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Malaria incidence data at the district level from 1997 to 2002 and total malaria case data from 1965 to 2002 in Thailand were analyzed to determine the spatial and temporal dynamics of Plasmodium falciparum and P. vivax malaria incidence. Over the 37-year period, there was a 35-fold reduction in the incidence rates of P. falciparum malaria (11.86% in 1965 versus 0.34% in 2002) and a 7-fold reduction in P. vivax malaria (2.89% in 1965 versus 0.40% in 2002). The incidence ratio of P. falciparum to P. vivax malaria was reduced from 4.1 to 0.8 during this period. Malaria incidence rate exhibited the most rapid reduction between 1975 and 1985, coinciding with the introduction of a combination of antifolate drugs (sulfadoxine-pyrimethamine). The distribution maps of P. falciparum and P. vivax malaria incidence rates indicated a high spatial heterogeneity. The Thailand-Myanmar and Thailand-Cambodia border areas, where migration of foreign workers was pronounced, had the highest incidence rates for P. falciparum, P. vivax, and mixed-species infections. Transition probability analysis based on the malaria incidence rate among Thai residents indicated that there was an overall trend of decrease in the number of malaria cases and the number of high incidence districts between 1997 and 2002. High spatial variation in malaria incidence and local human migration patterns suggest that malaria control measures need to be adjusted according to local environmental and demographic settings.
Received February 26, 2004. Accepted for publication October 3, 2004.
Acknowledgments: We thank two anonymous reviewers for constructive suggestions.
Financial support: This work was supported by National Institute of Health grant R01 AI-50243 and FIC D43 TW06571.
Authors’ addresses: Guofa Zhou and Guiyun Yan, Department of Biological Sciences, 220 Hochstetter Hall, State University of New York at Buffalo, Buffalo, NY 14260. Jeeraphat Sirichaisinthop, Vector Borne Disease Training Center, 6 Tambon TharnKasem, Phrabuddhabat, Saraburi 18120, Thailand. Jetsumon Sattabongkot and James Jones, Department of Entomology, Armed Forces Institute of Medical Sciences, United States Army Military Component, Bangkok 10400, Thailand. Ottar N. Bjørnstad and Liwang Cui, Department of Entomology, The Pennsylvania State University, University Park, PA 16802.
Reprint requests: Liwang Cui, Department of Entomology, The Pennsylvania State University, University Park, PA 16802, Telephone: 814-863-7663, Fax: 814-865-3048, E-mail: luc2{at}psu.edu or Guiyun Yan, Department of Biological Sciences, 220 Hochstetter Hall, State University of New York at Buffalo, Buffalo, NY 14260, Telephone: 716-645-2363 extension 121, Fax: 716-645-2975, E-mail: gyan{at}acsu.buffalo.edu.
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