Social and Climatic Factors Contributing to the Persistence of Malaria in The Chittagong Hills Tracts of Bangladesh

Abstract

Malaria persists in 13 of Bangladesh's 64 districts, notably in the Chittagong Hill Tract (CHT) districts consisting of Bandarban, Rangamati, and Khagrachhari. While prior studies have explored malaria in Bangladesh, none have delved into the behavioral and climatic factors that simultaneously contribute to its persistence in the CHT districts. This study aims to fill this gap by investigating behaviors influencing malaria persistence in Bangladesh's endemic region, focusing on the Lama, Alikodom, and Naikhongchhari subdistricts of Bandarban district. Data were collected through surveys and key informant interviews (KIIs) in Lama and Alikodom, revealing tribal villages as having the highest concentration of cases, with inhabitants lacking essential knowledge about malaria and prevention methods. Socio-economic dynamics between tribal and Bengali communities emerged as a barrier to accepting information provided by NGOs. Additionally, occupation (employment) was found to be closely linked to malarial sickness. These findings can inform policies to eradicate malaria and protect tribal minorities. Meanwhile, in Naikhongchhari, this study analyzes the relationship between malaria incidence and climatic variables such as rainfall and temperature from 2013 to 2022. Utilizing NGO malaria registry data and meteorological data, significant correlations between rainfall, temperature, and malaria incidence were identified, with temperature and rainfall spikes preceding increases in cases. Despite limitations such as retrospective data collection inaccuracies and omitted determinants, these findings underscore the importance of considering climatic factors in malaria control efforts, necessitating further research for a comprehensive understanding of malaria dynamics. Combined, the overall findings suggest the need for greater education measures using improved communication devoted to preventative efforts among the ethnic minority residents of the CHTs, particularly during the time periods immediately after high rainfall and temperature. Such efforts could contribute greatly to Bangladesh's attempt to eliminate malaria within its borders.