Predictors of malaria rapid diagnostic test positivity in a high burden area of Paletwa Township, Chin State in Western Myanmar

Background

Despite major reductions in malaria burden across Myanmar, clusters of the disease continue to persist in specific subregions. This study aimed to assess the predictors of test positivity among people living in Paletwa Township of Chin State, an area of persistently high malaria burden.

Methods

Four villages with the highest malaria incidence from Paletwa Township were purposively selected. The characteristics of 1045 subjects seeking malaria diagnosis from the four assigned village health volunteers from January to December, 2018 were retrospectively analyzed. Their household conditions and surroundings were also recorded using a checklist. Descriptive statistics and logistic regression models were applied to investigate potential associations between individual and household characteristics and malaria diagnosis.

Results

In 2017, the Paletwa township presented 20.9% positivity and an annual parasite index of 46.9 cases per 1000 people. Plasmodium falciparum was the predominant species and accounted for more than 80.0% of all infections. Among 1045 people presenting at a clinic with malaria symptoms, 31.1% were diagnosed with malaria. Predictors for test positivity included living in a hut [adjusted odds ratios (a OR): 2.3, 95% confidence intervals (CI): 1.2–4.6], owning farm animals (aOR: 1.7, 95% CI: 1.1–3.6), using non-septic type of toilets (aOR: 1.9, 95% CI: 1.1–8.4), presenting with fever (aOR: 1.9, 95% CI: 1.1–3.0), having a malaria episode within the last year (aOR: 2.9, 95% CI: 1.4–5.8), traveling outside the village in the previous 14 days (aOR: 4.5, 95% CI: 1.5–13.4), and not using bed nets (a OR: 3.4, 95% CI: 2.3–5.1). There were no statistically significant differences by age or gender in this present analysis.

Conclusions

The results from this study, including a high proportion of P. falciparum infections, little difference in age, sex, or occupation, suggest that malaria is a major burden for these study villages. Targeted health education campaigns should be introduced to strengthen synchronous diagnosis-seeking behaviors, tighten treatment adherence, receiving a diagnosis after traveling to endemic regions, and using bed nets properly. We suggest increased surveillance, early diagnosis, and treatment efforts to control the disease and then to consider the local elimination.

Husbandry and trade of indigenous chickens in Myanmar--results of a participatory rural appraisal in the Yangon and the Mandalay divisions

There is a variety of professions working with village chickens in developing countries, including farmers, veterinarians and chicken traders. People from all these occupations were involved in a participatory rural appraisal to investigate husbandry practices and trade of village chickens in Myanmar. Data were collected in two climatically different regions of the country, in the Yangon and in the Mandalay divisions. The breeding and training of fighting cocks was practised only in the Mandalay division, with well-trained birds sold for very high prices. Apart from this, chickens were raised in both regions mainly for small disposable income and were generally sold when money was needed, in particular during religious festivals. Chicken traders on bicycles, often called 'middle men', usually purchase birds from farmers in about 10 villages per day. Several 'middle men' supply birds to wealthier chicken merchants, who sell these birds at larger chicken markets. There is in general limited knowledge among farmers about the prevention of Newcastle disease via vaccination. Commercial indigenous chicken production is practised in Myanmar, but family poultry farming dominates indigenous chicken production in the country.

Infected atrial myxoma

A patient is reported in whom a left atrial myxoma was found to be infected with Staphylococcus aureus. The clinical presentation, diagnosis and treatment are described and discussed.