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Query: UMLS:C0024530 (malaria)
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Yunnan Province, due its international borders with Myanmar, Vietnam and Lao PDR has a large number of imported cases of malaria, including a high proportion of Plasmodium falciparum, as a result of the mobility of the population. This movement is due to workers coming from other provinces where there is no malaria to work in the productive tropical lowlands. Chinese nationals who have gone to work in neighboring countries, border trade and refugees from Myanmar. Much of Yunnan is peopled by ethnic minorities living in remote mountainous and forested areas which are difficult to reach. However, surveillance has been strengthened by training 3,900 primary health care workers and combining the search for visiting foreigners, returning Chinese and people from other provinces with public security, customs formalities and employers. Any visitor detected by these services is obliged to have a blood slide taken. This has resulted in an earlier and more complete detection of malaria cases, reducing incidence from 19.19 to 12.12/10,000 in the border area over the last 10 years. This is despite a considerable increase in population movement and the threat of drug resistant malaria.
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PMID:Border malaria in Yunnan, China. 956 91

In 1991-1995 by using the Rieckmann in vitro micro-method, susceptibilities of Plasmodium falciparum to eight antimalarials in the China-Lao PDR and China-Myanmar border areas were tested. The resistant rates of P. falciparum to chloroquinine were 95.0%-100%; IC50 114-240nmol/l. P. falciparum resistant rates to amodiaquine resistance accounted for 83.5%-100%, IC50 52-72nmol/l. All cases were sensitive to quinine, IC50 470-608nmol/l. P. falciparum isolates from the Lao PDR frontier were highly sensitive to artesunate, dihydroartemisinin, and arteether. Resistant rates from other areas were 0-11%. P. falciparum from China-Myanmar and Lao PDR border areas were also sensitive to mefloquine, IC50 68-88nmol/l. A longitudinal survey of the sensitivity of P. falciparum in vivo on the China-Lao PDR border showed that the average defervescent time of falciparum malaria was treated by pyronaridine increased from 32.7 +/- 16.0 hours during 1984-85 to 56.2 +/- 27.4 hours in 1995; the recrudescence rate rose up from 15.2% to 37.5%. The results monitored in vitro showed that all cases assessed in 1988 for response to pyronaridine were sensitive, but 36.4% of cases had emerging resistance, IC50 increased from 13nmol/l to 40 nmol/l. The above results suggested that P. falciparum in these areas has expressed resistance to chloroquine and amodiaquine. However, the parasites are still sensitive to artemisinin, pyronaridine, mefloquine, quinine, but with a declining sensitivities.
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PMID:In vitro sensitivity of Plasmodium falciparum to eight antimalarials in China-Myanmar and China-Lao PDR border areas. 956 92

This study is an initial attempt to apply disease mapping through Geographical Information System (GIS) with multiple regression analysis to determine the nature and extent of factors influencing malaria transmission in Yunnan Province, PR China, particularly in border areas. Secondary county-based data covering the period 1990 to 1996 were collected and analyzed. The malaria situation in Yunnan Province as a whole is influenced mainly by the combined effects of the physical environment, the presence of efficient vector species, and mobile population along international borders with Myanmar, Lao PDR and Vietnam.
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PMID:Factors influencing malaria endemicity in Yunnan Province, PR China (analysis of spatial pattern by GIS). Geographical Information System. 988 98

In Khammouane, a southeastern province in Lao PDR, active case detection (ACD) surveys for malaria infection on the villagers in three villages were conducted four times from December, 1995 to August, 1996. The malaria infection was demonstrated in 5.3-10.5% of the villagers throughout the year in 2 villages located in mountainous forest, but the infection was rarely observed in the other village located in the plain along the Mekong River, in which only 4 malaria cases were detected in August, 1996. Although the positive rate of malaria parasites among the villagers was not so significantly different in the rainy season compared with the dry season, the intensity of infections (ie parasitemia) was significantly higher in the rainy season. More than 90% of the positive villagers were children under 15 years old. Most infections were due to Plasmodium falciparum.
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PMID:Current status of malaria infection in a southeastern province of Lao PDR. 988 4

We surveyed Nongceng, a village in a south-eastern province of Lao PDR, for malaria and its vectors. Nongceng is situated in a basin and surrounded by rice fields. In February 1998 (dry season), 28.6% of 126 villagers were infected with malaria, and in September 1998 (rainy season), 16.3% of 147 villagers. The prevalence of malaria infection was consistently high in children under 10, and the predominant malaria species was Plasmodium falciparum. In brief surveys of the mosquitoes performed on the same day as the malaria surveys, 2007 Anopheles females from 12 species were collected by means of human bait, animal bait and resting collections. Of the vector species known to be important in transmitting malaria in neighbouring Thailand - An. minimus, An. dirus, and An. maculatus groups - only An. minimus was found. Its density was, however, very low in both seasons and it was therefore unlikely to be the vector. In fact, An. nivipes accounted for more than 65% of all mosquitoes collected and was the most common species collected from human baits. The results of this study show that endemic areas of malaria in Lao PDR are not necessarily related to forest. Rather, An. nivipes is suspected to be the most important vector.
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PMID:Malaria prevalence and a brief entomological survey in a village surrounded by rice fields in Khammouan province, Lao PDR. 1067 1

