Epidemiological situation of malaria infections in Nikshahr: A city in the endemic area of Sistan and Balouchestan province, Southeastern Iran

Abstract

in four geographic regions (central, north, northeast , and south). We analyzed these data using a previously described approach of epidemic reconstruction to derive estimates of how the effective reproduction number, Rt, varied with region and over time. Confidence intervals were calculated using a bootstrap procedure. Results: We found that the estimated Rt values for the first wave peaked at 1.5 (with 95% CI, 1.4-1.7) in the central region and 1.6 (95% CI, 1.4-1.9) in the north, whilst the corresponding values in the northeast and the south were close to 1.3. By the time that the Rt estimate in the central region was below one, the value of Rt in the rest of Thailand had started to increase above one. The value of Rt in the first wave was estimated to be above one continuously for 30 days in all regions. For the second wave, the Rt estimates were only marginally above one within the first three months in all regions except the south. Conclusion: The estimate values of Rt for the first and the second waves of the influenza A H1N1pdm epidemic in Thailand varied by region, with higher estimates obtained from the central and northern regions in the first wave. Accounting for regional variation in transmission potential is important for helping to predict the course of future pandemics and for analysing potential control measures (i.e. regionally-targeted control policies).