Modelling malaria incidence in the upper part of southern Thailand

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Pawit Chaivisit
Suriyo Chujun
Amornrat Chutinantakul


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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Author Biographies

Pawit Chaivisit, Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat, Mueang, Nakhon Si Thammarat, Thailand

Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat, Mueang, Nakhon Si Thammarat, Thailand

Suriyo Chujun, Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat, Mueang, Nakhon Si Thammarat, Thailand

Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat, Mueang, Nakhon Si Thammarat, Thailand

Amornrat Chutinantakul, Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat, Mueang, Nakhon Si Thammarat, Thailand

Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat, Mueang, Nakhon Si Thammarat, Thailand


1. WHO, World Health Organization. World malaria report 2016 [Internet]. [Cited 2020 April 30]. Available from:
2. Onwujekwe O, Uguru N, Etiaba E, Chikezie I, Uzochukwu B, Adjagba A. The Economic burden of malaria on households and the health system in Enugu State Southeast Nigeria. PLOS ONE; 2013:8(11): e78362.
3. Junior SG, Pamplona VMS, Corvelo TCO, Ramos EMLS. Quality of life and risk of contracting malaria by multivariate analysis in the Brazilian Amazon region. Malaria Journal [Internet]. 2014;13(86). Available from: 10.1186/1475-2875-13-86
4. CDC, Centers for disease control and prevention. Malaria information and prophylaxis, by Country 2018 [Internet]. [Cited 30th April 2020]. Available from: malaria/travelers/country_table/t.html
5. Messina JP, Taylor SM, Meshnick SR, Linke AM, Tshefu AK, Atua B, et al. Population, behavioral and environmental drivers of malaria prevalence in the Democratic Republic of Congo. Malaria journal [Internet]. 2011:10(161). Available from:
6. Wilson AL, Chen-Hussey V, Logan JG, Lindsay SW. Are topical insect repellent effective against malaria in endemic populations? A systematic review and meta-analysis. Malaria Journal [Internet]. 2014:13:446. Available from: 10.1186/1475-2875-13-446.
7. Chirebvu E, Chimbari MJ, Ngwenya BN. Assessment of risk factors associated with malaria trasmission in Tubu village, Northern Botswana. Malaria Research and Treatment 201; Article ID 403069 [Internet]. Available from: 2014/403069
8. Sriwichai P, Karl S, Samung Y, Kiattibutr K, Sirichaisinthop J, Mueller L, et al. Imported Plasmodium falciparum and locally transmitted Plasmodium vivax: cross-border malaria transmission scenario in northwestern Thailand. Malaria Journal [Internet]. 2017:16(258). Available from:
9. Tipmontree R, Fungladda W, Kaewkungwal J, Tempongko MASB, Scheip FP. Migrants and malaria risk factors: A study of the Thai-Myanmer border. Asian Journal of Tropical Medicine and Public Health. 2009;40(6): 1148–1157.
10. Cotter C, Sturrock HJ, Hsiang MS, Liu J, Phillips AA., Hwang J, et al. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet. 2013;382(9895): 900–911.
11. Gómez-Barroso D, García-Carrasco E, Herrador Z, Ncogo P, Romay-Barja M, Mangue MEO, et al. Spatial clustering and risk factors of malaria infections in Bata district, Equatorial Guinea. Malaria Journal [Internet]. 2017;16: (146). Available from: 10.1186/ s12936-017-1794-z
12. Chujun S, Chaivisit P, Chutinantakul A. Epidemiological characteristics and factors related to malaria disease. Disease Control Journal. 2019;45(4): 380–391.
13. Venables WN, Ripley, BD. Modern Applied Statistics with S (4th ed). New York: Springer-Verlag 2002.
14. Tongkumchum P, McNeil D. Confidence intervals using contrasts for regression model. Songklanakarin Journal of Science and Technology 2009;31(2): 151–156.
15. Kongchouy N, Sampantarak U. Confidence intervals for adjusted proportions using logistic regression. Modern Applied Science. 2010;4(6): 2–6.
