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In light of the national goal of malaria elimination by 2025, remaining pockets of high risk need to be well defined and strategies well-tailored to identify and target the persisting burden cost-effectively. This study presents species-specific prevalence estimates and risk stratification for a remote area in Cambodia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional survey was conducted in 17 villages in the high-incidence province Mondulkiri in the dry season (December 2017 to\u00a0April 2018). 4200 randomly selected participants (2\u201380\u00a0years old) were tested for\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection by PCR. Risk of infection was associated with questionnaire-derived covariates and spatially stratified based on household GPS coordinates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of PCR-detectable\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection was 8.3% (349\/4200) and was more than twice as high for\n                      <jats:italic>Plasmodium vivax<\/jats:italic>\n                      (6.4%, 268) than for\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      (3.0%, 125,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). 97.8% (262\/268) of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      and 92.8% (116\/125,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) of\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      infections were neither accompanied by symptoms at the time of the interview nor detected by microscopy or RDT. Recent travels to forest sites (aOR 2.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and forest work (aOR 2.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were particularly strong risk factors and risk profiles for both species were similar. Large village-level differences in prevalence of\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection were observed, ranging from 0.6% outside the forest to 40.4% inside. Residing in villages at the forest fringe or inside the forest compared to outside was associated with risk of infection (aOR 2.14 and 12.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Villages inside the forest formed spatial hotspots of infection despite adjustment for the other risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Persisting pockets of high malaria risk were detected in forested areas and in sub-populations engaging in forest-related activities. High levels of asymptomatic infections suggest the need of better case detection plans and the predominance of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      the implementation of radical cure. In villages inside the forest, within-village exposure was indicated in addition to risk due to forest activities. Village-level stratification of targeted interventions based on forest proximity could render the elimination efforts more cost-effective and successful.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-020-03482-4","type":"journal-article","created":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T11:03:03Z","timestamp":1605783783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Forest malaria in Cambodia: the occupational and spatial clustering of Plasmodium vivax and Plasmodium falciparum infection risk in a cross-sectional survey in Mondulkiri province, Cambodia"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-6537","authenticated-orcid":false,"given":"Mirco","family":"Sandfort","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Vantaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saorin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Obadia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u00efs","family":"Pepey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soazic","family":"Gardais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimol","family":"Khim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dysoley","family":"Lek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne J.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Witkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,19]]},"reference":[{"key":"3482_CR1","unstructured":"National Center for Parasitology, Entomology and Malaria Control (CNM). 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