title: Seasonal dynamics and microgeographical spatial heterogeneity of malaria along the China-Myanmar border.
abstract: Malaria transmission is heterogeneous in the Greater Mekong Subregion with most of the cases occurring along international borders. Knowledge of transmission hotspots is essential for targeted malaria control and elimination in this region. This study aimed to determine the dynamics of malaria transmission and possible existence of transmission hotspots on a microgeographical scale along the China-Myanmar border. Microscopically confirmed clinical malaria cases were recorded in five border villages through a recently established surveillance system between January 2011 and December 2014. A total of 424 clinical cases with confirmed spatial and temporal information were analyzed, of which 330 (77.8%) were Plasmodium vivax and 88 (20.8%) were Plasmodium falciparum, respectively. The P. vivax and P. falciparum case ratio increased dramatically from 2.2 in 2011 to 4.7 in 2014, demonstrating that P. vivax malaria has become the predominant parasite species. Clinical infections showed a strong bimodal seasonality. There were significant differences in monthly average incidence rates among the study villages with rates in a village in China being 3-8 folds lower than those in nearby villages in Myanmar. Spatial analysis revealed the presence of clinical malaria hotspots in four villages. This information on malaria seasonal dynamics and transmission hotspots should be harnessed for planning targeted control.
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.|Department of Pathology, Kunming Medical University, Kunming, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Program in Public Health, University of California at Irvine, Irvine, CA, USA.
authors.forename: Guofa
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Kunming Medical University, Kunming, China.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Ruan
authors.affiliation: Program in Public Health, University of California at Irvine, Irvine, CA, USA.
authors.forename: Ming-Chieh
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Pathology, Kunming Medical University, Kunming, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Deng
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Eukaryotic Pathogens Innovation Center, Department of Genetics and Biochemistry, Clemson University, SC, USA.
authors.forename: James
authors.initials: J
authors.lastname: Morris
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
authors.forename: Huaie
authors.initials: H
authors.lastname: Liu
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Dalian Institute of Biotechnology, Dalian, Liaoning, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Fan
authors.affiliation: Dalian Institute of Biotechnology, Dalian, Liaoning, China.
authors.forename: Peipei
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
authors.forename: Yanrui
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
authors.forename: Zhaoqing
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Program in Public Health, University of California at Irvine, Irvine, CA, USA.
authors.forename: Guiyun
authors.initials: G
authors.lastname: Yan
authors.affiliation: Department of Entomology, The Pennsylvania State University, University Park, PA 16802, USA.
authors.forename: Liwang
authors.initials: L
authors.lastname: Cui
mesh_terms: D002681:China / Q000453:epidemiology; D005843:Geography; D006801:Humans; D015994:Incidence; D008288:Malaria / Q000453:epidemiology / Q000469:parasitology* / Q000635:transmission*; D002052:Myanmar / Q000453:epidemiology; D012621:Seasons
keywords: China–Myanmar border; Clinical malaria; Hotspot; Seasonality
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