Results from literature search.

Vector resistance, human population movement, and cross-border malaria continue to pose a threat to the attainment of malaria elimination goals. Border malaria is prominent in border regions characterised by poor access to health services, remoteness, and vector abundance. Human socio-economic behaviour, vectoral behaviour, access and use of protective methods, age, sex, and occupation have been identified in non-border regions as key predictors for malaria. We conducted a systematic and meta-analysis review to characterise and establish pooled effect sizes of the factors associated with the occurrence of border malaria. An exhaustive search was done in EBSCOHost (Medline Full Text), Health Source, Google Scholar, Regional Office for Africa Library, African Index Medicus, and PubMed databases. A total of 847 articles were identified from the search and after screening for quality and eligibility, twelve (12) articles were included in the review. Pooled odds ratios, inverse variance statistic (I2), Luis Furuya-Kanamori (LFK) index, and forest plot were computed. Findings from this study suggest night outdoor activities (POR 2.87 95% CI, 1.17 7,01), engaging in forestry activities (POR 2.76 95% CI, 2.08 3.67), working in mines (POR 197 95% CI, 175 22171), access to poor housing structure (POR 3.42 95% CI, 2.14 5.46), and cross-border movement (POR 50.86 95% CI, 12.88 200.85) none use of insecticide-treated nets (POR 5.09 95% CI, 2.44 10.63) were all significantly associated with contracting malaria within border regions. The use of insecticide-treated nets (ITN) (POR 0.61 95% CI, 0.50 0.76) and indoor residual spraying (IRS) (POR 0.61 95% CI, 0.47 0.79) were protective. Risk factors for border malaria are comparable to non-border malaria. Effective border malaria control requires an integrated and targeted approach that addresses socio-economic, environmental, and behavioural drivers. Established vector control interventions remain protective and should be sustained to mitigate the border malaria burden effectively. Novel strategies should be developed to address the unique challenge of cross-border human population movement underpinned by robust regional, bilateral, and multi-sectoral collaborative initiatives.

媒介抗药性 (Vector resistance)、人口流动与跨境疟疾 (Cross-border malaria) 持续对疟疾消除目标的实现构成威胁。边境疟疾在医疗服务可及性差、地理位置偏远且媒介滋生密集的边境地区尤为突出。在非边境地区，人类社会经济行为、媒介行为、防护措施的可及与使用情况、年龄、性别及职业已被证实为疟疾感染的关键预测因素。本研究开展系统综述与元分析 (Meta-analysis)，旨在明确与边境疟疾发病相关的影响因素，并确定其合并效应量。研究团队在EBSCOHost（Medline全文数据库）、Health Source、Google Scholar、非洲区域办事处图书馆、《非洲医学索引》(African Index Medicus) 及PubMed数据库中开展了全面检索。本次检索共获取847篇文献，经质量与纳入排除标准筛查后，最终有12篇文献被纳入本综述。研究计算了合并比值比 (Pooled Odds Ratio, POR)、逆方差统计量（I²）、Luis Furuya-Kanamori（LFK）指数及森林图。本研究结果显示，夜间户外活动（POR=2.87，95%置信区间[CI]：1.17~7.01）、从事林业活动（POR=2.76，95%CI：2.08~3.67）、矿区作业（POR=1.97，95%CI：1.75~2.21）、居住条件简陋（POR=3.42，95%CI：2.14~5.46）、跨境流动（POR=50.86，95%CI：12.88~200.85）以及未使用经杀虫剂处理的蚊帐 (Insecticide-treated Nets, ITN)（POR=5.09，95%CI：2.44~10.63），均与边境地区的疟疾感染显著相关。使用经杀虫剂处理的蚊帐 (ITN)（POR=0.61，95%CI：0.50~0.76）与室内残效喷洒 (Indoor Residual Spraying, IRS)（POR=0.61，95%CI：0.47~0.79）则具有保护作用。边境疟疾的危险因素与非边境地区疟疾的危险因素具有相似性。要有效防控边境疟疾，需采用整合化、针对性的干预策略，以应对社会经济、环境及行为层面的驱动因素。现有媒介控制干预措施仍具有保护作用，应持续推行以有效减轻边境疟疾的疾病负担。应制定新型防控策略，以应对跨境人口流动带来的独特挑战，而这一挑战的应对需依托强有力的区域、双边及多部门协作机制。