Plasmodium ovate infection was demonstrated in 5 out of 143 inhabitants in a village in Lao PDR by blood microscopy and PCR assay. Although the specimen confirmed to be positive for P. ovale by microscopical examination was only one, the target sequences in the 18S rRNA genes of malaria parasite detected in all of the five cases were consisted with those of P. ovale by the PCR assay. This is the first report concerning the presence of so many cases with P. ovale infection in Lao PDR.
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PMID:Plasmodium ovale infections detected by PCR assay in Lao PDR. 1092 49

This was a descriptive cross sectional study. It was done in 4 communes along the Vietnam-Lao PDR border of two mountainous provinces: Sonla and Nghean. The cluster multistage sampling technique was applied to choose the study sites. The results of the study show: Among the 2,441 persons given blood tests to find malaria parasites, 0.7% of them carry malaria parasite, of whom 0.6% carry P. falciparum and 0.1% carry P. vivax. The malaria morbidity in the year was 6.9%. The mortality due to malaria is 1.59 per 100,000 population per year. Among the 106 hamlet motivators being interviewed, only 75.5% knew that malaria is transmitted by mosquitos, 71.7% knew that malaria patients are a source of transmission, over 50% of the motivators have mistaken understanding about the living environment of malaria mosquitos. Most of them have had mistakes in diagnosis, treatment of malaria, mosquito-killing spraying. Among the 729 adults being interviewed, 59.0% did not know about the causes of malaria, 30.7% did not take part in malaria control activities. Only 69.3% of the adults regularly sleep inside mosquito nets, 68% of adults buy medicine to cure malaria, 39.9% referred patients to health facilities for cure, and 25% use forest herbs to cure malaria. The factors that increased the malaria morbidity in communes along Vietnam-Lao PDR border have been identified.
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PMID:The situation of malaria along the Vietnam-Lao PDR border and some related factors. 1141 69

A detection survey for malaria infection by routine microscopy and polymerase chain reaction (PCR) assay was conducted on 336 inhabitants of two villages in Khammouane Province, Lao People's Democratic Republic (Lao PDR), in July 1997. Malaria infection was demonstrated in 58 (17.3%) subjects by microscopy and in 117 (34.8%) by PCR assay. Specimens positive by both methods were frequent in young villagers, suggesting the presence of many subclinical infections in older persons. The most common species of malaria parasite was Plasmodium falciparum (82.9%). Polymerase chain reaction assay detected mixed infections with 2-4 species in 27 specimens (23.1%). The results demonstrate that there are many subclinical malaria infections with low parasite level and infection with all four human malaria species in Lao PDR.
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PMID:A field study on malaria prevalence in southeastern Laos by polymerase chain reaction assay. 1146 12

Malaria vector surveys were carried out in 8 provinces in Lao PDR in 1999. The surveys were conducted in 4 provinces - Savannakhet, Champasak, Luang Perbang and Sayaboury in May and in another 4 provinces - Bolikhamsay, Sarvan, Sekong and Vientiane in December 1999. Bare leg collection were carried out indoors and outdoors from 6 pm to 5 am. All anopheline mosquitos were identified, dissected and the gut, gland and ovaries were examined. A total of 438 Anopheles mosquitos belonging to 19 species were obtained. Of these only 3 species were found to be infected with oocysts - An. maculatus, An. dirus and An. minimus. All these species were found biting both indoors and outdoors. An. aconitus was the predominant species obtained in the December collection but its vectorial status remains unknown.
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PMID:Preliminary studies of Anopheles mosquitos in eight provinces in Lao PDR. 1148 1

In 7 villages on the foothills of the Houayxai district of the Bokeo Province in Lao PDR between midyear 1995 to midyear 1997 an attempt was made to test the acceptability and use of DDT impregnated bed nets as well as environmental and behavioral risk factors. About 380 women between 15 to 45 years old and their children in the age range of 1 to 14 years had been studied. A pre-tested questionnaire had been applied and blood from women and children was taken from the finger prick and a conventional thick and thin blood smear was performed, fixed Giemsa stained and examined for malaria parasites. DDT (dichlorodiphenyltrichloroethane) impregnated mosquito nets were distributed in the intervention villages. The availability of mosquito nets increased statistically significant from approximately 50% to 70% for all family members in the intervention area between 1995 and 1997 and statistically significant decreased in the control area from 79% to 45.1%. There was a statistically significant decrease in malaria attacks as claimed by the females for the intervention area but not for the control villages. The proportion of positive blood smears did decrease overall for women and children in between 1995 to 1997. Occupation, location of the house and use of mosquito nets had been determined as the most important risk factors.
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PMID:Malaria control through impregnated bednets--a pilot project in selected villages in Lao PDR. 1148 43


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