Targeting vivax malaria in the Asia Pacific: The Asia Pacific Malaria Elimination Network Vivax Working Group

Anstey, NM; Auburn, Sarah; Baird, J. Kevin; Battle, KE; Bobogare, Albino; Chancellor, Arna; Chasombat, Sanchai; Cheng, Qin; Domingo, GJ; Drakeley, CJ; Drukpa, Tobgyel; Lek, Dysoley; Espino, Fe; Gething, Peter W.; Ghimire, Prakash; Gosling, Roland; Grewal-Daumerie, P; Hay, Simon I.; Howes, RE; Hwang, Jimee; Karim, Jahirul; Wa, Khan; Jy, Kim; Ley, Benedikt; Mannion, Kylie; McCarthy, James S.; Keong, W. M.; Müeller, Ivo; Namgay, Rinzin; Price, Ric N.; Gao, Qi; Rebueno, M; Reeder, John C.; Richards, James L.; Sattabongkot, Jetsumon; Shanks, G. Dennis; Sibley, CH; Surya, Asik; Taleo, George; Thang, ND; Thongpaseuth,; Thriemer, Kamala; Trimarsanto, Hidayat; Vestergaard, LS; Seidelein, L von; Whittaker, Maxine; Grp, VW

doi:10.1186/s12936-015-0958-y

Cited by 20 publications

(17 citation statements)

References 56 publications

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“…This process needs to begin now to enhance treatment practice for 8-aminoquinoline drugs based radical cure. Highlighting the benefits of radical cure for the patient and community will improve prescription practice and patient adherence [160].…”

Section: Targeting Vivax Malaria: a Bottleneck To Malaria Eliminationmentioning

confidence: 99%

Human and Simian Malaria in the Greater Mekong Subregion and Challenges for Elimination

Hii¹,

Vythilingam²,

Roca-Feltrer³

2018

Towards Malaria Elimination - A Leap Forward

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In recent years malaria initiatives have increasingly shifted from malaria control to a focus on achieving malaria elimination in the Southeast Asia region. However, this region experiences unique challenges in this transition due to its distinctive malaria ecosystem (mainly related to forests) and high volume of population movement (both within and between countries). These bioenvironmental factors increase the exposure of populations at higher risk due to their close association with forest, and contributes to outdoor and residual transmission. Given that this region has also historically been the source of resistance to anti-malarial drugs, the potential spread of artemisinin resistance via global transportation routes would pose a major threat to malaria control and elimination efforts worldwide. In addition, other factors also hinder the malaria elimination goal such as importation of parasite infection, uncontrolled monkey malaria (Plasmodium knowlesi), or the fact that many countries in this region experience mixed infections where P. vivax becomes a more predominant species as overall malaria transmission decreases. This chapter addresses these challenges in detail and provide recommendations and key priorities to overcome these obstacles to accelerate efforts for achieving malaria elimination.

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Section: Targeting Vivax Malaria: a Bottleneck To Malaria Eliminationmentioning

confidence: 99%

Human and Simian Malaria in the Greater Mekong Subregion and Challenges for Elimination

Hii¹,

Vythilingam²,

Roca-Feltrer³

2018

Towards Malaria Elimination - A Leap Forward

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“…Nearly all malaria-endemic countries in the Asia-Pacific region have committed to malaria elimination by 2030; however most of these countries do not test for G6PD deficiency on a routine basis and PQ is often not prescribed [ 11 , 12 ]. The inclusion of primaquine into national treatment guidelines and its implementation will be essential to the successful elimination of malaria [ 7 ], G6PD testing is currently available in a number of formats [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers to routine G6PD testing prior to treatment with primaquine

