Malaria Survey in the Tak Province Refugee Camps
According to the World Malaria Report, there were significant decreases in the number of P.falciparum (PF) malaria cases worldwide in the past decade. On the Thai-Myanmar border where transmission is low and seasonal and where incidence of Multi-drugs resistant P.falciparum parasites is the highest, the same trend has been observed with a clear decline in malaria episodes and the ratio of P. falciparum/P. vivax (PF/PV.
Economic development, unprecedented financial support, renewed efforts in vector control, a wider use of rapid diagnosic tests (RDTs) for malaria and the deployment of artemisinin based combination treatments (ACT) are the main contributing factors to those successes against malaria.
However the emergence in Cambodia and on the Thai-Myanmar border of P.falciparum isolates that exhibit resistance to artesunate is threatening those gains . This is characterized by a slow parasite clearance rate observed in patients treated with artesunate.
At the same time, recent SMRU surveys along the Thai-Burmese border using a new cutting-edge technology i.e. highly sensitive quantitative Real Time PCR (RT-PCR) able to detect very low parasitaemia (10 parasites per ml), found up to a 3-5 fold increase in the prevalence of malaria compared to what is found with the usual diagnostic tools such as microscopy, RDT or even conventional PCR.
It seems that a large number of asymptomatic carriers with very low parasites counts (a large potential malaria reservoir) go undetected. If confirmed, this might pose the greatest obstacle for malaria elimination in the region and containment of artemisinin resistance.
The purpose of the survey is to further study and understand the epidemiology of malaria in the refugee camp population using cutting-edge technology (RT-PCR) .
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Diagnostic
|Official Title:||Malaria Survey in the Tak Province Refugee Camps|
- Malaria prevalence [ Time Frame: 1 day ] [ Designated as safety issue: No ]Comparison of malaria prevalence by conventional microscopy and RT-PCR to determine the malaria epidemiology in the population
- Determine the percentage of households with at least one long lasting insecticide treated nets (LLIN) or insecticide treated nets (ITNs [ Time Frame: 1 day ] [ Designated as safety issue: No ]• percentage of households with at least one long lasting insecticide treated nets (LLIN) or insecticide treated nets (ITNs) per 2 persons
- Determine the percentage of refugees sleeping under an ITN/LLIN previous night [ Time Frame: 1 day ] [ Designated as safety issue: No ]Percentage of refugees sleeping under an ITN/LLIN previous night
- Determine the percentage of refugees who can recall at least 1 key messages on malaria control and containment/elimination [ Time Frame: 1 day ] [ Designated as safety issue: No ]The percentage of refugees who can recall at least 1 key messages on malaria control and containment/elimination
- Determine percentage of refugees who stay overnight outside the camp [ Time Frame: 1 day ] [ Designated as safety issue: No ]The percentage of refugees who stay overnight outside the camp
|Study Start Date:||July 2013|
|Study Completion Date:||December 2013|
|Primary Completion Date:||December 2013 (Final data collection date for primary outcome measure)|
In each camp, the camp residences are divided into different sections (as clusters for sampling) by camp registration. In the first stage, sections are selected using Population-proportion-to size (PPS) method. In the second stage, households are randomly selected from the household list in each section provided by NGO and local committee. When a household is not responding, a nearest household on the north will be used as replacement. All family members and overnight guests aged above 5 years in the selected household will be invited for venous blood sample (2 ml); for children aged 1-5 years old, the blood sample (100 microL) will be obtained by finger prick; children younger than 1 year old are excluded. The head of household will be invited for a short questionnaire.
Participants will be invited to complete questionnaires and those who are over 5 year of age will be asked to give blood samples.
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01902797
|Mae Sot, Tak, Thailand, 63110|
|Principal Investigator:||Stephane Proux, PhD||Shoklo Malaria Research Unit|