Pathogens and Global Health (2014) 108, 369-380

Christian P. Nixon, Christina E. Nixon, Dian Sidik Arsyad, Krisin Chand, Frilasita A. Yudhaputri, Wajiyo Sumarto, Suradi Wangsamuda, Puji B. Asih, Sylvia S. Marantina, Isra Wahid, Gang Han, Jennifer F. Friedman, Michael J. Bangs, Din Syafruddin and J. Kevin Baird (2014)
Distance to Anopheles sundaicus larval habitats dominant among risk factors for parasitemia in meso-endemic Southwest Sumba, Indonesia
Pathogens and Global Health 108 (8), 369-380
Abstract: Background: The decline in intensity of malaria transmission in many areas now emphasizes greater importance of understanding the epidemiology of low to moderate transmission settings. Marked heterogeneity in infection risk within these populations creates opportunities to understand transmission and guide resource allocation to greater impact.
Methods: In this study, we examined spatial patterns of malaria transmission in a hypo- to meso-endemic area of eastern Indonesia using malaria prevalence data collected from a cross-sectional socio-demographic and parasitological survey conducted from August to November 2010. An entomological survey performed in parallel, identified, mapped, and monitored local anopheline larval habitats.
Results: A single spatial cluster of higher malaria prevalence was detected during the study period (relative risk = 2·13; log likelihood ratio = 20·7; P < 0·001). In hierarchical multivariate regression models, risk of parasitemia was inversely correlated with distance to five Anopheles sundaicus known larval habitats [odds ratio (OR) = 0·21; 95% confidence interval (CI) = 0·14–0·32; P < 0·001], which were located in a geographically restricted band adjacent to the coastline. Increasing distance from these sites predicted increased hemoglobin level across age strata after adjusting for confounders (OR = 1·6; 95% CI = 1·30–1·98; P < 0·001).
Conclusion: Significant clustering of malaria parasitemia in close proximity to very specific and relatively few An. sundaicus larval habitats has direct implications for local control strategy, policy, and practice. These findings suggest that larval source management could achieve profound if not complete impact in this region.
(The abstract is excluded from the Creative Commons licence and has been copied with permission by the publisher.)
Link to article at publishers website
Database assignments for author(s): Michael J. Bangs

Research topic(s) for pests/diseases/weeds:
environment - cropping system/rotation

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Pest and/or beneficial records:

Beneficial	Pest/Disease/Weed	Crop/Product	Country	Quarant.
	Anopheles sundaicus		Indonesia