title: Malaria ecology along the Thailand-Myanmar border.
abstract: BACKGROUND
  Malaria in Southeast Asia frequently clusters along international borders. For example, while most of Thailand is malaria free, the border region shared with Myanmar continues to have endemic malaria. This spatial pattern is the result of complex interactions between landscape, humans, mosquito vectors, and malaria parasites. An understanding of these complex ecological and socio-cultural interactions is important for designing and implementing malaria elimination efforts in the region. This article offers an ecological perspective on the malaria situation along the Thailand-Myanmar border.
  
  
  CONCLUSIONS
  This border region is long (2000 km), mountainous, and the environment ranges from thick forests to growing urban settlements and wet-rice fields. It is also a biologically diverse region. All five species of malaria known to naturally infect humans are present. At least three mosquito vector species complexes, with widely varying behavioural characteristics, exist in the area. The region is also a hub for ethnic diversity, being home to over ten different ethnolinguistic groups, several of which have been engaged in conflict with the Myanmar government now for over half a century. Given the biological and ethnic diversity, as well as the complex socio-political context, malaria control and elimination in the region is challenging.
  
  
  CONCLUSIONS
  Despite these complexities, multipronged approaches including collaborations with multiple local organizations, quick access to diagnosis and treatment, prevention of mosquito bites, radical cure of parasites, and mass drug administration appear to be drastically decreasing Plasmodium falciparum infections. Such approaches remain crucial as the region moves toward elimination of P. falciparum and potentially Plasmodium vivax.
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand. daniel@shoklo-unit.com.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Parker
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand. verena@shoklo-unit.com.
authors.forename: Verena I
authors.initials: VI
authors.lastname: Carrara
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. sasithon.puk@mahidol.ac.th.
authors.forename: Sasithon
authors.initials: S
authors.lastname: Pukrittayakamee
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand. rose@shoklo-unit.com.|Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK. rose@shoklo-unit.com.
authors.forename: Rose
authors.initials: R
authors.lastname: McGready
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand. francois@tropmedres.ac.|Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK. francois@tropmedres.ac.
authors.forename: François H
authors.initials: FH
authors.lastname: Nosten
mesh_terms: D000818:Animals; D009033:Culicidae / Q000254:growth & development*; D017753:Ecosystem; D005006:Ethnicity; D005843:Geography; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology*; D016780:Malaria, Vivax / Q000188:drug therapy / Q000453:epidemiology*; D002052:Myanmar; D012275:Oryza / Q000254:growth & development*; D012959:Socioeconomic Factors; D013785:Thailand