CURRENT SITUATION AND TREND IN MALARIA IN PUBLIC HEALTH REGION 11, BY FISCAL YEARS 1993-2002, 2003

Abstract

Based on Longitudinal observation in malaria surveillance in Public Health Region 11 by fiscal years (FYs) 1993-2003, this epidemiological review focuses on current situation and trend in malaria, causing an important public health burden in 7 provinces in the region. By FYS 1993- 2003, reduction in malaria prevalence has been observed, showing overall morbidity rates, lower than that observed in the country but likely showing highest morbidity rate of 9.33 per 1,000 population in 1998. For examples, the high morbidity rates were recorded in Ranong, Chumporn, and Surattani Provinces, as in Phuket Province the lowest morbidity rate was observed. By FYS 1993-1997, the overall mortality rates were dramatically declined, but after FY 1998 there was likely to have an increase in the mortality rate. By FY 2003, malaria situation in Thai population tended to have decreases in overall prevalence rates, ie the morbidity and mortality rates were considered lower than arbitrarily quantitative level of malaria control in the region. However, the highest morbidity rates (per 1,000 population) in most 4 endemic provinces [eg Ranong, Chumporn, Phang-Nga, and Krabi] were 4.17, 2.30,1.48 and 1.40 respectively. And with seasonal transmission patterns, high malaria cases were periodically observed in June-July and in November, as the lowest number was seen in March. Of the malaria cases, 64.00 % male was evident and 39.43% affected person range 25-44 years old; most having agricultural practice were observed. In the meantime, malaria situation in foreign migrants tended to have similar decrease in overall prevalence (%): changing from 4.33 in FY 2002 to 2.62 in FY 2003. The highest number of malaria cases in most 3 risk provinces, for examples in Ranong, Phang Nga, and Chumporn, were 1,603, 213 and 74 respectively. As similar to the seasonal malaria cases observed in the Thai population, two malaria peaks were observed. Also, most were male (71.17%), 43.48% affected persons aged 25 - 44 years, and their occupation was agricultural - related work. These baseline informations have been suggested that, in background malaria surveillance both active and passive, local malaria endemicity in the region as well as seasonal tranmission patterns is needed for infection control personnel and epidemiologists to emphasize on the basis of intervention or control measure design.