An active and targeted survey reveals asymptomatic malaria infections among high-risk populations in Mondulkiri, Cambodia.


Journal

Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802

Informations de publication

Date de publication:
23 Jun 2023
Historique:
received: 06 02 2023
accepted: 20 06 2023
medline: 26 6 2023
pubmed: 24 6 2023
entrez: 23 6 2023
Statut: epublish

Résumé

Malaria is a mosquito-borne disease that is one of the most serious public health issues globally and a leading cause of mortality in many developing countries worldwide. Knowing the prevalence of both symptomatic and asymptomatic malaria on a subnational scale allows for the estimation of the burden of parasitaemia present in the transmission system, enabling targeting and tailoring of resources towards greater impact and better use of available capacity. This study aimed to determine the PCR-based point prevalence of malaria infection, by parasite species, among three high-risk populations in Mondulkiri province, Cambodia: forest rangers, forest dwellers, and forest goers. A cross-sectional survey was performed during the transmission season in November and December 2021. Blood samples collected on filter paper from participants (n = 1301) from all target groups were screened for Plasmodium spp using PCR. Malaria prevalence among all study participants was 6.7% for any Plasmodium species. Malaria prevalence in the forest ranger group was 8.1%, was 6.8% in forest goers, and 6.4% in forest dwellers; all infections were asymptomatic. Plasmodium vivax was detected in all participant groups, while the few Plasmodium falciparum infections were found in goers and dwellers. 81% of all infections were due to P. vivax, 9% were due to P. falciparum, 3% due to Plasmodium cynomolgi, and the rest (7%) remained undefined. Gender was associated with malaria infection prevalence, with male participants having higher odds of malaria infection than female participants (OR = 1.69, 95% CI 1.08-2.64). Passively collected malaria incidence data from the Cambodian government were also investigated. Health facility-reported malaria cases, based on rapid diagnostic tests, for the period Jan-Dec 2021 were 521 Plasmodium vivax (0.89% prevalence), 34 P. falciparum (0.06%) and four P. falciparum + mixed (0.01%)-a total of 559 cases (0.95%) for all of Mondulkiri. This reservoir of asymptomatic parasitaemia may be perpetuating low levels of transmission, and thus, new strategies are required to realize the goal of eliminating malaria in Cambodia by 2025.

Sections du résumé

BACKGROUND BACKGROUND
Malaria is a mosquito-borne disease that is one of the most serious public health issues globally and a leading cause of mortality in many developing countries worldwide. Knowing the prevalence of both symptomatic and asymptomatic malaria on a subnational scale allows for the estimation of the burden of parasitaemia present in the transmission system, enabling targeting and tailoring of resources towards greater impact and better use of available capacity. This study aimed to determine the PCR-based point prevalence of malaria infection, by parasite species, among three high-risk populations in Mondulkiri province, Cambodia: forest rangers, forest dwellers, and forest goers.
METHODS METHODS
A cross-sectional survey was performed during the transmission season in November and December 2021. Blood samples collected on filter paper from participants (n = 1301) from all target groups were screened for Plasmodium spp using PCR.
RESULTS RESULTS
Malaria prevalence among all study participants was 6.7% for any Plasmodium species. Malaria prevalence in the forest ranger group was 8.1%, was 6.8% in forest goers, and 6.4% in forest dwellers; all infections were asymptomatic. Plasmodium vivax was detected in all participant groups, while the few Plasmodium falciparum infections were found in goers and dwellers. 81% of all infections were due to P. vivax, 9% were due to P. falciparum, 3% due to Plasmodium cynomolgi, and the rest (7%) remained undefined. Gender was associated with malaria infection prevalence, with male participants having higher odds of malaria infection than female participants (OR = 1.69, 95% CI 1.08-2.64). Passively collected malaria incidence data from the Cambodian government were also investigated. Health facility-reported malaria cases, based on rapid diagnostic tests, for the period Jan-Dec 2021 were 521 Plasmodium vivax (0.89% prevalence), 34 P. falciparum (0.06%) and four P. falciparum + mixed (0.01%)-a total of 559 cases (0.95%) for all of Mondulkiri.
CONCLUSION CONCLUSIONS
This reservoir of asymptomatic parasitaemia may be perpetuating low levels of transmission, and thus, new strategies are required to realize the goal of eliminating malaria in Cambodia by 2025.

Identifiants

pubmed: 37353790
doi: 10.1186/s12936-023-04630-2
pii: 10.1186/s12936-023-04630-2
pmc: PMC10290344
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

193

Subventions

Organisme : Innovative Vector Control Consortium
ID : A134328

Informations de copyright

© 2023. The Author(s).

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Auteurs

Dyna Doum (D)

Health Forefront Organization, Phnom Penh, Cambodia.

David J Mclver (DJ)

Malaria Elimination Initiative, University of California, San Francisco, CA, USA. david.mciver@ucsf.edu.

John Hustedt (J)

Health Forefront Organization, Phnom Penh, Cambodia.

Jeffrey Hii (J)

Malaria Elimination Initiative, University of California, San Francisco, CA, USA.

Siv Sovannaroth (S)

National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.

Dysoley Lek (D)

National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.

Jason H Richardson (JH)

Innovative Vector Control Consortium, Liverpool, UK.

Allison Tatarsky (A)

Malaria Elimination Initiative, University of California, San Francisco, CA, USA.

Neil F Lobo (NF)

Malaria Elimination Initiative, University of California, San Francisco, CA, USA.
Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA.

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Classifications MeSH