Malaria Elimination Pilot Study in Military Forces in Cambodia

Summary

Antimalarial drug resistance has reached critical levels on the Thai-Cambodian border. Many have begun advocating for concerted malaria elimination efforts in Cambodia. However, there is currently no consensus on how malaria elimination is to be achieved with the tools available. In this study, the investigators will conduct operational research with the Royal Cambodian Armed Forces (RCAF) and National Malaria Center (CNM) to quantify the relative effectiveness of the two major interventional approaches - monthly malaria prophylaxis (MMP) or focused screening and treatment (FSAT) - in a head to-head comparison. In addition, the investigators will quantify the relative contribution of a recently advocated vector intervention for military personnel - the insecticide treated uniform (ITU) - in addition to other vector control measures currently employed by the RCAF. The investigators will employ the same permethrin insecticide self-application kits currently used by the US military. The investigators will estimate the cost effectiveness of each approach and attempt to define the best way forward for malaria elimination efforts in a critically important malaria reservoir in military population (and their dependents) who reside on the Thai-Cambodian border. The aim of the study is not only to conduct research to better define the best way forward in malaria elimination efforts in the high risk military populations, but to also build capacity within the RCAF to support and lead future elimination efforts in the most difficult-to-reach mobile populations.

Timeline

Start

2016-01

Primary completion

2016-08

Completion

2021-12

Publications

• Wojnarski M, Chaudhury S, Boonchan T, Bun R, Chann S, Gosi P, Soveasna K, Song S, Buathong N, Ittiverakul M, Sriwichai S, Arsanok M, Kuntawunginn W, Saingam P, Chaisatit C, Ponlawat A, Fansiri T, Vanachayangkul P, Jaichapor B, Sinoun M, Chuor CM, Kheangheng T, So M, Wanja E, Davidson S, Spring M, Rekol H, Dysoley L, Saly K, Livezey JR, Lin JT, Smith PL, Satharath P, Manning JE, Sok S, Saunders DL. Evaluating malaria elimination strategies among military forces in Cambodia: a multi-arm clinical trial comparing monthly prophylaxis and focused screening and treatment. BMC Infect Dis. 2025 Dec 12;26(1):84. doi: 10.1186/s12879-025-12207-4.
• Manning J, Lon C, Spring M, Wojnarski M, Somethy S, Chann S, Gosi P, Soveasna K, Sriwichai S, Kuntawunginn W, Fukuda MM, Smith PL, Rekol H, Sinoun M, So M, Lin J, Satharath P, Saunders D. Cluster-randomized trial of monthly malaria prophylaxis versus focused screening and treatment: a study protocol to define malaria elimination strategies in Cambodia. Trials. 2018 Oct 16;19(1):558. doi: 10.1186/s13063-018-2931-x.

Drugs

Indications