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The emergence and spread of drug resistance is a problem hindering malaria elimination in Southeast Asia. In this study, genetic variations in drug resistance markers of Plasmodium falciparum were determined in parasites from asymptomatic populations located in three geographically dispersed townships of Myanmar by PCR and sequencing. Mutations in dihydrofolate reductase (pfdhfr), dihydropteroate synthase (pfdhps), chloroquine resistance transporter (pfcrt), multidrug resistance protein 1 (pfmdr1), multidrug resistance-associated protein 1 (pfmrp1), and Kelch protein 13 (k13) were present in 92.3%, 97.6%, 84.0%, 98.8%, and 68.3% of the parasites, respectively. The pfcrt K76T, pfmdr1 N86Y, pfmdr1 I185K, and pfmrp1 I876V mutations were present in 82.7%, 2.5%, 87.5%, and 59.8% isolates, respectively. The most prevalent haplotypes for pfdhfr, pfdhps, pfcrt and pfmdr1 were 51I/59R/108N/164L, 436A/437G/540E/581A, 74I/75E/76T/220S/271E/326N/356T/371I, and 86N/130E/184Y/185K/1225V, respectively. In addition, 57 isolates had three different point mutations (K191T, F446I, and P574L) and three types of N-terminal insertions (N, NN, NNN) in the k13 gene. In total, 43 distinct haplotypes potentially associated with multidrug resistance were identified. These findings demonstrate a high prevalence of multidrug-resistant P. falciparum in asymptomatic infections from diverse townships in Myanmar, emphasizing the importance of targeting asymptomatic infections to prevent the spread of drug-resistant P. falciparum.

Background The malaria burden of Myanmar still remains high within the Greater Mekong Subregion of Southeast Asia. An important indicator of progress towards malaria elimination is the prevalence of parasite infections in endemic populations. Information about malaria epidemiology is mostly derived from reports of confirmed acute malaria cases through passive case detection, whereas the prevalence of baseline subclinical malaria infections is much less known. Methods In this study, cross-sectional surveys were conducted during the rainy season of 2017 in four townships (Bilin, Thabeikkyin, Banmauk and Paletwa) of Myanmar with divergent annual malaria incidences. A total of 1991 volunteers were recruited from local villages and Plasmodium subclinical infections were estimated by light microscopy (LM), rapid diagnostic tests (RDTs) and nested PCR. The nested PCR analysis was performed with a modified pooling strategy that was optimized based on an initial estimate the infection prevalence. Results The overall malaria infection prevalence based on all methods was 13.9% (277/1991) and it differed drastically among the townships, with Paletwa in the western border having the highest infection rate (22.9%) and Thabeikkyin in central Myanmar having the lowest (3.9%). As expected, nested PCR was the most sensitive and identified 226 (11.4%) individuals with parasite infections. Among the parasite species, Plasmodium vivax was the most prevalent in all locations, while Plasmodium falciparum also accounted for 32% of infections in the western township Paletwa. Two RDTs based on the detection of the hrp2 antigen detected a total of 103 P. falciparum infections, and the ultrasensitive RDT detected 20% more P. falciparum infections than the conventional RDT. In contrast, LM missed the majority of the subclinical infections and only identified 14 Plasmodium infections. Conclusions Cross-sectional surveys identified considerable levels of asymptomatic Plasmodium infections in endemic populations of Myanmar with P. vivax becoming the predominant parasite species. Geographical heterogeneity of subclinical infections calls for active surveillance of parasite infections in endemic areas. The pooling scheme designed for nested PCR analysis offers a more practical strategy for large-scale epidemiological studies of parasite prevalence. Such information is important for decision-makers to put forward a more realistic action plan for malaria elimination. Electronic supplementary material The online version of this article (10.1186/s13071-019-3330-1) contains supplementary material, which is available to authorized users.

IntroductionKyauk Kan village of Nyaung-U, Mandalay region, Myanmar is one of the most famous groundnut-growing zones and has been exposed to pesticides.MethodsThis study design provided evaluation of within-person changes in the season across growing and nongrowing periods. A cross-sectional study was performed to identify health problems related to organophosphate pesticide (OP) exposure, to explore the protected use of this pesticide among 400 participants in the community by face-to-face interviews, and to determine the reproductive effects of OP exposure by using biomarkers of 100 male groundnut farmers aged 18–49 years.ResultsThe mean age of the participants was 37.5±9.45 years. Analysis revealed statistically significant differences in seminal parameters (P<0.05 for pH, viscosity, motility, morphology, and sperm count) and in a reproductive hormonal assay (P<0.05 in follicle-stimulating hormone and testosterone) between the growing and nongrowing periods. Blood-cholinesterase levels of plasma cholinesterase in the growing period were significantly higher than those in the nongrowing period (P<0.05).ConclusionOur results suggest that chronic exposure related to OP dose may reduce potential male reproductivity.

Gastrointestinal parasite infection in small ruminants remains one of the major economic losses caused by reduced productivity. A total of 380 faecal samples were taken from 280 sheeps in Magway and Pwintbyu Townships and 100 goats in Natmauk Township, Myanmar. Faecal flotation and sedimentation methods were carried out to detect the presence of parasitic infections. Faecal egg and oocyst counts were carried out using the McMaster technique. The overall occurrence of gastrointestinal parasites in small ruminants was 98.4% (374/380). The occurrence of gastrointestinal parasites in sheep (99.3%) was higher than that in goats (96%). The highest occurrence was found in Eimeria spp. (96%), followed by Trichostrongyle (77.1%), Trichuris spp. (35%), and Moniezia expansa (14%). The mixed infection rate was 84.8% (317/374), while a single infection was 15.2% (57/374). The mean eggs per gram (EPG) and oocysts per gram (OPG) of faeces were ranged from 50 to 600 and 50 to 29,800, respectively. Among the 4 nucleotide sequences isolated, one sequence was 94.10-94.47% similarity with Trichostrongylus colubriformis, reported from Laos, and three sequences showed 96.64-99.46% identity with Haemonchus contortus from Laos, China, India, and Mongolia. As gastrointestinal parasite infection in small ruminants was relatively high in the study area, the development of appropriate treatment and control measures should be provided to reduce production losses.