title: The epidemiology of malaria in the Papua New Guinea highlands: 5. Aseki, Menyamya and Wau-Bulolo, Morobe Province.
abstract: Although not strictly a highlands province, Morobe encompasses large highlands areas, the most important being Aseki, Menyamya and Wau-Bulolo. A series of rapid malaria surveys conducted in both the wet and dry seasons found malaria to be clearly endemic in areas below 1400 m in Menyamya and Wau-Bulolo, with overall prevalence rates in the wet season (25.5%, range: 9.1%-39.2%) greatly exceeding those in the dry season (8.3%, range: 2.4%-22.8%; p < 0.001). In the wet season surveys Plasmodium falciparum was the clearly predominant species, accounting for 63% of all infections. P. vivax increased in frequency in the dry season (from 27% to 46%, p < 0.001), while P. falciparum and P. malariae decreased. In line with past surveys a low prevalence of malaria was found in the Aseki area. Malaria was found to be the main source of febrile illness in the wet season with at least 60% of measured or reported fever associated with parasitaemia. Other causes of febrile illness dominated in the dry. In villages with parasite prevalence rates < 20% mean haemoglobin levels and prevalence of severe anaemia were strongly correlated with overall parasite prevalence. In addition concurrent malarial infections were associated with a strong reduction of individual haemoglobin levels (-1.2 g/dl) and there was increased risk of moderate-to-severe anaemia with concurrent malaria. Malarial infections are thus the most significant cause of febrile illness and anaemia in the highlands fringe populations in Morobe. As a consequence all villages below 1500-1600 m in Morobe Province should be included in malaria control activities.
authors: Papua New Guinea Institute of Medical Research, Goroka.
authors: Ivo
authors: I
authors: Mueller
authors: Albert
authors: A
authors: Sie
authors: Moses
authors: M
authors: Ousari
authors: Jonah
authors: J
authors: Iga
authors: Simon
authors: S
authors: Yala
authors: Rex
authors: R
authors: Ivivi
authors: John C
authors: JC
authors: Reeder
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D010219:Papua New Guinea / Q000453:epidemiology; D018512:Parasitemia / Q000453:epidemiology; D010965:Plasmodium malariae / Q000302:isolation & purification; D011159:Population Surveillance; D015995:Prevalence; D012621:Seasons; D055815:Young Adult