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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Focused Screening and Treatment (FSAT): A PCR-Based Strategy to Detect Malaria Parasite Carriers and Contain Drug Resistant P. falciparum, Pailin, Cambodia
PLoS ONE, Volume 7, No. 10, Article e45797, Year 2012
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Description
Recent studies have shown that Plasmodium falciparum malaria parasites in Pailin province, along the border between Thailand and Cambodia, have become resistant to artemisinin derivatives. To better define the epidemiology of P. falciparum populations and to assess the risk of the possible spread of these parasites outside Pailin, a new epidemiological tool named "Focused Screening and Treatment" (FSAT), based on active molecular detection of asymptomatic parasite carriers was introduced in 2010. Cross-sectional malariometric surveys using PCR were carried out in 20 out of 109 villages in Pailin province. Individuals detected as P. falciparum carriers were treated with atovaquone-proguanil combination plus a single dose of primaquine if the patient was non-G6PD deficient. Interviews were conducted to elicit history of cross-border travel that might contribute to the spread of artemisinin-resistant parasites. After directly observed treatment, patients were followed up and re-examined on day 7 and day 28. Among 6931 individuals screened, prevalence of P. falciparum carriers was less than 1%, of whom 96% were asymptomatic. Only 1.6% of the individuals had a travel history or plans to go outside Cambodia, with none of those tested being positive for P. falciparum. Retrospective analysis, using 2010 routine surveillance data, showed significant differences in the prevalence of asymptomatic carriers discovered by FSAT between villages classified as "high risk" and "low risk" based on malaria incidence data. All positive individuals treated and followed-up until day 28 were cured. No mutant-type allele related to atovaquone resistance was found. FSAT is a potentially useful tool to detect, treat and track clusters of asymptomatic carriers of P. falciparum along with providing valuable epidemiological information regarding cross-border movements of potential malaria parasite carriers and parasite gene flow. © 2012 Hoyer et al.
Authors & Co-Authors
Hoyer, Stefan
Switzerland, Geneva
Organisation Mondiale de la Santé
Kim, Saorin
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Khim, Nimol
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Sum, Sarorn
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Christophel, Eva Maria
Switzerland, Geneva
Organisation Mondiale de la Santé
Kheng, Sim
Cambodia, Phnom Penh
National Center for Parasitology, Entomology and Malaria Control
Nguon, Chea
Cambodia, Phnom Penh
National Center for Parasitology, Entomology and Malaria Control
Ariey, Frédéric
France, Paris
Institut Pasteur, Paris
Witkowski, Benoît
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Yeung, Shunmay M.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Socheat, Duong
Cambodia, Phnom Penh
National Center for Parasitology, Entomology and Malaria Control
Newman, Robert David
Switzerland, Geneva
Organisation Mondiale de la Santé
Menard, Didier
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Statistics
Citations: 77
Authors: 13
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0045797
ISSN:
19326203
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study