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The Epidemiology Department of MORU and National Malaria Control Programme, Cambodia (CNM) have begun to implement a study to assess the efficacy of prophylaxis with artemether-lumefantrine (PAL) against forest malaria in Siem Pang District, north-eastern Cambodia bordering Laos.

Composite image of rural village in Cambodia © MORU 2020.
An improvised village for forest workers, who sustain themselves with food gathered from the surrounding jungle.

Sponsored by University of Oxford and funded by the Global Fund Regional Component of the Regional Artemisinin-resistance Initiative (RAI2E) Grant, PAL is led by Principal Investigator Prof Richard Maude, with co-investigators MORU’s S. Sovannaroth, Tom Peto, James Callery, Mallika Imwong, Rupam Tripura, Mehul Dhorda, and Lorenz von Seidlein.

An estimated 2,000 participants who travel to the forest and stay overnight will receive either artemether-lumefantrine or multivitamin twice daily for 3 days followed by two doses weekly. They will be followed up every 28 days as they continue to visit the forest. Participants’ travel in the forest will be mapped to identify potential transmission sites and in-depth interviews conducted among forest goers, community leaders, healthcare workers and policymakers in Cambodia, Lao PDR and Thailand to assess the potential feasibility of prophylaxis in each country.

On 10 Feb, MORU and CNM organized an orientation meeting with the Provincial Health Department, Governor Office, local authorities, NGO partners, Village leaders and Village Malaria Workers to inform activities and aim of the PAL-Cambodia project. Following the site Initiation visit and training conducted by MORU’s Epidemiology and CTSG departments, the Cambodia team, led by Dr Rupam Tripura, has conducted engagement activities through schools and meetings with villagers.

Recruitment began on 10 March, and trial participants were given either artemether-lumefantrine or multivitamin and a mobile phone with a GPS logger installed for each group. Participants took pictures and shared some of the images while they stayed in the forest.

- Thank you, Rupam Tripura and James Callery for text and photos.