Malaria

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the malaria parasites multiply in the liver, and then infect red blood cells.

Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

Key interventions to control malaria include: prompt and effective treatment with artemisinin-based combination therapies; use of insecticidal nets by people at risk; and indoor residual spraying with insecticide to control the vector mosquitoes.

The importance of malaria research in Viet Nam

Malaria remains a public health challenge in Viet Nam despite a substantial reduction in the incidence of disease over the last 20 years. In 2011 there were 45,588 cases reported to the National Malaria Control Programme (Annual Report NMCP 2011) and 14 deaths attributed to malaria. Viet Nam was one of the first countries to deploy artemisinin derivatives in its fight against malaria over 20 years ago. Since 2005, Viet Nam has used dihydroartemisinin-piperaquine (DHA-PPQ) as the first-line treatment for falciparum malaria. By 2009, there were worrying signs from western Cambodia that parasitological responses to artesunate-containing treatment regimens for uncomplicated falciparum malaria were slower than elsewhere and that unusually high failure rates with artesunate-mefloquine had been reported; both of these signals suggested the emergence of artemisinin resistance. In addition, prolongation of parasite clearance time (PCT) has been reported on the Thai-Myanmar border and evidence for artemisinin resistance has recently been reported from this area. Therefore, there is an urgent need to investigate whether there is any evidence of a change in the parasitological response to the artemisinin derivatives in Viet Nam.

Our malaria researchers

  • Tran Tinh Hien, MD, PhD
  • Christiane Dolecek, MD, PhD
  • Nguyen Hoan Phu, MD, PhD
  • Sarah Dunstan, PhD
  • Ngo Viet Thanh, MD
  • Nguyen Thanh Thuy Nhien, PhD
  • Nguyen Thuy Nha Ca, MSc


What we’re doing to improve outcomes for malaria patients

Our research is to characterize the susceptibility of P. falciparum to artesunate in Viet Nam: the impact of our studies for malaria control in Viet Nam is important – that we must begin considering whether the first-line drug combination (DHA-PQP) is the optimal choice to treat falciparum malaria in Viet Nam. Although overall responses to the currently recommended ACT remain adequate; clearly, further close monitoring is required to confirm the emergence of artemisinin resistance.

Our research studies are to define and develop new antimalaria drugs: Despite the Malaria Control Program, Viet Nam still adheres to the dihydroartemisinin-piperaquine combination because there is no alternative anti-malarial drug which is as good, as available, or as affordable as the current one. We initiate research to find out new antimalarial drugs such as OZ 439 or KEA 609 to re-enforce the armory to fight against malaria

Our malaria research locations

Binh Phuoc is a mountainous province in the western region of the Southeast of Viet Nam. It is surrounded by Lam Dong and Dong Nai provinces on the east, Tay Ninh Province and Cambodia on the west, Binh Duong province on the south, Dak-Lak and Cambodia on the north. Binh Phuoc province has 8 districts.

The area of Binh Phuoc is a plateau in the north and northeast and is mountainous and hilly the west and South West. Binh Phuoc is located on in a specific region with tropical and cross-equatorial monsoon climate. There are 2 distinct seasons: the rainy season and dry season. The average temperature is high and stable from 25.80 C to 26.20 C.

With a total natural area of 6,855.99 km2 which is covered by forests, Binh Phuoc province play a very important role in protecting the ecological environment of the Southeast region and regulating the flow of rivers.

Our studies have been conducted in Phuoc Long and Bu Gia Map District of Binh Phuoc

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Our malaria research collaborations/partnerships

Key milestones in our malaria research

  • 2010: Invivo susceptibility of artesunate in treatment of adult with P. falciparum malaria in Binh Phuoc Province, Vietnam in collaboration with WHO
  • 2011: Tracking Resistance to Artemisinin (TRAC): collaboration with Mahidol University and Worldwide Antimalarial Resistance Network (WWARN) funded by DFID UK

Key Malaria Publications

A clinicopathological correlation of the expression of the angiopoietin-Tie-2 receptor pathway in the brain of adults with Plasmodium falciparum malaria. Malar J. 2013 Feb 5;12:50. doi: 10.1186/1475-2875-12-50.
In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam. Malar J. 2012 Oct 26;11:355. doi: 10.1186/1475-2875-11-355.

Variation in human genes encoding adhesion and proinflammatory molecules are associated with severe malaria in the Vietnamese. Genes Immun. 2012 Sep;13(6):503-8. doi: 10.1038/gene.2012.25. Epub 2012 Jun 7.

Orally formulated artemisinin in healthy fasting Vietnamese male subjects: a randomized, four-sequence, open-label, pharmacokinetic crossover study. Clin Ther. 2011 May;33(5):644-54. doi: 10.1016/j.clinthera.2011.04.017.

Randomized controlled trial of artesunate or artemether in Vietnamese adults with severe falciparum malaria. Malar J. 2010 Apr 15;9:97. doi: 10.1186/1475-2875-9-97

New global estimates of malaria deaths. White NJ, Dondorp AM, Faiz A, Mishra S, Hien TT. Lancet. 2012 Aug 11;380(9841):559-60. doi: 10.1016/S0140-6736(12)61321-X