This synthesis mapped malaria evidence among migrant and mobile populations in the Greater Mekong Subregion across epidemiology, access, prevention, and health-system challenges. Of 847 records, 52 studies met inclusion criteria. Reported burden was generally low but highly variable, with hidden reservoirs from asymptomatic or submicroscopic infection in border and forest settings. Structural barriers contributed to delayed diagnosis, inconsistent prevention, and reliance on informal or cross-border care. The review exposes intervention-evaluation gaps rather than proving which approach works best.
Key findings
- Fifty-two of 847 records were included. Reported burden was generally low but highly heterogeneous across settings, populations, diagnostics, and periods, so it should not be collapsed into one pooled prevalence.
- Residual transmission concentrated in border and forest areas, with asymptomatic and submicroscopic infections suggesting reservoirs that routine detection may miss.
- Cross-border mobility, precarious work, legal and administrative status, language, and limited service access contributed to delayed diagnosis and treatment, inconsistent prevention, and informal or cross-border care.
- Community-based services and mobile-health approaches showed promise, but limited coverage and evaluation prevent claims that any one intervention is superior.
Why this matters globally
The 2030 elimination goal is vulnerable if surveillance assumes fixed residence and nationally bounded care while people work and move across provinces and borders. The review supports flexible services, cross-border follow-up, and forest-work prevention, but the evidence base still needs implementation and comparative studies measuring access, continuity, and epidemiological outcomes.
Thai researcher contribution
Pyae Linn Aung, Naing Bo Bo Min, and Jetsumon Sattabongkot are affiliated with the Mahidol Vivax Research Unit, while Ajjima Thussachan is with Mahidol’s Department of Tropical Pediatrics. Jetsumon is the corresponding author. Core support came from Mahidol University’s Research Cluster Development Fund, with NIH and Gates Foundation support for selected authors. The Early Version does not expose individual CRediT roles, so no further task-level attribution is inferred.
Limitations to consider
A scoping review maps evidence rather than producing pooled effects or direct intervention comparisons. Searching only PubMed and Scopus may miss programme reports, government data, and literature outside those databases. The 52 studies varied substantially in population definitions, settings, diagnostics, and outcomes, limiting quantitative comparison. Evidence of asymptomatic infection does not quantify the total reservoir, and community or mobile-health approaches remain sparsely evaluated. The publisher page is an accepted, peer-reviewed Early Version still subject to editing before the Version of Record.