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Title
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Households or hotspots? Defining intervention targets for malaria elimination in Ratanakiri Province, Eastern Cambodia
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Author
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Abstract
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| Background. Malaria "hotspots" have been proposed as potential intervention units for targeted malaria elimination. Little is known about hotspot formation and stability in settings outside sub-Saharan Africa. Methods. Clustering of Plasmodium infections at the household and hotspot level was assessed over 2 years in 3 villages in eastern Cambodia. Social and spatial autocorrelation statistics were calculated to assess clustering of malaria risk, and logistic regression was used to assess the effect of living in a malaria hotspot compared to living in a malaria-positive household in the first year of the study on risk of malaria infection in the second year. Results. The crude prevalence of Plasmodium infection was 8.4% in 2016 and 3.6% in 2017. Living in a hotspot in 2016 did not predict Plasmodium risk at the individual or household level in 2017 overall, but living in a Plasmodium-positive household in 2016 strongly predicted living in a Plasmodium-positive household in 2017 (Risk Ratio, 5.00 [95% confidence interval, 2.09-11.96], P < .0001). There was no consistent evidence that malaria risk clustered in groups of socially connected individuals from different households. Conclusions. Malaria risk clustered more clearly in households than in hotspots over 2 years. Household-based strategies should be prioritized in malaria elimination programs in this region. |
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Language
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English
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Source (journal)
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The journal of infectious diseases. - Chicago, Ill.
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Publication
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Chicago, Ill.
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2019
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ISSN
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0022-1899
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DOI
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10.1093/INFDIS/JIZ211
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Volume/pages
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220
:6
(2019)
, p. 1034-1043
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ISI
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000490985400015
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Pubmed ID
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31028393
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Full text (Publisher's DOI)
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Full text (open access)
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