BackgroundMyanmar is one of the 31 highest burden malaria countries worldwide. Scaling up the appropriate use of insecticide-treated nets (ITNs) is a national policy for malaria prevention and control. However, the data on use, influencing factors and maintenance of bed nets is still lack among the population in Kachin Special Region II (KR2), Northeastern Myanmar.MethodsThe study combined a quantitative household questionnaire survey and qualitative direct observation of households. A Chi-squared test was used to compare the percentages of ownership, coverage, and rates of use of bed nets. Additionally, multivariate logistic regression analysis (MVLRA) was used to analyse factors that influence the use of bed nets. Finally, covariance compared the mean calibrated hole indexes (MCHI) across potential influence variables.ResultsThe bed net to person ratio was 1:1.96 (i.e., more than one net for every two people). The long-lasting insecticidal net (LLIN) to person ratio was 1: 2.52. Also, the percentage of households that owned at least one bed net was 99.7 % (666/688). Some 3262 (97.3 %) residents slept under bed nets the prior night, 2551 (76.1 %) of which slept under ITNs/LLINs the prior night (SUITNPN). The poorest families, those with thatched roofing, those who use agriculture as their main source of family income, household heads who knew that mosquitoes transmit malaria and those who used bed nets to prevent malaria, were significantly more likely to be in the SUITNPN group. However, residents in lowlands, and foothills were significantly less likely to be SUITNPNs. Finally, head of household attitude towards fixing bed nets influenced MCHI (F = 8.09, P = 0.0046).ConclusionsThe coverage and usage rates of bed nets were high, especially among children, and pregnant women. Family wealth index, geographical zones, household roofing, source of family income, household head’s knowledge of malaria transmission and of using bed nets as tools for malaria prevention are all independent factors which influence use of ITNs/LLINs in KR2. Maintaining high coverage, and use rate of bed nets should be a priority for the war-torn population of KR2 to ensure equity and human rights.

bMalaria in the China-Myanmar border region is still severe; local transmission of both falciparum and vivax malaria persists, and there is a risk of geographically expanding antimalarial resistance. In this research, the pfmdr1, pfcrt, pvmdr1, and K13-propeller genotypes were determined in 26 Plasmodium falciparum and 64 Plasmodium vivax isolates from Yingjiang county of Yunnan province. The pfmdr1 (11.5%), pfcrt (34.6%), and pvmdr1 (3.1%) mutations were prevalent at the China-Myanmar border. The indigenous samples exhibited prevalences of 14.3%, 28.6%, and 14.3% for pfmdr1 N86Y, pfcrt K76T, and pfcrt M74I, respectively, whereas the samples from Myanmar showed prevalences of 10.5%, 21.1%, and 5.3%, respectively. The most prevalent genotypes of pfmdr1 and pfcrt were Y 86 Y 184 and M 74 N 75 T 76 , respectively. No pvmdr1 mutation occurred in the indigenous samples but was observed in two cases coming from Myanmar. In addition, we are the first to report on 10 patients (38.5%) with five different K13 point mutations. The F446I allele is predominant (19.2%), and its prevalence was 28.6% in the indigenous samples of Yingjiang county and 15.8% in samples from Myanmar. The present data might be helpful for enrichment of the molecular surveillance of antimalarial resistance and useful for developing and updating guidance for the use of antimalarials in this region. Malaria is a serious public health problem in the Greater Mekong Subregion (GMS), which includes Cambodia, Laos, Thailand, Vietnam, Myanmar, and Yunnan province of China (1). Within this region, malaria transmission is particularly intense in international border areas. The malaria prevalence along the China-Myanmar border is particularly high, and malaria outbreaks have occurred frequently (2). In 2010, China initiated the National Malaria Elimination Action Plan, which aims to eliminate local malaria transmission nationwide by 2015 with the exception of the border region in Yunnan province and to completely eliminate malaria from China by 2020 (3). Despite a great reduction in the number of local malaria cases recently, both Plasmodium falciparum and Plasmodium vivax infections persist in the counties at the China-Myanmar border.Effective chemotherapy is essential for malaria control, but the emergence and spread of multidrug-resistant (MDR) P. falciparum strains have led to the adoption of artemisinin-based combination therapies (ACTs) as the first-line treatment for uncomplicated falciparum malaria in the GMS. However, the confirmed emergence of artemisinin resistance in western Cambodia is a major threat for malaria control and elimination (4). Artemisinin resistance has since spread or emerged independently or both in other areas of mainland Southeast Asia (5). Because this area has been the origin of both chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) resistance (6, 7), the consequences of a similar spread of artemisinin resistance will be catastrophic. Therefore, the World Health Organization (WHO) is coordinating a largescale elimination campa...