Elsevier

Travel Medicine and Infectious Disease

Volume 11, Issue 1, January–February 2013, Pages 29-36
Travel Medicine and Infectious Disease

Review
An epidemiological overview of malaria in Bangladesh

https://doi.org/10.1016/j.tmaid.2013.01.004Get rights and content

Summary

Bangladesh is one of the four major malaria-endemic countries in South-East Asia having approximately 34% of its population at risk of malaria. This paper aims at providing an overview of the malaria situation in this country. Relevant information was retrieved from published articles and reports in PubMed and Google Scholar.

Malaria in Bangladesh is concentrated in 13 districts with a prevalence ranging between 3.1% and 36%, and is mostly caused by Plasmodium falciparum. Geographical conditions pose a potential risk for Plasmodium knowlesi malaria. Resistance to a number of drugs previously recommended for treatment has been reported. Low socio-economic status, poor schooling and close proximity to water bodies and forest areas comprise important risk factors.

Despite the significant steps in Long Lasting Insecticide Net (LLIN)/Insecticide Treated Net (ITN) coverage in Bangladesh, there are still many challenges including the extension of malaria support to the remote areas of Bangladesh, where malaria prevalence is higher, and further improvements in the field of referral system and treatment.

Introduction

Genetic research suggests that human malarial parasites might have originated some 2–3 million years ago, although some studies propose a later appearance of malarial pathogens in human populations, perhaps 10,000 years back.1, 2 Since then, malaria has established itself as a major cause of morbidity and mortality globally. The recent World Health Organization (WHO) estimates showed that 106 countries were malaria-endemic in 2010, and more than 3.3 billion people worldwide were likely to get a malarial infection that year.1, 3 The global malaria trends show a decline in the percentage of population exposed, at least up to 1994, but the total number of people at risk for malaria has never declined since 1900.1, 3

The burden of malaria is significant in South-East Asia, which follows Africa in terms of reported malaria cases; almost 70% of a total of 1.8 billion people living in this region are at risk of malaria.1, 3 All the countries in the area except the Maldives are malaria endemic. Cases of malaria in South-East Asia account for approximately 15% of the global toll and 38,000 people died from malaria in 2010.3 In addition, these numbers may be even higher because existing surveillance systems suffer from substantial under-reporting.4 Conversely, signs of reduction have been observed in both malaria cases and deaths over the last years as depicted in Fig. 1.5

Bangladesh is one of the four major malaria endemic countries in the region with approximately 34% of its population at risk of malaria.3, 6 Given the high burden of malaria in Bangladesh and the lack of recent comprehensive epidemiological reviews, in the current paper we try to describe the dynamics of malaria transmission in Bangladesh, explain trends and suggest measures for a better response.

Section snippets

Methods

Relevant information was retrieved from published articles and reports. Electronic databases (PubMed and Google Scholar) were searched using the terms: “Malaria” combined with “Bangladesh” (last search: February 07, 2012).

Malaria endemicity in Bangladesh

More than 10 million people of Bangladesh are at high risk for malaria.3 The steady rise of the prevalence of malaria in Bangladesh has partly been attributed to the 1985 ban on use of dichlorodiphenyltrichloroethane (DDT), to the discontinuation of malaria eradication program and to the large-scale population movements during the war of independence.7, 8 Malaria is not epidemic in the general population of Bangladesh.9, 10 However, certain areas of the country are more affected. Most of the

Conclusions

Malaria in Bangladesh is concentrated in areas along the South-Eastern border of the country. While Bangladesh managed to extend its coverage of RDTs and LLINs/ITNs to significant levels, cross-border malaria and drug resistance to commonly used anti-malarial drugs comprise a major challenge in controlling the disease. Potential for P. knowlesi infection is another serious issue. Success in neighbouring countries can point the way to significantly reducing the malaria burden and endemicity. For

Source of funding statement

There was no specific funding source for this manuscript.

Disclaimer

The opinions expressed by the authors of this manuscript do not necessarily reflect the opinions of the institutions with which the authors are affiliated.

Conflict of interest statement

We declare that we do not have any financial or personal conflict of interest.

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