To characterize malaria and assist in prevention efforts, we conducted a series of epidemiological studies in Sundargarh district, India, as part of an NIH-funded International Center of Excellence for Malaria Research. In a published survey around Rourkela in 2013-2014 (N=1307), malaria prevalence was found to be 8.3%. Using these data, villages were divided into low (<2%), medium (2-10%) and high (>10%) malaria prevalence, and risk factors assessed by type of village. In the six low malaria villages, four persons were positive by PCR; in the four medium malaria villages, prevalence was 7% (35 infections, 7 P. vivax); and in the three high malaria villages, prevalence was 21% (62 infections, 10 P. vivax and 5 mixed with P. vivax and P. falciparum). A total of 30.6% infections were submicroscopic and 40.6% were asymptomatic. Our analyses showed that the rainy season and male gender were risk factors for malaria; in high malaria villages, young age was an additional risk factor, and indoor and outdoor spraying was protective compared to no spraying. We undertook a subsequent behavioral survey in four of the medium and high malaria villages in 2017 to investigate the behavioral aspects of malaria risk. Among 500 participants in 237 households, adult men (15+ years) were more likely to be outside in the evening (34.5% vs. 7.9% among adult women 15+ years and 0.7% among children, p<0.001), or to sleep outside (7.5% vs. 0.5% and 0%, respectively, p<0.001). Although women were more likely to get up before 6 a.m. (86.6%, vs. 70.5% among men, 50.7% among children, p<0.001), men were more likely to be outside in the early morning (77.6% among men, 11.2% among women, and 11.1% among children, p<0.001). More children used insecticide treated nets the previous night (73.4%) than men (45.6%) or women (39.6%), and repellents were used by 29.5% of 234 households (insecticide creams were not used at all). Malaria control and elimination in India will need local approaches, and the promotion of repellent cream use by at-risk groups could be further explored in addition to mass-screen or treat programs in high-risk villages.

为了表征疟疾并协助预防工作，我们在印度 Sundargarh 区进行了一系列流行病学研究，作为 NIH 资助的国际疟疾研究卓越中心的一部分。在 2013 年至 2014 年（N=1307）鲁克拉附近公布的一项调查中，发现疟疾流行率为 8.3%。使用这些数据，村庄被分为低 (<2%)、中 (2-10%) 和高 (>10%) 疟疾流行率，并按村庄类型评估风险因素。在6个低疟村，4人PCR检测呈阳性；在四个中等疟疾村庄，流行率为 7%（35 例感染，7 例间日疟）；在三个疟疾高发村，流行率为 21%（62 例感染，10 例间日疟原虫和 5 例与间日疟原虫和恶性疟原虫）。总共 30.6% 的感染是亚显微的，40.6% 是无症状的。我们的分析表明，雨季和男性是疟疾的危险因素；在疟疾高发村，年轻是一个额外的风险因素，与不喷药相比，室内和室外喷药具有保护作用。我们于 2017 年在四个中高疟疾村庄进行了后续行为调查，以调查疟疾风险的行为方面。在 237 个家庭的 500 名参与者中，成年男性（15 岁以上）更有可能在晚上外出（34.5% 与 15 岁以上成年女性的 7.9% 和儿童的 0.7%，p<0.001）或睡觉外部（分别为 7.5% 与 0.5% 和 0%，p<0.001）。尽管女性更有可能在早上 6 点之前起床（86.6%，男性为 70.5%，儿童为 50.7%，p<0.001），男性更可能在清晨外出（男性为 77.6%，女性为 11.2%，儿童为 11.1%，p<0.001）。前一天晚上使用经杀虫剂处理过的蚊帐的儿童 (73.4%) 多于男性 (45.6%) 或女性 (39.6%)，234 户家庭中有 29.5% 使用了驱虫剂（根本没有使用杀虫剂霜）。在印度控制和消除疟疾需要当地方法，除了在高风险村庄进行大规模筛查或治疗计划之外，还可以进一步探索促进高危人群使用驱虫霜。234 个家庭中的 5%（根本没有使用杀虫剂霜）。在印度控制和消除疟疾需要当地方法，除了在高风险村庄进行大规模筛查或治疗计划之外，还可以进一步探索促进高危人群使用驱虫霜。234 个家庭中的 5%（根本没有使用杀虫剂霜）。在印度控制和消除疟疾需要当地方法，除了在高风险村庄进行大规模筛查或治疗计划之外，还可以进一步探索促进高危人群使用驱虫霜。