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Cambodia

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
Author(s): 
Ann-Sophie Stratil, Lieven Vernaeve, Sergio Lopes, Yves Bourny, Kylie Mannion, Prudence Hamade, Arantxa Roca-Feltrer, James K. Tibenderana, Siv Sovannaroth and Mark Debackere
Reference: 
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
Author(s): 
Shrestha B, Shah Z, Takala-Harrison S, et al.
Reference: 
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
Author(s): 
Amber Kunkel, Chea Nguon, Patrice Piola, et al.
Reference: 
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
Author(s): 
Lin JT, Waltmann A, Wojnarski M, et al.
Reference: 
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
Author(s): 
Mirco Sandfort, Amélie Vantaux, Ivo Mueller, et al.
Reference: 
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
Author(s): 
Watson JA, Taylor AR, Ashley EA, Dondorp A, Buckee CO, White NJ, Holmes CC
Reference: 
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
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.

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