title: Characterizing Types of Human Mobility to Inform Differential and Targeted Malaria Elimination Strategies in Northeast Cambodia.
abstract: Human population movements currently challenge malaria elimination in low transmission foci in the Greater Mekong Subregion. Using a mixed-methods design, combining ethnography (n = 410 interviews), malariometric data (n = 4996) and population surveys (n = 824 indigenous populations; n = 704 Khmer migrants) malaria vulnerability among different types of mobile populations was researched in the remote province of Ratanakiri, Cambodia. Different structural types of human mobility were identified, showing differential risk and vulnerability. Among local indigenous populations, access to malaria testing and treatment through the VMW-system and LLIN coverage was high but control strategies failed to account for forest farmers' prolonged stays at forest farms/fields (61% during rainy season), increasing their exposure (p = 0.002). The Khmer migrants, with low acquired immunity, active on plantations and mines, represented a fundamentally different group not reached by LLIN-distribution campaigns since they were largely unregistered (79%) and unaware of the local VMW-system (95%) due to poor social integration. Khmer migrants therefore require control strategies including active detection, registration and immediate access to malaria prevention and control tools from which they are currently excluded. In conclusion, different types of mobility require different malaria elimination strategies. Targeting mobility without an in-depth understanding of malaria risk in each group challenges further progress towards elimination.
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.|School of International Health Development, Nagasaki University, Nagasaki, Japan.|Partners for Applied Social Sciences (PASS) International, Tessenderlo, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Peeters Grietens
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gryseels
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Susan
authors.initials: S
authors.lastname: Dierickx
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Melanie
authors.initials: M
authors.lastname: Bannister-Tyrrell
authors.affiliation: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Suzan
authors.initials: S
authors.lastname: Trienekens
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Sambunny
authors.initials: S
authors.lastname: Uk
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Pisen
authors.initials: P
authors.lastname: Phoeuk
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Sokha
authors.initials: S
authors.lastname: Suon
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Srun
authors.initials: S
authors.lastname: Set
authors.affiliation: Amsterdam Institute for Social Science Research, Amsterdam, The Netherlands.
authors.forename: René
authors.initials: R
authors.lastname: Gerrets
authors.affiliation: Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hoibak
authors.affiliation: Partners for Applied Social Sciences (PASS) International, Tessenderlo, Belgium.
authors.forename: Joan
authors.initials: J
authors.lastname: Muela Ribera
authors.affiliation: Partners for Applied Social Sciences (PASS) International, Tessenderlo, Belgium.
authors.forename: Susanna
authors.initials: S
authors.lastname: Hausmann-Muela
authors.affiliation: National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Sochantha
authors.initials: S
authors.lastname: Tho
authors.affiliation: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Durnez
authors.affiliation: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Sluydts
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.|Medical Research Council, Fajara, The Gambia.|London School of Tropical Medicine and Hygiene, London, UK.
authors.forename: Umberto
authors.initials: U
authors.lastname: d'Alessandro
authors.affiliation: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Coosemans
authors.affiliation: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Annette
authors.initials: A
authors.lastname: Erhart
mesh_terms: D000818:Animals; D000852:Anopheles / Q000469:parasitology*; D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000627:therapeutic use; D000077332:Artesunate; D002160:Cambodia; D002738:Chloroquine / Q000627:therapeutic use; D060740:Disease Eradication / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology*; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D016780:Malaria, Vivax / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D015767:Mefloquine / Q000627:therapeutic use; D010963:Plasmodium falciparum / Q000187:drug effects / Q000254:growth & development; D010966:Plasmodium vivax / Q000187:drug effects / Q000254:growth & development; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D002738:Chloroquine; D015767:Mefloquine