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Navigating the COVID-19 Crisis to Sustain Community-Based Malaria Interventions in Cambodia

May 19, 2021 - 14:05 -- Open Access
Feldman M, Vernaeve L, Tibenderana J, Braack L, Debackere M, Thu HK, Hamade P, Lo K
Glob Health Sci Pract. 2021 May 13

Cambodia has made impressive progress in reducing malaria trends and, in 2018, reported no malaria-related deaths for the first time. However, the coronavirus disease (COVID-19) pandemic presents a potential challenge to the country's goal for malaria elimination by 2025. The path toward malaria elimination depends on sustained interventions to prevent rapid resurgence, which can quickly set back any gains achieved.Malaria Consortium supported mobile malaria workers (MMWs) to engage with target communities to build acceptance, trust, and resilience.

Novel anti-malarial drug strategies to prevent artemisinin partner drug resistance: A model-based analysis

March 30, 2021 - 14:22 -- Open Access
Kunkel A, White M, Piola P
PLoS Comput Biol. 2021 Mar 25;17(3):e1008850

Emergence of resistance to artemisinin and partner drugs in the Greater Mekong Subregion has made elimination of malaria from this region a global priority; it also complicates its achievement. Novel drug strategies such as triple artemisinin combination therapies (ACTs) and chemoprophylaxis have been proposed to help limit resistance and accelerate elimination. The objective of this study was to better understand the potential impacts of triple ACTs and chemoprophylaxis, using a mathematical model parameterized using data from Cambodia.

Anopheles ecology, genetics and malaria transmission in northern Cambodia

March 24, 2021 - 14:09 -- Open Access
Vantaux A, Riehle MM, Witkowski B, et al.
Sci Rep. 2021 Mar 19;11(1):6458

In the Greater Mekong Subregion, malaria cases have significantly decreased but little is known about the vectors or mechanisms responsible for residual malaria transmission. We analysed a total of 3920 Anopheles mosquitoes collected during the rainy and dry seasons from four ecological settings in Cambodia (villages, forested areas near villages, rubber tree plantations and forest sites). Using odor-baited traps, 81% of the total samples across all sites were collected in cow baited traps, although 67% of the samples attracted by human baited traps were collected in forest sites. Overall, 20% of collected Anopheles were active during the day, with increased day biting during the dry season.

Eliminating Plasmodium falciparum malaria: results from tailoring active case detection approaches to remote populations in forested border areas in north-eastern Cambodia

February 23, 2021 - 14:22 -- Open Access
Ann-Sophie Stratil, Lieven Vernaeve, Sergio Lopes, Yves Bourny, Kylie Mannion, Prudence Hamade, Arantxa Roca-Feltrer, James K. Tibenderana, Siv Sovannaroth and Mark Debackere
Malaria Journal 2021 20:108, 22 February 2021

Remaining Plasmodium falciparum cases in Cambodia are concentrated in forested border areas and in remote populations who are hard to reach through passive case detection. A key approach to reach these populations is active case detection by mobile malaria workers (MMWs). However, this is operationally challenging because of changing movement patterns of the target population moving into less accessible areas. From January 2018 to December 2020, a tailored package of active case detection approaches was implemented in forested border areas of three provinces in north-eastern Cambodia to reach remote populations and support the elimination of falciparum malaria.

NOT Open Access | Distribution and temporal dynamics of P. falciparum chloroquine resistance transporter mutations associated with piperaquine resistance in Northern Cambodia

February 3, 2021 - 15:27 -- NOT Open Access
Shrestha B, Shah Z, Takala-Harrison S, et al.
J Infect Dis. 2021 Feb 2:jiab055

Newly emerged mutations within the Plasmodium falciparum chloroquine resistance transporter (PfCRT) can confer piperaquine resistance in the absence of amplified plasmepsin II (pfpm2). In this study, we estimated the prevalence of co-circulating piperaquine resistance mutations in P. falciparum isolates collected in northern Cambodia from 2009-2017.

Choosing interventions to eliminate forest malaria: preliminary results of two operational research studies inside Cambodian forests

January 21, 2021 - 15:43 -- Open Access
Amber Kunkel, Chea Nguon, Patrice Piola, et al.
Malaria Journal 2021 20:51, 20 January 2021

Rapid elimination of Plasmodium falciparum malaria in Cambodia is a goal with both national and international significance. Transmission of malaria in Cambodia is limited to forest environments, and the main population at risk consists of forest-goers who rely on forest products for income or sustenance. The ideal interventions to eliminate malaria from this population are unknown.

Not Open Access | Selection of cytochrome b mutants is rare among Plasmodium falciparum patients failing treatment with atovaquone-proguanil in Cambodia

December 29, 2020 - 14:56 -- NOT Open Access
Lin JT, Waltmann A, Wojnarski M, et al.
Antimicrob Agents Chemother. 2020 Dec 23:AAC.01249-20

Atovaquone-proguanil remains effective against multidrug-resistant Plasmodium falciparum in Southeast Asia, but resistance is mediated by a single point mutation in cytochrome b (cytb) that can arise during treatment. Among 14 atovaquone-proguanil treatment failures in a clinical trial in Cambodia, only one recrudescence harbored the cytb mutation Y268C.

Forest malaria in Cambodia: the occupational and spatial clustering of Plasmodium vivax and Plasmodium falciparum infection risk in a cross-sectional survey in Mondulkiri province, Cambodia

November 24, 2020 - 13:39 -- Open Access
Mirco Sandfort, Amélie Vantaux, Ivo Mueller, et al.
Malaria Journal 2020 19:413, 19 November 2020

After a marked reduction in malaria burden in Cambodia over the last decades, case numbers increased again in 2017–2018. In light of the national goal of malaria elimination by 2025, remaining pockets of high risk need to be well defined and strategies well-tailored to identify and target the persisting burden cost-effectively. This study presents species-specific prevalence estimates and risk stratification for a remote area in Cambodia.

A cautionary note on the use of unsupervised machine learning algorithms to characterise malaria parasite population structure from genetic distance matrices

October 13, 2020 - 12:34 -- Open Access
Watson JA, Taylor AR, Ashley EA, Dondorp A, Buckee CO, White NJ, Holmes CC
PLoS Genet. 2020 Oct 9;16(10):e1009037

Genetic surveillance of malaria parasites supports malaria control programmes, treatment guidelines and elimination strategies. Surveillance studies often pose questions about malaria parasite ancestry (e.g. how antimalarial resistance has spread) and employ statistical methods that characterise parasite population structure. Many of the methods used to characterise structure are unsupervised machine learning algorithms which depend on a genetic distance matrix, notably principal coordinates analysis (PCoA) and hierarchical agglomerative clustering (HAC).

Prevalence of CYP2D6 Genotypes and Predicted Phenotypes in a Cohort of Cambodians at High Risk for Infections with Plasmodium vivax

August 12, 2020 - 15:12 -- Open Access
Spring MD, Lon C, Sok S, Sea D, Wojnarski M, Chann S, Kuntawunginn W, Kheang Heng T, Nou S, Arsanok M, Sriwichai S, Vanachayangkul P, Lin JT, Manning JE, Jongsakul K, Pichyangkul S, Satharath P, Smith PL, Dysoley L, Saunders DL, Waters NC
Am J Trop Med Hyg. 2020 Aug;103(2):756-759.

Clinical failure of primaquine (PQ) has been demonstrated in people with CYP450 2D6 genetic polymorphisms that result in reduced or no enzyme activity. The distribution of CYP2D6 genotypes and predicted phenotypes in the Cambodian population is not well described. Surveys in other Asian countries have shown an approximate 50% prevalence of the reduced activity CYP2D6 allele *10, which could translate into increased risk of PQ radical cure failure and repeated relapses, making interruption of transmission and malaria elimination difficult to achieve.


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