Characterization of Plasmodium falciparum and Plasmodium vivax recent exposure in an area of significantly decreased transmission intensity in Central Vietnam

• Published in: Malaria Journal
• Main Authors: Johanna Helena Kattenberg, Annette Erhart, Minh Hieu Truong, Eduard Rovira-Vallbona, Khac Anh Dung Vu, Thi Hong Ngoc Nguyen, Van Hong Nguyen, Van Van Nguyen, Melanie Bannister-Tyrrell, Michael Theisen, Adam Bennet, Andrew A. Lover, Thanh Duong Tran, Xuan Xa Nguyen, Anna Rosanas-Urgell
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2018
• Subjects: Plasmodium falciparum; Plasmodium vivax; Sero-epidemiology; Vietnam; Reservoir of infection; Malaria exposure; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-018-2326-1; https://doaj.org/article/6a5cfe36811a40b8901fa334e5caeae8

Abstract Background In Vietnam, malaria transmission has been reduced to very low levels over the past 20 years, and as a consequence, the country aims to eliminate malaria by 2030. This study aimed to characterize the dynamics and extent of the parasite reservoir in Central Vietnam, in order to further target elimination strategies and surveillance. Methods A 1-year prospective cohort study (n = 429) was performed in three rural communities in Quang Nam province. Six malaria screenings were conducted between November 2014 and November 2015, including systematic clinical examination and blood sampling for malaria parasite identification, as well as molecular and serological analysis of the study population. Malaria infections were detected by light microscopy (LM) and quantitative real time PCR (qPCR), while exposure to Plasmodium falciparum and Plasmodium vivax was measured in the first and last survey by ELISA for PfAMA1, PfGLURP R2, PvAMA1, and PvMSP1-19. Classification and regression trees were used to define seropositivity and recent exposure. Results Four malaria infections (2 P. falciparum, 2 P. vivax) were detected in the same village by qPCR and/or LM. No fever cases were attributable to malaria. At the same time, the commune health centre (serving a larger area) reported few cases of confirmed malaria cases. Nevertheless, serological data proved that 13.5% of the surveyed population was exposed to P. falciparum and/or P. vivax parasites during the study period, of which 32.6% were seronegative at the start of the study, indicating ongoing transmission in the area. Risk factor analysis for seroprevalence and exposure to P. falciparum and/or P. vivax identified structural or economic risk factors and activity/behaviour-related factors, as well as spatial heterogeneity at the village level. Conclusions Previous studies in Central Vietnam demonstrated high occurrence of asymptomatic and sub-microscopic infections. However, in this study very few asymptomatic infections were detected despite serological ...