title: Malaria epidemiology in Lihir Island, Papua New Guinea.
abstract: BACKGROUND
  Plasmodium vivax and Plasmodium falciparum malaria remain highly endemic in the Pacific Islands including Lihir Island, Papua New Guinea. Lihir Gold Limited is conducting mining activities and funded an integrated vector control intervention within the villages surrounding the mine. The aim of this study was to assess the impact of such programme by comparing the epidemiological trends of malaria in different parts of the island.
  
  
  METHODS
  Two cross-sectional surveys were conducted before and after the intervention (2006-2010) to determine malaria prevalence in mine-impact (MI) and non-MI areas. Incidence of malaria was estimated for the Lihir Medical Centre catchment area using island population denominators and a health-centre passive case detection ongoing from 2006-2011.
  
  
  RESULTS
  A total of 2,264 and 1,653 children < 15 were surveyed in the cross-sectional studies. The prevalence of any malaria parasitaemia initially was 31.5% in MI areas and, 34.9% in non-MI (POR 1.17; 95 CI 0.97 - 1.39). After four years there was a significant reduction in prevalence in the MI areas (5.8%; POR 0.13, 95 CI 0.09-0.20), but reduction was less marked in non-MI areas (26.9%; POR 0.69, 95 CI 0.58-0.81).28,747 patients were included in the evaluation of incidence trends and overall malaria in local Lihirian population in MI areas declined over time, while it remained at similar high levels among migrants. The age-incidence analysis showed that for each higher age range the malaria incidence declines compared to that of the previous stratum.
  
  
  CONCLUSIONS
  There was a substantial reduction in prevalence and incidence rates of both P. vivax and P. falciparum in the mining area following implementation of a malaria control intervention, which was not seen in the area outside the mining activities.
authors.affiliation: Department of Medicine, Lihir Medical Center, PO Box 34, Lihir Island, NIP, Papua New Guinea. oriolmitja@hotmail.com
authors.forename: Oriol
authors.initials: O
authors.lastname: Mitjà
authors.forename: Raymond
authors.initials: R
authors.lastname: Paru
authors.forename: Billy
authors.initials: B
authors.lastname: Selve
authors.forename: Inoni
authors.initials: I
authors.lastname: Betuela
authors.forename: Peter
authors.initials: P
authors.lastname: Siba
authors.forename: Elisa
authors.initials: E
authors.lastname: De Lazzari
authors.forename: Quique
authors.initials: Q
authors.lastname: Bassat
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D009032:Mosquito Control / Q000379:methods*; D010219:Papua New Guinea / Q000453:epidemiology; D015995:Prevalence; D019371:Topography, Medical; D055815:Young Adult