Multiplicity of Infection
Multiplicity of infection (MOI), determined by genotyping highly polymorphic markers and counting the numbers of alleles in each infection, is a proxy measure of the intensity of transmission. MOI in all areas was lower in all areas post-LLIN distribution decreasing from 1.8 to 1.3 (p=0.0463 Mann Whitney U test) and 2.0 to 1.4 (p=0.0495 Mann Whitney U test), respectively for P. falciparum and P. vivax . This corresponds with a lower proportion of multiclonal infections, except for P. falciparum in ESP in 2012-13 (Figure 1 and Table S1). Despite an increase in PCR prevalence of P. vivaxin Madang Province in 2014, few multiclonal infections were detected (Figure 1 and Table S1).