Cambodia is moving towards eliminating malaria. According to the WHO World Malaria Report, less than 100 deaths were attributable to malaria in 2012 (World Malaria Report 2013).
Data from the Cambodia Malaria Surveys of 2004, 2007 and 2010 show that clustering of malaria cases tends to happen not only at village but also at household level. The current research project tests the hypothesis that in a household where a febrile case is reported, testing and treating the co-habitants for asymptomatic malaria may help reduce transmission, and therefore support malaria elimination.
“Understanding how to optimise malaria response approaches to identify asymptomatic infections is key if we are to achieve malaria elimination,” said Asia Technical Director for Malaria Consortium, Dr Arantxa Roca-Feltrer. “This study will provide valuable information on how to implement reactive case detection activities in pre-elimination settings.”
The research team have reported on the challenges and preliminary results. Interim results from January 2014 show that the risk of harbouring an asymptomatic malaria infection is 2.6 times higher in households with a febrile malaria case. Of the febrile cases, 90.8 percent were positive for P.vivax malaria.
Importantly, behind this research project are trained village malaria workers and a fully functional malaria data alert system. Within three days of the village malaria worker reporting a febrile case, 95.5 percent of household members are reached for malaria screening.
Nevertheless, challenges in terms of feasibility remain. These include the time and human resources needed to access remote areas, and test and treat an average of six people per household. The authors comment that in this setting, a field-friendly diagnostic test, which provides a more sensitive but still rapid result, would be a very useful tool. Results from the PCR analyses will be available soon and disseminated through www.malariaconsortium.org and www.mesamalaria.org.
Project title: Understanding the feasibility and potential impact of screening for asymptomatic malaria in households where a febrile case of malaria has been reported in a malaria elimination setting in Pailin province, Western Cambodia.
Principal investigator: Arantxa Roca-Feltrer, Malaria Consortium Asia.
Funded by a grant from the Malaria Eradication Scientific Alliance (MESA).