Ley

Thriemer

Jaswal

et al. 2017

Malar J

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BackgroundPrimaquine is essential for the radical cure of vivax malaria, however its broad application is hindered by the risk of drug-induced haemolysis in individuals with glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Rapid diagnostic tests capable of diagnosing G6PD deficiency are now available, but these are not used widely.MethodsA series of qualitative interviews were conducted with policy makers and healthcare providers in four vivax-endemic countries. Routine G6PD testing is not part of current policy in Bangladesh, Cambodia or China, but it is in Malaysia. The interviews were analysed with regard to respondents perceptions of vivax malaria, -primaquine based treatment for malaria and the complexities of G6PD deficiency.ResultsThree barriers to the roll-out of routine G6PD testing were identified in all sites: (a) a perceived low risk of drug-induced haemolysis; (b) the perception that vivax malaria was benign and accordingly treatment with primaquine was not regarded as a priority; and, (c) the additional costs of introducing routine testing. In Malaysia, respondents considered the current test and treat algorithm suitable and the need for an alternative approach was only considered relevant in highly mobile and hard to reach populations.ConclusionsGreater efforts are needed to increase awareness of the benefits of the radical cure of Plasmodium vivax and this should be supported by economic analyses exploring the cost effectiveness of routine G6PD testing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1981-y) contains supplementary material, which is available to authorized users.

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“…Early diagnosis, highly effective treatment and intense vector control have led to reductions in the number of malaria cases, as well as severe disease and associated mortality [1]. In 2014, 18 countries in the Asia-Pacific committed to eliminate malaria from the region by 2030; however, the challenges to achieve this goal are immense [2]. The final stages of malaria elimination are often prolonged, with low-grade transmission sustained by a parasite reservoir present in asymptomatic individuals who may not readily engage or attend healthcare facilities to be treated.…”

Section: Introductionmentioning

confidence: 99%

Submicroscopic and Asymptomatic Plasmodium Parasitaemia Associated with Significant Risk of Anaemia in Papua, Indonesia

et al. 2016

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Submicroscopic Plasmodium infections are an important parasite reservoir, but their clinical relevance is poorly defined. A cross-sectional household survey was conducted in southern Papua, Indonesia, using cluster random sampling. Data were recorded using a standardized questionnaire. Blood samples were collected for haemoglobin measurement. Plasmodium parasitaemia was determined by blood film microscopy and PCR. Between April and July 2013, 800 households and 2,830 individuals were surveyed. Peripheral parasitaemia was detected in 37.7% (968/2,567) of individuals, 36.8% (357) of whom were identified by blood film examination. Overall the prevalence of P. falciparum parasitaemia was 15.4% (396/2567) and that of P. vivax 18.3% (471/2567). In parasitaemic individuals, submicroscopic infection was significantly more likely in adults (adjusted odds ratio (AOR): 3.82 [95%CI: 2.49–5.86], p<0.001) compared to children, females (AOR = 1.41 [1.07–1.86], p = 0.013), individuals not sleeping under a bednet (AOR = 1.4 [1.0–1.8], p = 0.035), and being afebrile (AOR = 3.2 [1.49–6.93], p = 0.003). The risk of anaemia (according to WHO guidelines) was 32.8% and significantly increased in those with asymptomatic parasitaemia (AOR 2.9 [95% 2.1–4.0], p = 0.007), and submicroscopic P. falciparum infections (AOR 2.5 [95% 1.7–3.6], p = 0.002). Asymptomatic and submicroscopic infections in this area co-endemic for P. falciparum and P. vivax constitute two thirds of detectable parasitaemia and are associated with a high risk of anaemia. Novel public health strategies are needed to detect and eliminate these parasite reservoirs, for the benefit both of the patient and the community.

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Targeting vivax malaria in the Asia Pacific: The Asia Pacific Malaria Elimination Network Vivax Working Group

Cited by 20 publications

References 56 publications

Human and Simian Malaria in the Greater Mekong Subregion and Challenges for Elimination

Human and Simian Malaria in the Greater Mekong Subregion and Challenges for Elimination

Barriers to routine G6PD testing prior to treatment with primaquine

Submicroscopic and Asymptomatic Plasmodium Parasitaemia Associated with Significant Risk of Anaemia in Papua, Indonesia

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