The prevalence, incidence and prevention of Plasmodium falciparum infections in forest rangers in Bu Gia Map National Park, Binh Phuoc province, Vietnam: a pilot study

Malaria Journal

Research

Bui Van Quan¹  Nguyen Van Dung¹  Lorenz von Seidlein²  Arjen M. Dondorp²  Nicholas J. White²  Nicholas P. J. Day²  Nguyen Huyen Tran³  Nguyen Thi Kim Tuyen³  Truong Le Phuc-Nhi³  Do Hung Son³  Nguyen Thuy-Nhien³  Ngo Thi Phu³  Guy E. Thwaites⁴  Tran Tinh Hien⁴ 

[1] Binh Phuoc Malaria Prevention and Control Center, Dong Xoai, Binh Phuoc, Vietnam;Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Churchill Hospital, Oxford, UK;Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam;Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam;Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Churchill Hospital, Oxford, UK;

关键词: Plasmodium falciparum;    Plasmodium vivax;    An. dirus;    An. maculatus;    An. barbirostris;    Anti-malarial resistance;    Forest;    Prophylaxis;    DHA;    Piperaquine;    Kelch K13-C580Y;    Plasmepsin;   

DOI  :  10.1186/s12936-017-2091-6

 received in 2017-08-07, accepted in 2017-10-27,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundProphylaxis for high-risk populations, such as forest workers, could be one component for malaria elimination in the Greater Mekong Sub-region. A study was conducted to assess the malaria incidence in forest rangers and the feasibility of malaria prophylaxis for rangers sleeping in forest camps.MethodsForest rangers deployed in the Bu Gia Map National Park, Vietnam were invited to participate in the study. Plasmodium infections were cleared using presumptive treatment, irrespective of malaria status, with a 3-day course dihydroartemisinin/piperaquine (DP) and a 14-day course of primaquine. Before returning to the forest, study participants were randomly allocated to a 3-day course of DP or placebo. Fifteen days after returning from their forest deployment the participants were tested for Plasmodium infections using uPCR.ResultsPrior to treatment, 30 of 150 study participants (20%) were found to be infected with Plasmodium. Seventeen days (median) after enrolment the rangers were randomized to DP or placebo 2 days before returning to forest camps where they stayed between 2 and 20 days (median 9.5 days). One ranger in the DP-prophylaxis arm and one in the placebo arm were found to be infected with Plasmodium falciparum 15 days (median) after returning from the forest. The evaluable P. falciparum isolates had molecular markers indicating resistance to artemisinins (K13-C580Y) and piperaquine (plasmepsin), but none had multiple copies of pfmdr1 associated with mefloquine resistance.ConclusionAnti-malarial prophylaxis in forest rangers is feasible. The findings of the study highlight the threat of multidrug-resistant malaria.Trial registration NCT02788864

【 授权许可】

CC BY   
© The Author(s) 2017