Focused Screening and Treatment (FSAT): A PCR-based strategy to detect malaria parasite carriers and contain drug resistant P. falciparum, Pailin, Cambodia
The main goal was to evaluate a Focused Screening and Treatment (FSAT) strategy intended to detect P. falciparum asymptomatic carriers. In this pilot study FSAT was employed to elucidate the epidemiology, i.e. detect foci of asymptomatic carriers with the objective of containing artemisinin-resistant strains in Pailin, Cambodia.
This study could demonstrate that there was a significant correlation between villages that identified as having the highest P.f. incidence - as registered in health facilities - had also the greatest proportion of asymptomatic carriers detected by a mobile PCR lab (which made up 95% of detected P.f. in Pailin).
Cross-sectional malariometric surveys were carried out in 20 out of 109 villages of Pailin province. Insecticide treated nets were distributed and finger prick samples collected from all survey participants. Axillary temperature was recorded for each participant and any individuals detected as being sub-febrile or febrile were tested with a rapid diagnostic test (RDT). Follow-up of PCR positive cases was conducted when results from IPC lab were received by field teams through SMS. RDT-positive cases were initially treated with atovaquone-proguanil for P. falciparum and CQ for P. vivax using DOT. PCR-positive individuals were treated with the same regimen, plus additional PQ, provided that the participant was not G6PD deficient.
Interviews were conducted to elicit history of cross-border travel that might contribute to the spread of artemisinin-resistant parasites.