Let's 'cut to the chase' on malaria elimination in the Greater Mekong Subregion.

The Greater Mekong Subregion has made remarkable progress towards eliminating malaria in recent years, but efforts are now faltering in some areas. The development of tools to control forest-based transmission is taking too long and efforts to control malaria among high-risk mobile people are failing. If countries are to meet their elimination targets and prevent the spread of multidrug-resistant falciparum malaria, urgent and radical changes will be required.

Malaria control in the Greater Mekong Subregion: an overview of the current response and its limitations.

The malaria burden in the Greater Mekong Subregion has been dramatically reduced over the last 20 years but the disease remains an important public health issue in all six countries. This chapter introduces the standard tools for malaria control (long lasting insecticidal nets; indoor residual spraying; early diagnosis and appropriate treatment; epidemic surveillance and response; and, communication) and presents the evidence base supporting the use of each of these tools in the Subregion. Targeting approaches and delivery mechanisms for these tools are presented and discussed country by country.

Malaria situation in the Greater Mekong Subregion.

The epidemiology of malaria in the Greater Mekong Subregion is complex and rapidly evolving. Malaria control and elimination efforts face a daunting array of challenges including multidrug-resistant parasites. This review presents secondary data collected by the national malaria control programs in the six countries between 1998 and 2010 and examines trends over the last decade.

Sub-microscopic malaria cases and mixed malaria infection in a remote area of high malaria endemicity in Rattanakiri province, Cambodia: implication for malaria elimination.

Background: Malaria microscopy and rapid diagnostic tests are insensitive for very low-density parasitaemia. This insensitivity may lead to missed asymptomatic sub-microscopic parasitaemia, a potential reservoir for infection. Similarly, mixed infections and interactions between Plasmodium species may be missed.

Towards high-throughput molecular detection of Plasmodium: new approaches and molecular markers.

Background: Several strategies are currently deployed in many countries in the tropics to strengthen malaria control toward malaria elimination. To measure the impact of any intervention, there is a need to detect malaria properly. Mostly, decisions still rely on microscopy diagnosis.

Large sequence heterogeneity of the small subunit ribosomal RNA gene of Plasmodium ovale in cambodia.

Plasmodium ovale malaria has been reported in various countries in southeast Asia, but never in Cambodia. Using a species-specific polymerase chain reaction (PCR) targeting the small subunit (SSU) ribosomal RNA (rRNA) gene, we detected P. ovale in nearly 4% of the inhabitants of a northeastern Cambodian village.

Evidence for a new conceptualization of semantic representation in the left and right cerebral hemispheres.

Two experiments are reported that examined qualitative differences in how semantic information is represented in the two hemispheres. In the first experiment, items that were associatively related but did not share semantic features or membership in semantic categories produced priming when delivered to the LH (RVF) but not to the RH (LVF). In the second experiment items that shared semantic features but were neither associates nor in the same category produced priming in the RH (LVF), but not in the LH (RVF).

Physiological evidence that a masked unrelated intervening item disrupts semantic priming: implications for theories of semantic representation and retrieval models of semantic priming.

Event-related potentials were recorded in a paradigm where an unrelated word was interposed between two related words. In one condition, the intervening item was masked and in another condition it was not. The N400 component indicated that priming of the related word was disrupted by the intervening item whether it was masked or not.

Population pharmacokinetics of piperaquine in adults and children with uncomplicated falciparum or vivax malaria.

Aims: To study the population pharmacokinetics of piperaquine after co-administration with dihydroartemisinin in uncomplicated malaria.

Methods: The disposition of piperaquine was studied in 85 Cambodian patients with uncomplicated falciparum or vivax malaria treated with the piperaquine-dihydroartemisinin coformulation Artekin. All patients were given Artekin orally at 0, 6, 24 and 32 h with a total piperaquine dose of 32-35 mg base kg-1.

Treatment of uncomplicated falciparum malaria in southern Vietnam: can chloroquine or sulfadoxine-pyrimethamine be reintroduced in combination with artesunate?

The effectiveness of chloroquine or sulfadoxine-pyrimethamine administered with artesunate for treating uncomplicated falciparum malaria was assessed in 2 Vietnamese provinces where the sensitivity of parasites in vitro to conventional therapies had increased with the removal of drug pressure. In the province of Dac Lac, where potential malaria exposure begins at birth, 57 subjects (mean age, 9.6 years) were randomized to receive artesunate-chloroquine (group 1) or artesunate-sulfadoxine-pyrimethamine (group 2).

Anopheline vectors and malaria transmission in eastern Afghanistan.

Anopheline vectors and malaria transmission were studied in 2 river-irrigated, rice-growing districts of eastern Afghanistan from May 1995 to December 1996. Clinical malaria was monitored in 12 rural villages (population 14,538) by passive case detection at local clinics. Adult mosquitoes were collected by space-spraying of living quarters and stables and by cattle bait catches.

pfcrt polymorphism and chloroquine resistance in Plasmodium falciparum strains isolated in Cambodia.

Plasmodium falciparum chloroquine resistance was first detected in Cambodia in the early sixties. Treatment with chloroquine was abandoned 20 years ago. In vitro chloroquine sensitivity monitoring indicates that all eastern Cambodian isolates were sensitive to chloroquine, whereas most isolates collected from western provinces displayed reduced susceptibility to chloroquine.

Efficacy and safety of dihydroartemisinin-piperaquine (Artekin) in Cambodian children and adults with uncomplicated falciparum malaria.

The safety and efficacy of a novel combination of dihydroartemisinin (DHA) and piperaquine, Artekin (Holleykin Pharmaceuticals), were assessed in 106 patients (76 children and 30 adults) with uncomplicated falciparum malaria from 2 remote areas in Cambodia. Age-based doses were given at 0, 8, 24, and 32 h. Mean total DHA and piperaquine doses were 9.

Comparison of three antigen detection methods for diagnosis and therapeutic monitoring of malaria: a field study from southern Vietnam.

Objectives: To compare the sensitivity, specificity and post-treatment persistence of three commonly used rapid antigen detection methods.

Method: We studied 252 Vietnamese patients aged from 4 to 60 years, 157 with falciparum and 95 with vivax malaria and 160 healthy volunteers. An initial blood sample was taken for microscopy, and OptiMAL, immunochromatographic test (ICT) malaria P.