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Greater Mekong Subregion

Evolution of multidrug resistance in Plasmodium falciparum: a longitudinal study of genetic resistance markers in the Greater Mekong Subregion

September 15, 2021 - 11:46 -- Open Access
Author(s): 
Imwong M, Suwannasin K, Dondorp AM, et al.
Reference: 
Antimicrob Agents Chemother. 2021 Sep 13:AAC0112121

Increasing drug resistance in Plasmodium falciparum to artemisinins and their ACT partner drugs jeopardises effective antimalarial treatment. Resistance is worst in the Greater Mekong Subregion. Monitoring genetic markers of resistance can help to guide antimalarial therapy. Markers of resistance to artemisinins (PfKelch mutations), mefloquine (amplification of P. falciparum multidrug resistance-1, PfMDR1,), and piperaquine (PfPlasmepsin2/3 amplification and specific P. falciparum chloroquine resistance transporter, PfCRT, mutations) were assessed in 6,722 P. falciparum samples from Vietnam, Lao PDR, Cambodia, Thailand, Myanmar between 2007 and 2019.

Clustering of malaria in households in the Greater Mekong Subregion: operational implications for reactive case detection

September 1, 2021 - 16:29 -- Open Access
Author(s): 
Mavuto Mukaka, Pimnara Peerawaranun, Lorenz von Seidlein, et al.
Reference: 
Malaria Journal 2021 20:351, 26 August 2021

Malaria reactive case detection is the testing and, if positive, treatment of close contacts of index cases. It is included in national malaria control programmes of countries in the Greater Mekong Subregion to accelerate malaria elimination. Yet the value of reactive case detection in the control and elimination of malaria remains controversial because of the low yield, limited evidence for impact, and high demands on resources.

NOT Open Access | Bold measures to accelerate malaria elimination

June 22, 2021 - 14:07 -- NOT Open Access
Author(s): 
Price RN
Reference: 
Lancet Infect Dis. 2021 Jun 17:S1473-3099(21)00003-7

In the Greater Mekong subregion, intense drug pressure and indiscriminate use of poor-quality antimalarial drugs has led to the emergence of antimalarial resistance to all widely used drugs, including the artemisinin derivatives.

Costing electronic private sector malaria surveillance in the Greater Mekong Subregion

April 21, 2021 - 15:00 -- Open Access
Author(s): 
Ann Levin, Rebecca Potter, Kemi Tesfazghi, Saysana Phanalangsy, Phally Keo, Elijah Filip, Si Hein Phone and M. James Eliades
Reference: 
Malaria Journal 2021 20:192, 20 April 2021

Private sector malaria programmes contribute to government-led malaria elimination strategies in Cambodia, Lao PDR, and Myanmar by increasing access to quality malaria services and surveillance data. However, reporting from private sector providers remains suboptimal in many settings. To support surveillance strengthening for elimination, a key programme strategy is to introduce electronic surveillance tools and systems to integrate private sector data with national systems, and enhance the use of data for decision-making. During 2013–2017, an electronic surveillance system based on open source software, District Health Information System 2 (DHIS2), was implemented as part of a private sector malaria case management and surveillance programme. The electronic surveillance system covered 16,000 private providers in Myanmar (electronic reporting conducted by 200 field officers with tablets), 710 in Cambodia (585 providers reporting through mobile app), and 432 in Laos (250 providers reporting through mobile app).

Targeting high risk forest goers for malaria elimination: a novel approach for investigating forest malaria to inform program intervention in Vietnam

October 20, 2020 - 16:18 -- Open Access
Author(s): 
Canavati SE, Kelly GC, Quintero CE, Vo TH, Tran LK, Ngo TD, Tran DT, Edgel KA, Martin NJ
Reference: 
BMC Infect Dis. 2020 Oct 15;20(1):757

Individuals that work and sleep in remote forest and farm locations in the Greater Mekong Subregion continue to remain at high risk of both acquiring and transmitting malaria. These difficult-to-access population groups largely fall outside the reach of traditional village-centered interventions, presenting operational challenges for malaria programs. In Vietnam, over 60% of malaria cases are thought to be individuals who sleep in forests or on farms. New malaria elimination strategies are needed in countries where mobile and migrant workers frequently sleep outside of their homes. The aim of this study was to apply targeted surveillance-response based investigative approaches to gather location-specific data on confirmed malaria cases, with an objective to identify associated malaria prevention, treatment and risk behaviors of individuals sleeping in remote forest and farms sites in Vietnam.

