Epidemiology and Control of Malaria in Papua New Guinea

Malaria in Papua New Guinea remains a complex public‐health challenge due to co‐endemic Plasmodium falciparum and Plasmodium vivax, multiple Anopheles vector species and a mosaic of ecological and social settings. Transmission intensity varies from high‐burden lowland regions to epidemic‐prone highlands, shaped by vector behaviour, human movement and heterogeneity in health‐service access. Control efforts since 2004 have centred on widespread distribution of long‐lasting insecticidal nets, introduction of artemisinin‐based combination therapies and expansion of rapid diagnostic testing. These measures drove prevalence down from double figures in the late 2000s to below 1 per cent in many areas by 2014. However, resurgence in recent years has exposed limitations in vector surveillance, insecticide efficacy and management of asymptomatic and sub‐microscopic infections. Innovative surveillance systems and targeted interventions, informed by local epidemiology and human behavioural patterns, are now essential to sustain progress and move towards elimination.

Research from Nature Portfolio

Recent work has revealed a marked decline in the bioefficacy of long‐lasting insecticidal nets manufactured after 2013. Laboratory assays using pyrethroid‐susceptible Anopheles farauti mosquitoes showed that fewer than one in five nets met World Health Organization mortality or knockdown criteria, in contrast to full compliance among older nets. This reduced insecticidal activity is implicated in the rebound of malaria transmission since 2015 and underscores the need for stringent quality control of vector‐control commodities and for monitoring net performance under local conditions.

Epidemiology and Control of Malaria in Papua New Guinea publication trend

The graph below shows the total number of articles in epidemiology and control of malaria in papua new guinea across all publications each year (not limited to Nature Index journals).

Technical terms

Long‐lasting insecticidal net (LLIN): A mosquito‐proof bed net treated with insecticide designed to remain effective for at least three years without retreatment.

Bioefficacy: The capacity of an insecticide‐treated material to kill or incapacitate target insects under standardised testing conditions.

Hypnozoite: A dormant liver stage of Plasmodium vivax or Plasmodium ovale that can reactivate weeks to months after initial infection, causing relapse.

Entomological inoculation rate (EIR): The estimated number of infective mosquito bites received per person per unit time, reflecting transmission intensity.

Sub‐microscopic infection: A malaria infection detectable by molecular methods (e.g. PCR) but not by microscopy, contributing to hidden reservoirs of transmission.

References

1. A cross-sectional study to ascertain malaria prevalence among asymptomatic travellers arriving on the Lihir Group of Islands, Papua New Guinea: implications for elimination efforts. Malaria Journal (2023).
2. Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea. Nature Communications (2020).
3. Insecticide-treated nets and malaria prevalence, Papua New Guinea, 2008–2014. Bulletin of the World Health Organization (2017).
4. A review of malaria epidemiology and control in Papua New Guinea 1900 to 2021: Progress made and future directions. Frontiers in Epidemiology (2022).
5. Human Behavior, Livelihood, and Malaria Transmission in Two Sites of Papua New Guinea. The Journal of Infectious Diseases (2021).