Factors Associated With P. knowlesi Clusters in Cleared Foci Areas in Sabah
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Abstract
Introduction: Plasmodium knowlesi cases is increasing in trend despite integrated vector management leading to morbidity and death. This study determines the association between P. knowlesi cluster with vector control, risk fac- tors and its spatiotemporal distribution in cleared foci area in Sabah. Methods: This is a cross sectional study between 2017 and 2019 involving P. knowlesi cases in cleared foci registered in Vekpro Online. Simple logistic regression tests were performed using Statistics Package for the Social Sciences (SPSS) software and spatiotemporal distribution mapped using Quantum Geographic Information System (QGIS) software. Results: A total of 4,739 cases were anal- ysed and high P. knowlesi cases reported in Ranau (17.1%), Keningau (12.8), Tenom (10.8%), Kudat (8.1%) and Kota Marudu (7.2%). Younger age groups (0 – 9 years), the Rungus ethnicity, and the use of vector control measures were positively associated with P. knowlesi clusters with the odds ratio of 2.421 (95% CI [1.596, 3.674]), 2.654 (95% CI [1.899, 3.708]), and 2.559 (95% CI [2.175, 3.011]) respectively. However, age group of 50-59 years, male gender, occupations related to agriculture, and employment in the private sector or self-employed were negatively associated with P. knowlesi clusters in cleared foci in Sabah with odds ratio between 0.478 and 0.771. The prevalence of P. knowlesi in cleared foci in Sabah were 36.2%, 44.09% per and 41.59% per 100,000 population in 2017, 2018 and 2019 respectively. The distribution differs in districts. Conclusion: Tailored measures and spatiotemporal distribu- tion of P. knowlesi cluster is useful to reduce transmission and aids focus-based planning.
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