Importance of kelch 13 C580Y mutation in the studies of artemisinin resistance in Plasmodium falciparum in Greater Mekong Subregion

October 7, 2020 - 16:23 -- Open Access
Author(s): 
Zaw MT, Lin Z, Emran NA
Reference: 
J Microbiol Immunol Infect. 2020 Oct;53(5):676-681

The mortality caused by Plasmodium falciparum was reduced by Artemisinin (ART) and ART combination therapy (ACT). However, Artemisinin resistance (ART-R) emerge during 2008 in Cambodia and spread to Greater Mekong Subregion (GMS).

NOT Open Access | Lineage-Specific Expansion of Plasmodium falciparum Parasites With pfhrp2 Deletion in the Greater Mekong Subregion

October 7, 2020 - 14:48 -- NOT Open Access
Author(s): 
Gibbons J, Qin J, Malla P, Wang Z, Brashear A, Wang C, Miao J, Adams JH, Kim K, Jiang R, Cui L
Reference: 
J Infect Dis. 2020 Oct 1;222(9):1561-1569

Deletion of the pfhrp2 gene in Plasmodium falciparum can lead to false-negative rapid diagnostic test (RDT) results, constituting a major challenge for evidence-based malaria treatment. Here we analyzed the whole genome sequences of 138 P. falciparum clinical samples collected from the China-Myanmar boarder for pfhrp2 and pfhrp3 gene deletions.

Current vector research challenges in the greater Mekong subregion for dengue, Malaria, and Other Vector-Borne Diseases: A report from a multisectoral workshop March 2019

August 3, 2020 - 15:40 -- Open Access
Author(s): 
Christofferson RC, Parker DM, Overgaard HJ, Hii J, Devine G, Wilcox BA, Nam VS, Abubakar S, Boyer S, Boonnak K, Whitehead SS, Huy R, Rithea L, Sochantha T, Wellems TE, Valenzuela JG, Manning JE
Reference: 
PLoS Negl Trop Dis 14(7): e0008302

Vector-borne diseases (VBDs) are a significant and growing threat to the health of the 326 million people living in the Greater Mekong Subregion (GMS) (Fig 1). The GMS is a diverse landscape of cities, rural agricultural communities, forests, deltas, wooded hills, and mountains in the six countries along the Mekong River basin.

Molecular epidemiology of resistance to antimalarial drugs in the Greater Mekong subregion: an observational study

July 20, 2020 - 15:55 -- Open Access
Author(s): 
Imwong M, Dhorda M, White NJ, et al.
Reference: 
Lancet Infect Dis. 2020 Jul 14:S1473-3099(20)30228-0

The Greater Mekong subregion is a recurrent source of antimalarial drug resistance in Plasmodium falciparum malaria. This study aimed to characterise the extent and spread of resistance across this entire region between 2007 and 2018.

NOT Open Access | Lineage-specific expansion of Plasmodium falciparum parasites with pfhrp2 deletion in the Greater Mekong Subregion

May 13, 2020 - 13:55 -- NOT Open Access
Author(s): 
Gibbons J, Qin J, Malla P, Wang Z, Brashear A, Wang C, Miao J, Adams JH, Kim K, Jiang R, Cui L
Reference: 
J Infect Dis. 2020 May 9. pii: jiaa250

Deletion of the pfhrp2 gene in Plasmodium falciparum can lead to false negative RDT results, constituting a major challenge for evidence-based malaria treatment. Here we analyzed the whole genome sequences of 138 P. falciparum clinical samples collected from the China-Myanmar boarder for pfhrp2 and pfhrp3 gene deletions. We found pfhrp2 and pfhrp3 deletions in 9.4% and 3.6% samples, respectively, with no samples harboring deletions of both genes.

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