ArticleMalaria journal2021
Civilian-military malaria outbreak response in Thailand: an example of multi-stakeholder engagement for malaria elimination.
Article in Malaria journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 41 citations in OpenAlex.
- Digital Health Center App for Community and National Malaria Surveillance in Cambodia: Implementation Case Study.JMIR public health and surveillance · 2026Article
- Combatting malaria together: key findings from a rapid formative assessment on Royal Thai Army malaria practices and military-civilian collaboration in Sisaket Province, Thailand.Malaria journal · 2026Article
- Immunological surveillance using anti-gSG6-P1 IgG biomarker reveals spatio-temporal dynamics of Anopheles exposure and gaps in malaria risk assessment in the Greater Mekong Subregion.Parasite (Paris, France) · 2026Article
- Estimating malaria risk behaviours and their determinants among at-risk populations in a pre-elimination setting, Sisaket Province, Thailand-Cambodia border.Malaria journal · 2025Article
- Mapping malaria transmission foci in Northeast Thailand from 2011 to 2021: approaching elimination in a hypoendemic area.Malaria journal · 2024Article
- Early warning systems for malaria outbreaks in Thailand: an anomaly detection approach.Malaria journal · 2024Article
- 1-3-7 surveillance and response approach in malaria elimination: China's practice and global adaptions.Malaria journal · 2023Review
- Reactive Case Detection Strategy for Malaria Control and Elimination: A 12 Year Systematic Review and Meta-Analysis from 25 Malaria-Endemic Countries.Tropical medicine and infectious disease · 2023Review
- Understanding work-related travel and its relation to malaria occurrence in Thailand using geospatial maximum entropy modelling.Malaria journal · 2023Article
- Modelling malaria in southernmost provinces of Thailand: a two-step process for analysis of highly right-skewed data with a large proportion of zeros.Malaria journal · 2022Article
- Assessing Thailand's 1-3-7 surveillance strategy in accelerating malaria elimination.Malaria journal · 2022Article
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Authors and funding
27 authors at 5 institutions in 2 countries.
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Abstract
backgroundIn April 2017, the Thai Ministry of Public Health (MoPH) was alerted to a potential malaria outbreak among civilians and military personnel in Sisaket Province, a highly forested area bordering Cambodia. The objective of this study was to present findings from the joint civilian-military outbreak response.
methodsA mixed-methods approach was used to assess risk factors among cases reported during the 2017 Sisaket malaria outbreak. Routine malaria surveillance data from January 2013 to March 2018 obtained from public and military medical reporting systems and key informant interviews (KIIs) (n = 72) were used to develop hypotheses about potential factors contributing to the outbreak. Joint civilian-military response activities included entomological surveys, mass screen and treat (MSAT) and vector control campaigns, and scale-up of the "1-3-7" reactive case detection approach among civilians alongside a pilot "1-3-7" study conducted by the Royal Thai Army (RTA).
resultsBetween May-July 2017, the monthly number of MoPH-reported cases surpassed the epidemic threshold. Outbreak cases detected through the MoPH mainly consisted of Thai males (87%), working as rubber tappers (62%) or military/border police (15%), and Plasmodium vivax infections (73%). Compared to cases from the previous year (May-July 2016), outbreak cases were more likely to be rubber tappers (OR = 14.89 [95% CI: 5.79-38.29]; p < 0.001) and infected with P. vivax (OR=2.32 [1.27-4.22]; p = 0.006). Themes from KIIs were congruent with findings from routine surveillance data. Though limited risk factor information was available from military cases, findings from RTA's "1-3-7" study indicated transmission was likely occurring outside military bases. Data from entomological surveys and MSAT campaigns support this hypothesis, as vectors were mostly exophagic and parasite prevalence from MSAT campaigns was very low (range: 0-0.7% by PCR/microscopy).
conclusionsIn 2017, an outbreak of mainly P. vivax occurred in Sisaket Province, affecting mainly military and rubber tappers. Vector control use was limited to the home/military barracks, indicating that additional interventions were needed during high-risk forest travel periods. Importantly, this outbreak catalyzed joint civilian-military collaborations and integration of the RTA into the national malaria elimination strategy (NMES). The Sisaket outbreak response serves as an example of how civilian and military public health systems can collaborate to advance national malaria elimination goals in Southeast Asia and beyond.
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