Cambodia has been described as the “epicenter of anti-malarial drug resistance” in Southeast Asia and serves as a unique base to study mechanisms of parasite resistance as well as genetic resistance and acquired immunity to both P. falciparum and P. vivax malaria.
In 2005, The Laboratory of Malaria and Vector Research (LMVR), Division of Intramural Research (DIR), National Institute of Allergy and Infectious Diseases (NIAID) in partnership with the National Center for Malaria Control, Entomology and Parasitology (CNM) in Phnom Penh, Cambodia established a malaria research initiative.
On behalf of the LMVR, NIAID has issued a solicitation to secure support (facilities, equipment, personnel, etc.) to conduct studies on malaria in Cambodia. It will also support training of scientists from Cambodia.
LMVR is involved in research on all aspects of malaria and its vectors. This includes studies on pathology and immunology in the human host, studies on malaria prevention and control, studies on the genetics of the malaria parasite, studies on anti-malarial drug resistance, and studies on the mosquito vectors of malaria. This work is encompassed in three major clinical projects based in Cambodia.
The clinical studies requiring support are conducted in collaboration with CNM at the District Hospital in Pursat Province and the regional health clinics in Preah Vihear Province and Ratanakiri Province. LMVR investigators work closely with Cambodian investigators both in training and execution of the research objectives. The overall goal is to help establish research infrastructure that facilitates research relevant to pathogenesis and control of Malaria in Cambodia.
Three Malaria Clinical Studies:
Studies of P. vivax and P. falciparum malaria in Cambodia
Primary study objective: To investigate whether HbE, alpha-thalassemia, G6PD-deficiency, or ABO/Rh blood groups protect individuals against mild P. falciparum and/or P. vivax malaria, and associated anemia and determine if any of these hemoglobinopathies influence the cytoadherence properties and surface modifications of P. vivax-infected RBCs. We are also studying chloroquine resistance in P. vivax patients.
Artemisinin-resistant Plasmodium falciparum Malaria in Cambodia
Primary study objective: The primary objective of this study is to compare parasite recrudescence rates in Western, Northern and Eastern Cambodia, following DHA-PPQ treatment (Parasite Recrudescence Study). Secondary objectives are to determine whether parasite recrudescence associates with the parasite clearance rate in Western, Northern and Eastern Cambodia (Parasite Clearance Rate Sub-study) and to assess the influence of parasite genetics and host factors on parasite recrudescence rates and parasite clearance rates.
Randomized trial of artesunate-mefloquine and DHA-PPQ in Pursat
Primary study objective: To the compare the efficacy of artesunate-mefloquine vs. DHA-PPQ in patients with P. falciparum malaria in Pursat, Cambodia.
Laboratory based projects/clinical support:
Provide two laboratories, one Phnom Penh (space provided in the CNM facilities) and one in Pursat (space provided in the Pursat Regional Health Center) equipped with state-of-the-art equipment and staffed by competent personnel to conduct the following (but not exclusive) projects and clinical study support. Provide field site clinics at Preah Vihear and Ratanakiri:
- Study volunteer hemoglobin type determination (D-10 instrument (Bio-Rad))
- Identify the presence of G6PD deficiency and alpha-thalassemia by standard PCR/RFLP methods
- Host and parasite DNA extraction
- Cultivation of malaria parasites (cryopreservation or establishment of long-term cultured parasite lines)
- Parasite cytoadherence assays
- Anti-malarial drug testing in vitro
- Determine prevalence, spread and genetic basis of Artesunate resistance in Cambodia
Further requirements are detailed under Solicitation Number: NIHAO2014005. The response deadline is June 13, 2014.
Image: Thin film micrograph depicts a growing P. vivax trophozoite with conspicuous pigment granules, Magnified 1125X. There are approximately 156 named species of Plasmodium which infect various species of vertebrates. Four species, P. falciparum, P. vivax, P. ovale, and P. malariae are known to infect humans. Credit: CDC/Dr. Mae Melvin, adapted.