moe Myint Oo Thandar Lwin Zaw Lin Thiri San Kay Thwe Han Myaing Myaing Nyunt Christopher Plowe Gillian Stresman Tom Hall Chris Drakeley Prudence Hamade Siddhi Aryal Arantxa Roca-Feltrer Thaung Hlaing Aung Thi |
| author_sort |
Hannah M Edwards |
| title |
Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| title_short |
Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| title_full |
Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| title_fullStr |
Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| title_full_unstemmed |
Prevalence and seroprevalence of Plasmodium infection in Myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| title_sort |
prevalence and seroprevalence of plasmodium infection in myanmar reveals highly heterogeneous transmission and a large hidden reservoir of infection. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/cccb5186ce5f49678c589d5b4dd58033 |
| work_keys_str_mv |
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