16. R Development Core Team 2018. A Language and Environment for Statistical Computing [Internet]. R Foundation for Statistical Computing, Vienna. [Cited April 2020 30]. Available from:
17. Murrell, PR. Graphics. New York: Chapman and Hall. 2006.
18. Heriana H, Cotter C, Coutrier FN, Zarlinda I, Zelman WB, Tirta YK, et al. Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum. Malaria Journal [Internet]. 2016;15(468). Available from:
19. Midekisa A, Beyene B, Mihretie A, Bayabil E, Wimberly MC. 2015. Seasonal associations of climatic drivers and malaria in the highlands of Ethiopia. Parasites & Vectors [Internet]. 2015; 8(339). Available from: 10.1186/s13071-015-0954-7.
20. Jawara M, Pinder M, Drakeley CJ, Nwakanma DC, Jallow E, Bogh C, et al. Dry season ecology of Anopheles gambiae complex mosquitoes in The Gambia. Malaria Journal [Internet]. 2008;7(156). Available from: 10.1186/1475-2875-7-156.
21. Park JW, Cheong HK, Honda Y, Ha M, Kim H, Kolam J, et al. Time trend of malaria in relation to climate variability in Papua New Guinea. Environmental Health and Toxicology [Internet]. 2016;31:e2016003. Available from:
22. Touré M, Sanogo D, Dembele S. Diawara SI, Oppfeldt K, Schiøler KL, et al. Seasonality and shift in age-specific malaria prevalence and incidence in Binko and Carrière villages close to the lake in Selingué, Mali. Malaria Journal [Internet]. 2016;15:219. Available from: 10.1186/s12936-016-1251-4.
23. Hanandita W, Tammpubo G. Geography and social distribution of malaria in Indonesian Papua: a cross-sectional study. International Journal of Health Geographics [Internet]. 2016;15(13). Available from:
24. Tainchum K, Kongmee M, Manguin S. Bangs MJ, Chareonviriyaphap T. Anopheles species diversity and distribution of malaria vectors of Thailand. Trends in Parasitology [Internet]. 2015;31:3. Available from:
25. Atieli HE, Zhou G, Afrane Y, Lee MC, Mwanzo I, Githeko AK, et al. Insecticide-treated net (ITN) ownership, Usage, and malaria transmission in the highlands of western Kanya. Parasites & Vectors [Internet]. 2011;4:(113). Available from:
26. Apinjoh TO, Anchang-Kimbi JK, Mugri RN, Tangoh DA, Nyingchu RV, Chi HF, et al. The effect of insecticide treated nets (ITNs) on Plasmodium falciparum infection in rural and semi-urban communities in the south West region of Cameroon. PLOS ONE [Internet]. 2015. Available from: 10.1371/journal.pone.0116300
27. Nonaka D, Laimanivong S, Kobayashi J, Chindavosa K, Kano S, Vanisaveth V, et al. Is staying overnight in a farming hut a risk factor for malaria infection in a setting with insecticide-treated bed nets in rural Laos?. Malaria Journal [Internet]. 2010;9(372). Available from: 10.1186/1475-2875-9-372
28. Aribodor DN, Ugwuanyi IK, Aribodor OB. Challenges to achieving malaria elimination in Nigeria. American Journal of Public Health research [Internet]. 2016; 4(1):38–41. Available from: 10.12691/ajphr-4-1-6
29. Bhumiratana A, Intarapuk A, Sorosjinda-Nunthawaraslip P, Maneekan P, Koyadun S. Border Malaria Associated with Multidrug Resistance on Thailand-Myanmar and Thailand-Cambodia Borders: Transmission Dynamic, Vulnerability, and Surveillance. BioMed Research International [Internet]. 2013;363417. Available from: 10.1155/2013/363417
30. Stryker JJ, Bomblies A. The impacts of land use change on malaria vector abundance in a water-limited, Highland Region of Ethiopia. Ecohealth [Internet]. 2012;9(4):455–70. Available from: 10.1007/s10393-012-0801-7
31. Kweka EJ, Kimaro EE, Munga S. Effect of deforestation and land use changes on mosquito productivity and development in Western Kenya Highlands: Implication for Malaria risk. Frontiers in Public Health [Internet]. 2016;238(4):1–9. Available from: 10.3389/fpubh.2016.00238
32. Bureau of vector-borne disease. National strategic plan for malaria control and elimination in Thailand 2011-2016 [Internet]. [Cited 2020 April 30]. Available from: https://www.