Evidence map›Paper›PMID 41622177›Full record

Observational studyMalaria journal2026

Re-emergence of malaria in Karen State, Myanmar: has the battle of Burma been lost?

Chanapat Pateekhum, Aung Myint Thu, Khin Maung Lwin, Saw Baw Nyaw, Saw Win Tun, Saw Daniel, Aye Khin, Wai Linn Aung, Khaung Kain, Mallika Imwong and 3 more

Abstract readObservational Study
In one paragraph

Observational study in Malaria journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Chanapat PateekhumShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Aung Myint ThuShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Khin Maung LwinShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Saw Baw NyawShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Saw Win TunShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Saw DanielShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Aye KhinShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Wai Linn AungShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Khaung KainShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.
Mallika ImwongMahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Nicholas P DayMahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Nicholas J WhiteMahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
François H NostenShoklo Malaria Research Unit (SMRU), Faculty of Tropical Medicine, Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand. francois@tropmedres.ac.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHistorically malaria has been a major cause of morbidity and mortality in the Greater Mekong Sub-region. In recent years, significant progress towards malaria elimination has been made. Myanmar harbours most of the region's malaria burden, however after initial progress during peace time, the civil war and the COVID-19 pandemic have coincided with a resurgence of malaria. This observational study examines the resurgence of malaria in Eastern Myanmar and its contributory factors. METHODS AND

resultsMalariometric and genomic data from a long-established network of malaria clinics and village health workers in eastern Karen State serving an estimated population of 350,000 were reviewed and analysed in the context of the COVID-19 pandemic and the military coup that followed. Data from 2020 and 2024 show that the number of cases of P. falciparum malaria increased 12-fold and those of P. vivax malaria increased threefold. This resurgence was greatest in the northern parts of Karen State and coincided with reduced access to timely diagnosis and treatment. This was associated with increased malaria transmission of P. falciparum (RR = 1.72, 95% CI 1.68-1.76) and P. vivax (RR = 1.82, 95% CI 1.80-1.84). Reported malaria-related deaths remained low during the study period though underreporting cannot be excluded.

conclusionOur study provides evidence that the disruption of services (early diagnosis and treatment) caused by the COVID-19 pandemic followed by insecurity, explains the resurgence of malaria in Karen State in Myanmar. Population movements and the clonal expansion of a specific parasite lineage were likely contributing factors. However, the decline recorded in 2024 in the number of cases and the near absence of malaria mortality showed that despite the difficulties, the malaria control system has been successful in containing the crisis. The battle for malaria control in Burma has not been lost, but the future remains uncertain.

Indexed as

COVID-19Malaria, FalciparumMalaria, VivaxHumansMyanmarPlasmodium vivaxBurmaKaren StateMalariaMyanmarP. falciparumP. vivax

Identifiers

PMID41622177
PMCPMC12951982

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.