title: Risk factors for border malaria in a malaria elimination setting: a retrospective case-control study in Yunnan, China.
abstract: A retrospective case-control study was conducted to identify risk factors for border malaria in a malaria elimination setting of Yunnan Province, China. The study comprised 214 cases and 428 controls. The controls were individually matched to the cases on the basis of residence, age, and gender. In addition, statistical associations are based on matched analyses. The frequencies of imported, male, adult, and vivax malaria cases were respectively 201 (93.9%), 194 (90.7%), 210 (98.1%), and 176 (82.2%). Overnight stay in Myanmar within the prior month was independently associated with malaria infection (odds ratio [OR] 159.5, 95% confidence interval [CI] 75.1-338.9). In particular, stays in lowland and foothill (OR 5.5, 95% CI 2.5-11.8) or mid-hill (OR 42.8, 95% CI 5.1-319.8) areas, or near streamlets (OR 15.3, 95% CI 4.3-55.2) or paddy field or pools (OR10.1, 95% CI 4.4-55.8) were found to be independently associated with malaria. Neither forest exposure nor use of vector control measures was associated with malaria. In conclusion, travel to lowland and foothill or mid-hill hyperendemic areas, especially along the waterside in Myanmar, was found to be the highest risk factor for malaria. In considering the limitations of the study, further investigations are needed to identify the major determinants of malaria risk and develop new strategies for malaria elimination on China-Myanmar border.
authors.affiliation: Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Xu
authors.affiliation: Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China liubible@126.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China.
authors.forename: Xiang-Rui
authors.initials: XR
authors.lastname: Guo
authors.affiliation: Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China.
authors.forename: Jia-Zhi
authors.initials: JZ
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002160:Cambodia / Q000453:epidemiology; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D006798:Housing; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D002052:Myanmar / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult