A cross-sectional study to ascertain malaria prevalence among asymptomatic travellers arriving on the Lihir Group of Islands, Papua New Guinea: implications for elimination efforts.


Journal

Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802

Informations de publication

Date de publication:
29 Nov 2023
Historique:
received: 20 09 2023
accepted: 23 11 2023
medline: 1 12 2023
pubmed: 30 11 2023
entrez: 30 11 2023
Statut: epublish

Résumé

The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial influx of mine employees, informal cross-country traders, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation. In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity. 398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were significantly different. Mean age among travellers arriving by plane was 40.1 years (SD ± 10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD ± 14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p = 0.0066). Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies.

Sections du résumé

BACKGROUND BACKGROUND
The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial influx of mine employees, informal cross-country traders, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation.
METHODS METHODS
In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity.
RESULTS RESULTS
398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were significantly different. Mean age among travellers arriving by plane was 40.1 years (SD ± 10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD ± 14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p = 0.0066).
CONCLUSIONS CONCLUSIONS
Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies.

Identifiants

pubmed: 38031175
doi: 10.1186/s12936-023-04804-y
pii: 10.1186/s12936-023-04804-y
pmc: PMC10688477
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

364

Subventions

Organisme : Beatriu de Pinós Program
ID : BP3, 801370

Informations de copyright

© 2023. The Author(s).

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Auteurs

Pere Millat-Martínez (P)

ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.

Bàrbara Baro (B)

ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain. barbara.baro@isglobal.org.

Bernadine Kasian (B)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.

Lina Lorry (L)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.

Sergi Sanz (S)

ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.

Chilaka Wali (C)

Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea.

Sylvia Raulo (S)

Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea.

Arthur Elizah (A)

Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea.

Tamarah Koleala (T)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.

Maria Kaius-Ome (M)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.

Stephan Karl (S)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia.

Oriol Mitjà (O)

Fight Infectious Diseases Foundation, Hospital Germans Trias I Pujol, Badalona, Spain.
School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Vic, Catalonia, Spain.
Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea.

Moses Laman (M)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.

William Pomat (W)

Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.

Quique Bassat (Q)

ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain.
Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.
Centro de Investigação Em Saúde de Manhiça (CISM), Maputo, Mozambique.
CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.

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