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Spatial clustering and risk factors of malaria infections in Ratanakiri Province, Cambodia

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dc.contributor.author Sluydts, V.
dc.contributor.author Heng, S.
dc.contributor.author Coosemans, M.
dc.contributor.author Van Roey, K.
dc.contributor.author Gryseels, C.
dc.contributor.author Canier, L.
dc.contributor.author Kim, S.
dc.contributor.author Khim, N.
dc.contributor.author Siv, S.
dc.contributor.author Mean, V.
dc.contributor.author Uk, S.
dc.contributor.author Peeters Grietens, K.
dc.contributor.author Tho, S.
dc.contributor.author Menard, D.
dc.contributor.author Durnez, L.
dc.date.accessioned 2015-02-17T15:41:31Z
dc.date.available 2015-02-17T15:41:31Z
dc.date.issued 2014
dc.identifier.issn 1475-2875
dc.identifier.doi http://dx.doi.org/10.1186/1475-2875-13-387
dc.identifier.other ITG-B1B
dc.identifier.other ITG-B3A
dc.identifier.other ITG-B4B
dc.identifier.other ITG-B5B
dc.identifier.other ITG-H12A
dc.identifier.other ITG-BLB
dc.identifier.other MULTI
dc.identifier.other DBM
dc.identifier.other U-MALAR
dc.identifier.other U-ENTOM
dc.identifier.other DPH
dc.identifier.other U-ECMAL
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other URL
dc.identifier.other OAJ
dc.identifier.other Abstract
dc.identifier.other UPD57
dc.identifier.uri http://hdl.handle.net/10390/8284
dc.description.abstract BACKGROUND: Malaria incidence worldwide has steadily declined over the past decades. Consequently, increasingly more countries will proceed from control to elimination. The malaria distribution in low incidence settings appears patchy, and local transmission hotspots are a continuous source of infection. In this study, species-specific clusters and associated risk factors were identified based on malaria prevalence data collected in the north-east of Cambodia. In addition, Plasmodium falciparum genetic diversity, population structure and gene flows were studied. METHOD: In 2012, blood samples from 5793 randomly selected individuals living in 117 villages were collected from Ratanakiri province, Cambodia. Malariometric data of each participant were simultaneously accumulated using a standard questionnaire. A two-step PCR allowed for species-specific detection of malaria parasites, and SNP-genotyping of P. falciparum was performed. SaTScan was used to determine species-specific areas of elevated risk to infection, and univariate and multivariate risk analyses were carried out. RESULT: PCR diagnosis found 368 positive individuals (6.4%) for malaria parasites, of which 22% contained mixed species infections. The occurrence of these co-infections was more frequent than expected. Specific areas with elevated risk of infection were detected for all Plasmodium species. The clusters for Falciparum, Vivax and Ovale malaria appeared in the north of the province along the main river, while the cluster for Malariae malaria was situated elsewhere. The relative risk to be a malaria parasite carrier within clusters along the river was twice that outside the area. The main risk factor associated with three out of four malaria species was overnight stay in the plot hut, a human behaviour associated with indigenous farming. Haplotypes did not show clear geographical population structure, but pairwise Fst value comparison indicated higher parasite flow along the river. DISCUSSION: Spatial aggregation of malaria parasite carriers, and the identification of malaria species-specific risk factors provide key insights in malaria epidemiology in low transmission settings, which can guide targeted supplementary interventions. Consequently, future malaria programmes in the province should implement additional specific policies targeting households staying overnight at their farms outside the village, in addition to migrants and forest workers. en_US
dc.language English en_US
dc.subject Protozoal diseases en_US
dc.subject Malaria en_US
dc.subject Plasmodium falciparum en_US
dc.subject Plasmodium vivax en_US
dc.subject Plasmodium ovale en_US
dc.subject Vectors en_US
dc.subject Mosquitoes en_US
dc.subject Anopheles en_US
dc.subject Epidemiology en_US
dc.subject Prevalence en_US
dc.subject Risk factors en_US
dc.subject Spatial analysis en_US
dc.subject Clustering en_US
dc.subject Co-infections en_US
dc.subject Carriers en_US
dc.subject Water contact en_US
dc.subject Geographical variation en_US
dc.subject Cambodia en_US
dc.subject Asia, Southeast en_US
dc.title Spatial clustering and risk factors of malaria infections in Ratanakiri Province, Cambodia en_US
dc.type Article-E en_US
dc.citation.issue 387 en_US
dc.citation.jtitle Malaria Journal en_US
dc.citation.volume 13 en_US
dc.citation.pages 1-12 en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/25269827
dc.citation.jabbreviation Malar J en_US


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