Arboshield Plus Project

Project Coordinator: Dr. Darouny Phonekeo
Assistant Coordinator: Dr. Phonepadith Khattignavong

Consultant: Dr. Philippe Cavailler

Staff members in Parasitology lab:
Dr. Moritoshi Iwagami, Dr. Phoyphaylinh Prasayasith,
Ms. Pheovaly Soundala, and Ms. Sonesimmaly Sannikone

Finance and administration:
Dr. Antoine des Graviers and Ms. Phouvanhnamalee
Vilaysouk

 

Background and objectives

The military sector in Lao People’s Democratic Republic (Lao PDR) covers a certain portion of the Lao population including their family. The Lao Ministry of Defense has a medical institute in Vientiane capital and several hospitals across the country. However, unfortunately, the Lao Ministry of Defense has limited support from donors to improve their capacity and facilities since most of the donors hesitate to support the military sector. On the other hand, several studies reported that soldiers are at high risk population for malaria infection because they patrol and stay in the forests where malaria and other vector-borne diseases are highly prevalent [1,2].

Moreover, our previous study found household clustering of asymptomatic malaria infections which means malaria is transmitted by Anopheles mosquito within a family [3]. These results suggested that even though malaria is not frequently transmitted in a village nowadays, malaria can be introduced by their family members who work and stay in the forests.

The objective of the Arboshield project is to strengthen the capacity of the medical sector in the Ministry of Defense and some of the selected civilian hospitals in the Ministry of Health, Lao PDR in the areas of vector-borne diseases, especially surveillance, outbreak detection/ response, diagnosis, treatment, prevention, as well as biosafety and security through training and improving their facilities. The roles of the Lao-Japan Parasitology lab in this project are giving a training course on malaria for the trainees from military sector and civil sector, and quality assessment of malaria diagnosis in the Lao Institute for Disease Prevention and six military provincial hospitals (Xieng Khouang, Luang Prabang, Vang Vieng, Vientiane Capital, Savannakhet, and Champasak), which participate in the Arboshield Plus project.

Results of quality assessment for malaria diagnosis

As a quality assessment, we analyzed blood samples collected from malaria-suspected patients in the military hospitals by malaria real-time PCR. From 2018-2022, a total of 612 blood samples that collected from malariasuspected patients in the military hospitals, were analyzed by the real-time PCR. 13 samples were malaria parasite DNA positive (3 P. falciparum and 10 P. vivax). On the other hand, in 2022, 188 blood samples were analyzed by the real-time PCR. All the samples were malaria parasite DNA negative. It would be a good sign of improvement of malaria prevention and control among the military sector in Lao PDR. However, one mortality case of malaria was reported from military personnel in Attapeu province in 2022. When the patient was transferred to a hospital, the patient was unconscious, and it was too late to treat. Therefore, a caution is still needed for malaria infection especially those who stay in a forest.

Financial support

This project is financially supported by The Defense Threat Reduction Agency (DTRA), USA.

References

1. Iwagami M, Keomalaphet S, Khattignavong P, Soundala P, Lorphachan L, Matsumoto-Takahashi E, Strobel M, Reinharz D, Phommasansack M, Hongvanthong B, Brey PT, Kano S. The detection of cryptic Plasmodium infection among villagers in Attapeu province, Lao PDR. PLoS Neglected Tropical Diseases, 11(12): e0006148, 2017.

2. Vilay P, Nonaka D, Senamonty P, Lao M, Iwagami M, Kobayashi J, Hernandez PM, Phrasisombath K, Kounnavong S, Hongvanthong B, Brey PT, Kano S. Malaria prevalence, knowledge, perception, preventive and treatment behavior among military in Champasak and Attapeu provinces, Lao PDR: a mixed methods study. Tropical Medicine and Health, 47:11, 2019.

3. Pongvongsa T, Nonaka D, Iwagami M, Nakatsu M, Phongmany P, Nishimoto F, Kobayashi J, Hongvanthong B, Brey PT, Moji K, Mita T, Kano S. Household clustering of asymptomatic malaria infections in Xepon district, Savannakhet province, Lao PDR. Malaria Journal, 15(1): 508, 2016.

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