Characterizing Types of Human Mobility to Inform Differential and Targeted Malaria Elimination Strategies in Northeast Cambodia.


Peeters Grietens, K; Gryseels, C; Dierickx, S; Bannister-Tyrrell, M; Trienekens, S; Uk, S; Phoeuk, P; Suon, S; Set, S; Gerrets, R; Hoibak, S; Muela Ribera, J; Hausmann-Muela, S; Tho, S; Durnez, L; Sluydts, V; d'Alessandro, U; Coosemans, M; Erhart, A; (2015) Characterizing Types of Human Mobility to Inform Differential and Targeted Malaria Elimination Strategies in Northeast Cambodia. Sci Rep, 5. p. 16837. ISSN 2045-2322 DOI: https://doi.org/10.1038/srep16837

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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.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
PubMed ID: 26593245
Web of Science ID: 365088000001
URI: http://researchonline.lshtm.ac.uk/id/eprint/2373843

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