The selected study sites in the Maprik and Wosera-Gawi districts cover a combined area of over 160 km
2 that is characterized by low hills, plains and riverine plains with a wet tropical climate [26 (
link)]. The natural vegetation is lowland hill forest that has mostly been replaced by re-growth following cultivation. Extensive grasslands are common on the riverine plans near the Sepik River. The Wosera study site described previously [26 (
link)] is situated near the center of this expanded study region. In the early 1990's malaria was found to be holoendemic with a peak prevalence of 77% in children 5–9 years of age in the central Wosera area [26 (
link)], with entomological inoculation rates (EIR) estimated at 35.4 infective bites/person-year for
P. falciparum, 12.1 for
P. vivax, and 9.6 for
P. malariae [27 (
link)]. By comparison, recent human studies in the Wosera found prevalence of
P. falciparum to be significantly reduced [24 (
link)].
For the present study five distinct areas surrounding local health facilities (i.e. Brukham, Burui, Ilaita, Ulupu and Wombisa HC) were selected (Figure
1). Brukham, Ilaita and Ulupu are situated in the foothills of the Prince Alexander range, Burui and Wombisa are in the Sepik River plain. In April and May 2005, 3 villages were surveyed in each of the five areas. In order to achieve a near-random sample of the village population a household-based sampling strategy was pursued. A number of households with a total population of 150–200 persons were included in each survey. The surveys included every member of the selected households who could be reached on the day of survey. Individual informed consent was obtained from all study participants (or consent granted by parents or guardians for inclusion of children) using study protocols evaluated and approved by the PNG Medical Research Advisory Committee (MRAC 00.26 & MRAC 05.20).
From each household a semi-structured questionnaire was administered to collect data on type of house, household assets, education of the parents, personal use of bednets, recent health facility attendance and use of antimalarial drugs. From each individual, a thick and thin film was prepared on a single slide and a 250 μl blood sample collected into a K+EDTA microtainer from a finger or heel prick. Haemoglobin measurements were made from this blood sample using a HemoCue 201+ Hb meter (Angholm, Sweden); remaining blood was preserved for extraction of DNA.
A socio-economic index was created using data on household ownership of consumer durables (i.e. bed, mattress, bednet, chairs, umbrella, clothing cupboard, kerosene pressure lamp, kerosene cooker, electric torch, radio, television, car). Households that owned < five consumer durables were classified as "low", > five consumer durables were classified as "medium", those with > 10 as "high" socio-economic status.
Mueller I., Widmer S., Michel D., Maraga S., McNamara D.T., Kiniboro B., Sie A., Smith T.A, & Zimmerman P.A. (2009). High sensitivity detection of Plasmodium species reveals positive correlations between infections of different species, shifts in age distribution and reduced local variation in Papua New Guinea. Malaria Journal, 8, 41.