title: The practice of jhum cultivation and its relationship to Plasmodium falciparum infection in the Chittagong Hill Districts of Bangladesh.
abstract: Malaria is endemic in the Chittagong Hill Districts of southeastern Bangladesh. Previous epidemiological analyses identified the agricultural practice of jhum cultivation as a potential risk factor for malaria infection. We conducted qualitative interviews with jhum cultivators and surveillance workers to describe jhum cultivation and used demographic and malaria surveillance in two study unions from May of 2010 to August of 2012 to better understand the relationship between jhum cultivation and malaria infection. Qualitative interviews revealed that jhum cultivation is conducted on remote, steep hillsides by ethnic tribal groups. Quantitative analyses found that adult jhum cultivators and individuals who live in the same residence had significantly higher incidence rates of symptomatic Plasmodium falciparum infection compared with non-cultivators. These results confirm that jhum cultivation is an independent risk factor for malaria infection and underscore the need for malaria testing and treatment services to reach remote populations in the Chittagong Hill Districts.
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Sean R
authors.initials: SR
authors.lastname: Galagan
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Chai Shwai
authors.initials: CS
authors.lastname: Prue
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Jacob
authors.initials: J
authors.lastname: Khyang
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Wasif Ali
authors.initials: WA
authors.lastname: Khan
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Sabeena
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Malathi
authors.initials: M
authors.lastname: Ram
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Mohammad Shafiul
authors.initials: MS
authors.lastname: Alam
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: M Zahirul
authors.initials: MZ
authors.lastname: Haq
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Akter
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Peter Kim
authors.initials: PK
authors.lastname: Streatfield
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Gregory
authors.initials: G
authors.lastname: Glass
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Norris
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Myaing Myaing
authors.initials: MM
authors.lastname: Nyunt
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Timothy
authors.initials: T
authors.lastname: Shields
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: David J
authors.initials: DJ
authors.lastname: Sullivan
authors.affiliation: Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh dsack@jhsph.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Sack
mesh_terms: D000293:Adolescent; D000383:Agriculture / Q000379:methods*; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires