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Cambodia

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
Author(s): 
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
Reference: 
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.

Piperaquine resistant Cambodian Plasmodium falciparum clinical isolates: in vitro genotypic and phenotypic characterization

July 27, 2020 - 12:37 -- Open Access
Author(s): 
Nonlawat Boonyalai, Brian A. Vesely, Mariusz Wojnarski, et al.
Reference: 
Malaria Journal 2020 19:269, 25 July 2020

High rates of dihydroartemisinin–piperaquine (DHA–PPQ) treatment failures have been documented for uncomplicated Plasmodium falciparum in Cambodia. The genetic markers plasmepsin 2 (pfpm2), exonuclease (pfexo) and chloroquine resistance transporter (pfcrt) genes are associated with PPQ resistance and are used for monitoring the prevalence of drug resistance and guiding malaria drug treatment policy.

Knowing the enemy: genetics to track antimalarial resistance

July 20, 2020 - 15:51 -- Open Access
Author(s): 
Ménard D, Mayor A
Reference: 
Lancet Infect Dis. 2020 Jul 14:S1473-3099(20)30271-1

In the absence of an effective vaccine, the efficacy of antimalarial chemotherapies  underpins the success of malaria control programmes. Artemisinin-based combination therapies (ACTs), which combine fast-acting artemisinin derivatives and longer-acting  partner drugs, are the mainstay of treatment of uncomplicated falciparum malaria in endemic regions.

Clinical and in vitro resistance of Plasmodium falciparum to artesunate-amodiaquine in Cambodia

May 29, 2020 - 14:34 -- Open Access
Author(s): 
Mairet-Khedim M, Leang R, Witkowski B, et al.
Reference: 
Clin Infect Dis. 2020 May 27:ciaa628

Artesunate-amodiaquine is a potential therapy for uncomplicated malaria in Cambodia.

Malaria elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia

April 27, 2020 - 11:59 -- Open Access
Author(s): 
Kheang ST, Sovannaroth S, Kak N, et al.
Reference: 
BMC Public Health. 2020 Apr 22;20(1):544

Cambodia has targeted malaria elimination within its territory by 2025 and is developing a model elimination package of strategies and interventions designed to achieve this goal.

Tools to accelerate falciparum malaria elimination in Cambodia: a meeting report

April 15, 2020 - 14:32 -- Open Access
Author(s): 
Dysoley Lek, James J. Callery, Jean-Olivier Guintran, et al.
Reference: 
Malaria Journal 2020 19:151, 15 April 2020

Cambodia targets malaria elimination by 2025. Rapid elimination will depend on successfully identifying and clearing malaria foci linked to forests. Expanding and maintaining universal access to early diagnosis and effective treatment remains the key to malaria control and ultimately malaria elimination in the Greater Mekong Subregion (GMS) in the foreseeable future. Mass Drug Administration (MDA) holds some promise in the rapid reduction of Plasmodium falciparum infections, but requires considerable investment of resources and time to mobilize the target communities.

Detecting geospatial patterns of Plasmodium falciparum parasite migration in Cambodia using optimized estimated effective migration surfaces

April 13, 2020 - 15:25 -- Open Access
Author(s): 
Li Y, Shetty AC, Lon C, Spring M, Saunders DL, Fukuda MM, Hien TT, Pukrittayakamee S, Fairhurst RM, Dondorp AM, Plowe CV, O'Connor TD, Takala-Harrison S, Stewart K
Reference: 
Int J Health Geogr. 2020 Apr 10;19(1):13

Understanding the genetic structure of natural populations provides insight into the demographic and adaptive processes that have affected those populations. Such information, particularly when integrated with geospatial data, can have translational applications for a variety of fields, including public health. Estimated effective migration surfaces (EEMS) is an approach that allows visualization of the spatial patterns in genomic data to understand population structure and migration. In this study, we developed a workflow to optimize the resolution of spatial grids used to generate EEMS migration maps and applied this optimized workflow to estimate migration of Plasmodium falciparum in Cambodia and bordering regions of Thailand and Vietnam.

Ability of the Premise Condition Index to Identify Premises with Adult and Immature Aedes Mosquitoes in Kampong Cham, Cambodia

April 13, 2020 - 15:12 -- Open Access
Author(s): 
Hustedt J, Doum D, Hii J, et al.
Reference: 
Am J Trop Med Hyg. 2020 Apr 6

Aedes-transmitted diseases, especially dengue, are increasing throughout the world and the main preventive methods include vector control and the avoidance of mosquito bites. A simple Premise Condition Index (PCI) categorizing shade, house, and yard conditions was previously developed to help prioritize households or geographical areas where resources are limited. However, evidence about the accuracy of the PCI is mixed.

Impact of the first-line treatment shift from dihydroartemisinin/piperaquine to artesunate/mefloquine on Plasmodium vivax drug susceptibility in Cambodia

March 30, 2020 - 10:11 -- Open Access
Author(s): 
Roesch C, Mairet-Khedim M, Kim S, Lek D, Popovici J, Witkowski B
Reference: 
J Antimicrob Chemother. 2020 Mar 24. pii: dkaa092

Cambodia is the epicentre of the emergence of Plasmodium falciparum drug resistance. Much less is known regarding the drug susceptibility of the co-endemic Plasmodium vivax. Only in vitro drug assays can determine the parasite’s intrinsic susceptibility, but these are challenging to implement for P. vivax and rarely performed.

Significant efficacy of single low dose primaquine compared to stand alone artemisinin combination therapy in reducing gametocyte carriage in Cambodian patients with uncomplicated multidrug resistant Plasmodium falciparum malaria

March 19, 2020 - 09:13 -- Open Access
Author(s): 
Vantaux A, Kim S, Piv E, Chy S, Berne L, Khim N, Lek D, Siv S, Mukaka M, Taylor WR, Ménard D
Reference: 
Antimicrob Agents Chemother. 2020 Mar 16. pii: AAC.02108-19

Since 2012, single low dose of primaquine (SLDPQ, 0.25mg/kg) has been recommended with artemisinin-based combination therapies, as first-line treatment of acute uncomplicated Plasmodium falciparum malaria, to interrupt its transmission, especially in low transmission settings of multidrug, including artemisinin, resistance. Policy makers in Cambodia have been reluctant to implement this recommendation due to primaquine safety concerns and lack of data on its efficacy.

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