Plasmodium prevalence and artemisinin-resistant falciparum malaria in Preah Vihear Province, Cambodia: a cross-sectional population-based study

Malaria Journal

Research

Fabienne Nackers¹  Lydie Canier²  Nimol Kim²  Didier Ménard²  Saorin Khim²  Sweet C Alipon³  Jean-Marie Kindermans⁴  William Etienne⁴  Jorgen Stassijns⁴  Martin De Smet⁴  Philippe Bosman⁴  Rafael Van den Bergh⁴  Meng Chuor Char⁵  Nguon Chea⁵  Lek Dysoley⁵ 

[1] Epicentre, Saint Sabin Street 8, 75011, Paris, France;Institut Pasteur of Cambodia, Malaria Molecular Epidemiology Unit, PO Box 983, 5 Boulevard Monivong, Phnom Penh, Cambodia;Médecins Sans Frontières, #19 Street 388, Tuol Svay Prey I, Phnom Penh, Chamkarmon, Cambodia;Médecins Sans Frontières, Duprestreet 94, 1090, Brussels, Belgium;National Center for Parasitology, Entomology and Malaria Control (CNM), Ministry of Health (MoH), Corner St 92, Village Trapaing Svay, Sangkat Phnom Penh Thmey, Khan Sen Sok, Phnom Penh, Cambodia;

关键词: Malaria;    Plasmodium falciparum;    Epidemiology;    Artemisinin resistance;    Polymerase chain reaction;    K13-Propeller;    Cambodia;   

DOI  :  10.1186/1475-2875-13-394

 received in 2014-08-06, accepted in 2014-09-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundIntensified efforts are urgently needed to contain and eliminate artemisinin-resistant Plasmodium falciparum in the Greater Mekong subregion. Médecins Sans Frontières plans to support the Ministry of Health in eliminating P. falciparum in an area with artemisinin resistance in the north-east of Cambodia. As a first step, the prevalence of Plasmodium spp. and the presence of mutations associated with artemisinin resistance were evaluated in two districts of Preah Vihear Province.MethodsA cross-sectional population-based study using a two-stage cluster sampling was conducted in the rural districts of Chhaeb and Chey Saen, from September to October 2013. In each district, 30 clusters of 10 households were randomly selected. In total, blood samples were collected for 1,275 participants in Chhaeb and 1,224 in Chey Saen. Prevalence of Plasmodium spp. was assessed by PCR on dried blood spots. Plasmodium falciparum positive samples were screened for mutations in the K13-propeller domain gene (PF3D7_1343700).ResultThe prevalence of Plasmodium spp. was estimated at 1.49% (95% CI 0.71–3.11%) in Chhaeb and 2.61% (95% CI 1.45–4.66%) in Chey Saen. Twenty-seven samples were positive for P. falciparum, giving a prevalence of 0.16% (95% CI 0.04–0.65) in Chhaeb and 2.04% (95% CI 1.04–3.99%) in Chey Saen. Only 4.0% of the participants testing positive presented with fever or history of fever. K13-propeller domain mutant type alleles (C580Y and Y493H) were found, only in Chey Saen district, in seven out of 11 P. falciparum positive samples with enough genetic material to allow testing.ConclusionThe overall prevalence of P. falciparum was low in both districts but parasites presenting mutations in the K13-propeller domain gene, strongly associated with artemisinin-resistance, are circulating in Chey Saen.The prevalence might be underestimated because of the absentees – mainly forest workers - and the workers of private companies who were not included in the study. These results confirm the need to urgently develop and implement targeted interventions to contain and eliminate P. falciparum malaria in this district before it spreads to other areas.

【 授权许可】

Unknown   
© Bosman et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.