Malaria risk stratification in Lao PDR guides program planning in an elimination setting

Area of Science:

• Global Health
• Epidemiology
• Infectious Disease Control

Background:

• Malaria incidence in Lao People's Democratic Republic (Lao PDR) has significantly decreased over the past two decades.
• Malaria elimination is a feasible objective, necessitating focused resource allocation to persistent transmission hotspots.

Purpose of the Study:

• To conduct an epidemiological stratification of districts and health facility catchment areas (HFCAs) in Lao PDR to identify malaria risk levels.
• To inform targeted resource allocation for malaria control and elimination efforts.

Main Methods:

• Utilized reported malaria case data from 2019-2021.
• Incorporated risk maps generated through predictive modeling.
• Integrated nationwide feedback from malaria control personnel.

Main Results:

• 14 out of 148 districts were classified as high-risk (burden reduction), with 134 designated as low-risk (elimination).
• 88 (7%) of 1235 HFCAs were identified as highest risk, an improvement from 15% in 2019.
• The at-risk population decreased by 26%, from 3,210,191 to 2,366,068.

Conclusions:

• The updated stratification effectively identifies areas requiring focused malaria control interventions.
• Results guide the strategic reallocation of resources to maximize impact in high-transmission zones.
• Regular national stratification updates are crucial for monitoring progress and achieving malaria elimination goals.