title: Geographic information system (GIS) maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos.
abstract: BACKGROUND
  Insecticide-treated nets (ITNs) are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations.
  
  
  METHODS
  Geographic information system (GIS) maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs) and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey.
  
  
  RESULTS
  As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower.
  
  
  CONCLUSIONS
  Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province.
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Japan. iruka_jp@m.u-tokyo.ac.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Shirayama
authors.forename: Samlane
authors.initials: S
authors.lastname: Phompida
authors.forename: Kenji
authors.initials: K
authors.lastname: Shibuya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D040362:Geographic Information Systems; D005843:Geography; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007812:Laos / Q000453:epidemiology; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods*; D011482:Protective Devices / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult