Evidence map›Paper›PMID 41382293›Full record

Trial reportBMC infectious diseases2025

Evaluating malaria elimination strategies among military forces in Cambodia: a multi-arm clinical trial comparing monthly prophylaxis and focused screening and treatment.

Mariusz Wojnarski, Sidhartha Chaudhury, Threechada Boonchan, Rathvicheth Bun, Soklyda Chann, Panita Gosi, Kin Soveasna, Sokhun Song, Nillawan Buathong, Mali Ittiverakul and 26 more

Registry-linked trialAbstract readClinical Trial, Phase IVRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02653898 (Defining Effective, Appropriate, Implementable Strategies for Malaria Elimination in Military Forces in Cambodia as a Model for Mobile Populations), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02653898 phase4unknown statusnot on this map

Defining Effective, Appropriate, Implementable Strategies for Malaria Elimination in Military Forces in Cambodia as a Model for Mobile Populations

TypeinterventionalSponsorArmed Forces Research Institute of Medical Sciences, ThailandRan2016 to 2021Enrolled1,050ConditionsMalaria, Parasitic DiseasesArmsDHA-PIP, Primaquine, Artesunate + Mefloquine, Permethrin (Insecticide treated uniform)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

36 authors.

Mariusz WojnarskiWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Sidhartha ChaudhuryWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand. sidhartha.chaudhury.mil@health.mil.
Threechada BoonchanWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Rathvicheth BunNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Soklyda ChannNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Panita GosiWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Kin SoveasnaDepartment of Health, Ministry of National Defense, Phnom Penh, Cambodia.
Sokhun SongWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Nillawan BuathongWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Mali IttiverakulWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Sabaithip SriwichaiWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Montri ArsanokWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Worachet KuntawunginnWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Piyaporn SaingamWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Chaiyaporn ChaisatitWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Alongkot PonlawatWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Thanyalak FansiriWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Pattaraporn VanachayangkulWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Boonsong JaichaporWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Muth SinounNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Char Meng ChuorNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Thay KheanghengNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Mary SoDepartment of Health, Ministry of National Defense, Phnom Penh, Cambodia.
Elizabeth WanjaWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Silas DavidsonWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Michele SpringWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Huy RekolNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Lek DysoleyNational Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
Kong SalyDepartment of Health, Ministry of National Defense, Phnom Penh, Cambodia.
Jeffrey R LivezeyWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Jessica T LinUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.
Philip L SmithWalter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Prom SatharathDepartment of Health, Ministry of National Defense, Phnom Penh, Cambodia.
Jessica E ManningInternational Center of Excellence in Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Phnom Penh, Cambodia.
Somethy Sok *Walter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
David L Saunders *Walter Reed Army Institute of Research - Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIdentifying effective malaria elimination strategies for remote regions and highly mobile populations in Southeast Asia is challenging given limited resources. In this clinical trial, two malaria elimination strategies were evaluated in partnership with the Royal Cambodian Armed Forces - monthly malaria prophylaxis (MMP) and focused screening and treatment (FSAT).

methodsEight military cohorts (1,050 volunteers total) along the Cambodian-Thai border were randomly assigned to three months of either MMP or FSAT (four cohorts in each treatment arm) with monthly malaria testing for six months. Cohorts were further randomly assigned to receive either permethrin treated (ITU) or sham-treated clothing (sITU). Volunteers in MMP cohort were given three monthly three-day doses dihydroartemisinin-piperaquine (DP) along with a ‘universal’ low-dose weekly regimen of 22.5 mg primaquine for 12 weeks, intended for use regardless of body weight or G6PD status. Volunteers in FSAT cohort were treated with appropriate first-line antimalarials if they tested positive for malaria.

resultsPlasmodium falciparum (Pf) positivity in MMP cohorts was reduced by 90% (10% at enrollment to 1% at six months; absolute risk reduction (ARR) 9%) at 6 months. However, 32% of Pf cases treated with DP as MMP at baseline recrudesced, requiring rescue treatment at 1 month with artesunate-mefloquine. Pf positivity in FSAT cohorts declined 66% over six months (7.6% to 2.7%; ARR 4.9%). MMP reduced P. vivax (Pv) positivity from 9% to 0% at three months, but Pv rebounded to 6.7% at six months. FSAT failed to significantly reduce Pv positivity during the study. The 22.5 mg weekly primaquine MMP regimen was safe, even for the 15% of volunteers with G6PD-deficiency. Those wearing ITU had additional Pv parasitemia reductions compared to sITU in the FSAT but not MMP cohorts.

conclusionsMMP was safe, and superior to FSAT, suggesting greater utility to achieve malaria elimination in Cambodia. Low dose (22.5 mg) weekly primaquine was a safe adjunct in this setting, even for those with G6PD-deficiency. Permethrin-treated clothing further reduced Pv parasitemia for FSAT but not MMP. We observed that MMP may be more easily scaled to eliminate malaria and that the military may provide substantial support for regional elimination efforts.

trial registrationThe study was registered on https://clinicaltrials.gov/ on 13-01-2016 prior to enrollment (NCT02653898).

Indexed as

AntimalarialsDisease EradicationMalariaMalaria, FalciparumMalaria, VivaxMilitary PersonnelAdolescentAdultArtemisininsCambodiaFemaleHumansMaleMass ScreeningPermethrinPiperazinesAntimalarialsArtemisininsartenimolPermethrinpiperaquinePiperazinesPrimaquineQuinolinesEliminationG6PDMalariaMass drug administrationProphylaxis

Identifiers

PMID41382293
PMCPMC12817837

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.