Investigating differences in village-level heterogeneity of malaria infection and household risk factors in Papua New Guinea

Gul, Desmond, Rodríguez‑Rodríguez, Daniela, Nate, Elma, Auwan, Alma, Salib, Mary, Lorry, Lina, Keven, John B., Katusele, Michelle, Rosado, Jason, Hofmann, Natalie, Ome-Kaise, Maria, Koepfli, Cristian, Felger, Ingrid, Kazura, James W., Hetzel, Manuel W., Mueller, Ivo, Karl, Stephan, Clements, Archie C.A., Fowkes, Freya J.I., Laman, Moses, and Robinson, Leanne J. (2021) Investigating differences in village-level heterogeneity of malaria infection and household risk factors in Papua New Guinea. Scientific Reports, 11. 16540.

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Malaria risk is highly heterogeneous. Understanding village and household-level spatial heterogeneity of malaria risk can support a transition to spatially targeted interventions for malaria elimination. This analysis uses data from cross-sectional prevalence surveys conducted in 2014 and 2016 in two villages (Megiar and Mirap) in Papua New Guinea. Generalised additive modelling was used to characterise spatial heterogeneity of malaria risk and investigate the contribution of individual, household and environmental-level risk factors. Following a period of declining malaria prevalence, the prevalence of P. falciparum increased from 11.4 to 19.1% in Megiar and 12.3 to 28.3% in Mirap between 2014 and 2016, with focal hotspots observed in these villages in 2014 and expanding in 2016. Prevalence of P. vivax was similar in both years (20.6% and 18.3% in Megiar, 22.1% and 23.4% in Mirap) and spatial risk heterogeneity was less apparent compared to P. falciparum. Within-village hotspots varied by Plasmodium species across time and between villages. In Megiar, the adjusted odds ratio (AOR) of infection could be partially explained by household factors that increase risk of vector exposure, such as collecting outdoor surface water as a main source of water. In Mirap, increased AOR overlapped with proximity to densely vegetated areas of the village. The identification of household and environmental factors associated with increased spatial risk may serve as useful indicators of transmission hotspots and inform the development of tailored approaches for malaria control.

Item ID: 68924
Item Type: Article (Research - C1)
ISSN: 2045-2322
Copyright Information: © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC Australian Centre of Research Excellence for Malaria Elimination (ACREME GNT1134989), NHMRC Fellowship GNT11155075, NHMRC Fellowship GNT1141441, NHMRC Fellowship GNT1161627
Date Deposited: 16 Nov 2021 04:33
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 100%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 100%
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