Nine Years of Malaria Cases in Bangladesh: A Time Series Analysis

Abstract

Aims: Bangladesh, a malaria endemic country in South East Asia Region, has successfully decreased malaria over the years through the adoption of different strategies. Still, this is un-notified and no systematic malaria trend analysis has been done. Hence this study assesses the malaria trend through different dimension with consideration of various anti-malarial programmes.  Study Design and Methodology: Secondary data from National Malaria Elimination Program (NMEP) and BRAC were used to analysis the trend of malaria cases and time series of the data were done to complement the analysis. A comparison of different regions through spatial distribution was also fitted out to determine the present scenario of malaria in Bangladesh.  Results: The annual malaria incidence declined from 7.77 per 1000 population in 2008 to 1.58 per 1000 population in 2016 [R2=0.712, P-value=0.004, 95% CI:-1.04, -0.29]. Both P. falciparum and P. vivax decreased by 75% and 77% respectively since 2008 though P. vivax is still slightly increased after major shuffling in 2014. Severe malaria gradually decreased by 78% from 2008 to 2016 [R2=0.779, P-value=0.002, 95% CI:- 480.9, -170.7]. A different scenario was found through stratification as malaria infection steadily decreased in both low [R2=0.83, P-value=0.0001, 95% CI:-5.98, -4.87] and medium [R2=0.29, P-value=0.0001, 95% CI:-5.82, - 2.82] endemic districts but the same rate of decrease of malaria infection did not happen in Chittagong Hill Tracts. The study showed that malaria prevalence was higher in males (57.86%) than females (42.13%) and older age group of 15 years and above (59.3%) more than in other younger age groups.  Conclusion: Though malaria infection has sharply declined in all endemic districts except Chittagong Hill Tracts, a sustained intensified strategy is required in all endemic districts to achieve malaria elimination within 2030.