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This study aimed to assess the village-level temporal patterns of<jats:italic>Plasmodium<\/jats:italic>infection in two districts of the north-eastern state of Meghalaya and evaluate risk factors that might explain these patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Primary Health Centre passive malaria case data from 2014 to 2018 were analysed to characterize village-specific annual incidence and temporal trends. Active malaria case detection was undertaken in 2018 and 2019 to detect<jats:italic>Plasmodium<\/jats:italic>infections using PCR. A questionnaire collected socio-demographic, environmental, and behavioural data, and households were spatially mapped via GPS. Adult mosquitoes were sampled at a subset of subjects' houses, and<jats:italic>Anopheles<\/jats:italic>were\u00a0identified by PCR and sequencing. Risk factors for<jats:italic>Plasmodium<\/jats:italic>infection were evaluated using bivariate and multivariate logistic regression analysis, and spatial cluster analysis\u00a0was undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The annual malaria incidence from PHC-based passive surveillance datasets in 2014\u20132018 was heterogenous but declining across villages in both districts. Active surveillance in 2018 enrolled 1468 individuals from 468 households (West Jaintia Hills) and 1274 individuals from 359 households (West Khasi Hills).<jats:italic>Plasmodium falciparum<\/jats:italic>prevalence per 100 people varied from 0 to 4.1% in the nine villages of West Jaintia Hills, and from 0 to 10.6% in the 12 villages of West Khasi Hills<jats:bold>.<\/jats:bold>Significant clustering of<jats:italic>P. falciparum<\/jats:italic>infections [observed\u2009=\u200911, expected\u2009=\u20092.15, Relative Risk (RR)\u2009=\u200912.65;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001] was observed in West Khasi Hills. A total of 13<jats:italic>Anopheles<\/jats:italic>species were found at 53 houses in five villages, with<jats:italic>Anopheles jeyporiensis<\/jats:italic>being the most abundant. Risk of infection increased with presence of mosquitoes and electricity in the households [Odds Ratio (OR)\u2009=\u20091.19 and 1.11], respectively. Households with reported animals had reduced infection risk (OR\u2009=\u20090.91).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Malaria incidence during 2014\u20132018 declined in all study villages covered by the passive surveillance data, a period that includes the first widespread insecticide-treated net campaign. The survey data from 2018 revealed a significant association between<jats:italic>Plasmodium<\/jats:italic>infection and certain household characteristics. Since species of<jats:italic>Plasmodium<\/jats:italic>-competent mosquito vectors continue to be abundant, malaria resurgence remains a threat, and control efforts should continue.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12936-021-03600-w","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T13:22:27Z","timestamp":1612444947000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Spatial and temporal village-level prevalence of Plasmodium infection and associated risk factors in two districts of Meghalaya, India"],"prefix":"10.1186","volume":"20","author":[{"given":"Anne","family":"Kessler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badondor","family":"Shylla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upasana Shyamsunder","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rilynti","family":"Lyngdoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bandapkupar","family":"Mawkhlieng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"van Eijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Sullivan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparup","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Walton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark L.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-5020","authenticated-orcid":false,"given":"Jane M.","family":"Carlton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Albert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"3600_CR1","doi-asserted-by":"publisher","DOI":"10.30875\/f309483f-en","volume-title":"World Malaria Report 2018","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. 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