Understanding the epidemiology, clinical characteristics, knowledge and barriers to treatment and prevention of malaria among returning international laborers in northern Vietnam: a mixed-methods study

Abstract

Background With the decline in local malaria transmission in Vietnam as a result of the National Malaria Control Program (NMCP) elimination activities, a greater focus on the importation and potential reintroduction of transmission are essential to support malaria elimination objectives. Methods We conducted a multi-method assessment of the demographics, epidemiology, and clinical characteristics of imported malaria among international laborers returning from African or Southeast Asian countries to Vietnam. Firstly, we conducted a retrospective review of hospital records of patients from January 2014 to December 2016. Secondly, we conducted a mixed-methods prospective study for malaria patients admitted to the study sites from January 2017 to May 2018 using a structured survey with blood sample collection for PCR analysis and in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. Results International laborers were young (median age 33.0 years IQR 28.0–39.5 years), predominantly male (92%) adults returning mostly from the African continent (84%) who stayed abroad for prolonged periods (median time 13.5 months; IQR 6.0–331.5 months) and were involved in occupations that exposed them to a higher risk of malaria infection. Epidemiological trends were also similar amongst study strands and included the importation of Plasmodium falciparum primarily from African countries and P. vivax from Southeast Asian countries. Of 11 P. malariae and P. ovale infections across two study strands, 10 were imported from the African continent. Participants in the qualitative arm demonstrated limited knowledge about malaria prior to travelling abroad, but reported knowledge transformation through personal or co-worker’s experience while abroad. Interestingly, those who had a greater understanding of the severity of malaria presented to the hospital for treatment sooner than those who did not; median of 3 days (IQR 2.0–7.0 days) versus 5 days (IQR 4.0–9.5 days) respectively. Conclusion To address the challenges to malaria elimination raised by a growing Vietnamese international labor force, consideration should be given to appropriately targeted interventions and malaria prevention strategies that cover key stages of migration including pre-departure education and awareness, in-country prevention and prophylaxis, and malaria screening upon return.

Exploring community participation in vectorborne disease control in Southeast Asia: a scoping review protocol

“… 3 Outbreaks of diseases such as dengue, chikungunya and Japanese encephalitis are becoming increasingly common, underscoring the urgent need for effective surveillance of the disease and vectors, rapid response mechanisms, multisectoral collaboration and community participation to prevent and control outbreaks of these diseases, 1 4 5 The SEA region also faces challenges related to preventing malaria reintroduction and reestablishment of disease transmission. 6 7 The WHO has, therefore, made tremendous efforts to eliminate and eradicate these diseases through frameworks and guidelines such as the multisectoral approach to the prevention and control of VBDs. Within these frameworks and guidelines, a crucial emphasis is placed on the necessity for effective community engagement and mobilisation in the control of VBDs…”

Magnitude and patterns of severe Plasmodium vivax monoinfection in Vietnam: a 4-year single-center retrospective study

“…Vietnam is located in Southeast Asia, in which the most prevalent malaria species are P. falciparum and P. vivax (18)(19)(20). The most recent WHO's statistics shows that a total of 381 malaria confirmed cases were reported in Vietnam in the first 10 months of 2022 (21).…”

“…Indeed, it has been well documented that in comparable developing countries, "efforts to control COVID-19 would impact efforts to control other existing health problems that are endemic, such as malaria" (23). To the best of our knowledge, there are a few papers related to malaria in Vietnam published between 2020 and 2022 (18,19,(24)(25)(26)(27). However, none of these studies specifically documented the evolution of malaria in southern Vietnam.…”