Modelling malaria incidence in the upper part of southern Thailand
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Abstract
Malaria is a major concern for public health in tropical countries. This disease is related to demographic and geographic factors. The objective of this study was to describe the incidence of malaria among Thai nationals in seven provinces in the upper part of southern Thailand and explore their patterns using statistical modelling. The secondary data were from a malaria online program from 2013 to 2016, which comprised 4,244 new cases of malaria in Thai nationals. Poisson regression and negative binomial regression were used for the analysis. The descriptive results showed that malaria cases clearly peaked during May and June. More than half (61.73%) of the occupations that developed malaria were rubber agriculturalists. Plasmodium falciparum was the predominant species in the upper part of southern Thailand at 60.13%. The control measure taken after a malaria outbreak was spraying in 61.97% of the infected areas and in 59.87% of the residential areas of patients. The regression model showed that the factors related to the malaria incidence were the district, sex-age category and year, which clearly illustrated trends and spatial variations. The patterns of malaria incidence rates were separated into three groups. Twenty-two districts were estimated to be high-risk areas of malaria infection. Areas of malaria infection were mostly in the border districts near Myanmar and in areas where land use had changed and deforestation had occurred near the mountain chains. The incidence of malaria was highest in males aged 15–44 years. The trend of malaria incidence in the upper part of southern Thailand tended to decrease from 2013 to 2016. This was possibly due to strong policy control measures, strengthened migrant labour laws, and environmental and behavioural changes. Results of this study can be used for planning, prevention, and control of malaria in the upper part of southern Thailand.
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