COVID Lockdown and Malaria Incidence: A Note from the Tropical Endemic Area : APIK Journal of Internal Medicine

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Letter to the Editor

COVID Lockdown and Malaria Incidence: A Note from the Tropical Endemic Area

Mungmunpuntipantip, Rujittika; Wiwanitkit, Viroj1

Author Information
APIK Journal of Internal Medicine 11(2):p 137-138, Apr–Jun 2023. | DOI: 10.4103/ajim.ajim_123_22
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Dear Editor,

Malaria is an important mosquito-borne infection. The pathogenic Plasmodium parasite is the causative agent of malaria and it is presently seen at many tropical countries around the world. In tropical Asia, the disease is highly prevalent and there is an extremely high prevalence of drug-resistant malaria along Myanmar–Thailand border area.[1] Children are an important group affected by malaria.[1] At the border area, the school children are the main group that gets malaria and it can affect school performance, therefore, many school-based malaria control programs have been implemented.[2]

Due to the present emerging COVID-19 crisis, the impact on malaria control is an interesting issue.[3] The interruption of the malaria control program during the COVID-19 pandemic is possible.[4] Here, the author would like to share the local data from the area that there is a co-endemicity between COVID-19 and malaria in Indochina. This area is the local rural province locating at Thailand–Myanmar border. The most updated data on June 2020 showed that there are already 9 COVID-19 cases and 265 malaria cases in this remote forestry area in 2020. All of the pediatric patients are school students and the primary presentation of all cases is high fever.

In the country, COVID-19 started in January 2020 and the lockdown started in March 2020. The data on the incidence of COVID-19 and malaria in this area before and after the COVID-19 lockdown are presented in Table 1. Based on this data, the COVID-19 lockdown, that includes school closure, transportation blockage, and international border closure, can effectively reduce the incidence of COVID-19 in this malaria-endemic area. However, after the lockdown, the incidence of malaria significantly increases.

Table 1:
The incidence of COVID-19 and malaria

In fact, although the study area is a forestry area with high malaria prevalence, the problem of COVID-19 can still be seen. In fact, the rural forestry area does not guarantee for absence of COVID -19 cases and disease might be imported by outside.[5] The blockage of transportation and school closure seems to effectively control COVID-19. However, the lockdown does not have a positive control effect on malaria. Indeed, the difficulty in malaria control due to the COVID-19 lockdown is proposed and the present observation is good clinical evidence to support that hypothesis.[4]

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Conflicts of interest

There are no conflicts of interest.


1. Wernsdorfer WH. Epidemiology of drug resistance in malaria. Acta Trop 1994;56:143–56.
2. Vorasan N, Pan-Ngum W, Jittamala P, Maneeboonyang W, Rukmanee P, Lawpoolsri S. Long-term impact of childhood malaria infection on school performance among school children in a malaria endemic area along the Thai-Myanmar border. Malar J 2015;14:401.
3. Okabayashi H, Thongthien P, Singhasvanon P, Waikagul J, Looareesuwan S, Jimba M, et al. Keys to success for a school-based malaria control program in primary schools in Thailand. Parasitol Int 2006;55:121–6.
4. Hogan AB, Jewell BL, Sherrard-Smith E, Vesga JF, Watson OJ, Whittaker C, et al. Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries:A modelling study. Lancet Glob Health 2020;8:e1132–41.
5. Sriwijitalai W, Wiwanitkit V. COVID-19 in a remote village in a tropical forest –A note. Rural Remote Health 2020;20:6014.
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