40 results on '"Maung, Than"'
Search Results
2. Prevalence of G6PD deficiency and diagnostic accuracy of a G6PD point-of-care test among a population at risk of malaria in Myanmar
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Than Htike Aung, Chayanut Suansomjit, Zaw Min Tun, Tin Maung Hlaing, Jaranit Kaewkungwal, Liwang Cui, Jetsumon Sattabongkot, and Wanlapa Roobsoong
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G6PD deficiency ,G6PD variant ,Diagnosis ,Prevalence ,Malaria ,Myanmar ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Over the past decade, the incidence of malaria has steadily declined in Myanmar, with Plasmodium vivax becoming predominant. The resilience of P. vivax to malaria control is attributed to the parasite’s ability to form hypnozoites in the host’s liver, which can cause relapse. Primaquine is used to eliminate hypnozoites but can cause haemolysis in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals. It is thus necessary to estimate the frequency and variant types of G6PD deficiency in areas where primaquine will be widely used for P. vivax elimination. Methods In this study, a descriptive cross-sectional survey was conducted to determine the prevalence of G6PD deficiency in a population residing in Nay Pyi Taw, Myanmar, using a standard spectrophotometric assay, a rapid diagnostic test (RDT), Biosensor, and by genotyping G6PD variants. Results G6PD enzyme activity was determined from 772 leukocyte-depleted samples, with an adjusted male median G6PD activity value of 6.3 U/g haemoglobin. Using a cut-off value of 30% enzyme activity, the overall prevalence of G6PD deficiency was 10.8%. Genotyping of G6PD variants was performed for 536 samples, of which 131 contained mutations. The Mahidol variant comprised the majority, and males with the Mahidol variant showed lower G6PD enzyme activity. The G6PD Andalus variant, which has not been reported in Myanmar before, was also identified in this study. Conclusion This study provides a G6PD enzyme activity reference value for the Myanmar population and further information on the prevalence and variants of G6PD deficiency among the Myanmar population; it also evaluates the feasibility of G6PD deficiency tests.
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- 2023
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3. The role of early detection and treatment in malaria elimination
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Landier, Jordi, Parker, Daniel M, Thu, Aung Myint, Carrara, Verena I, Lwin, Khin Maung, Bonnington, Craig A, Pukrittayakamee, Sasithon, Delmas, Gilles, and Nosten, François H
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Rare Diseases ,Infectious Diseases ,Clinical Research ,Vector-Borne Diseases ,Malaria ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Infection ,Good Health and Well Being ,Antimalarials ,Artemisinins ,Diagnostic Tests ,Routine ,Disease Eradication ,Disease Transmission ,Infectious ,Drug Therapy ,Combination ,Early Diagnosis ,Humans ,Lactones ,Primaquine ,Secondary Prevention ,Microbiology ,Medical Microbiology ,Public Health and Health Services ,Tropical Medicine - Abstract
Falciparum malaria persists in hard-to-reach areas or demographic groups that are missed by conventional healthcare systems but could be reached by trained community members in a malaria post (MP). The main focus of a MP is to provide uninterrupted and rapid access to rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) too all inhabitants of a village. RDTs allow trained community members to perform malaria diagnosis accurately and prescribe appropriate treatment, reducing as much as possible any delay between the onset of fever and treatment. Early treatment with ACT and with a low-dose of primaquine prevents further transmission from human to mosquito. A functioning MP represents an essential component of any malaria elimination strategy. Implementing large-scale, high-coverage, community-based early diagnosis and treatment through MPs requires few technological innovations but relies on a very well structured organization able to train, supervise and supply MPs, to monitor activity and to perform strict malaria surveillance.
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- 2016
4. An ultrasensitive reverse transcription polymerase chain reaction assay to detect asymptomatic low-density Plasmodium falciparum and Plasmodium vivax infections in small volume blood samples.
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Adams, Matthew, Joshi, Sudhaunshu N, Mbambo, Gillian, Mu, Amy Z, Roemmich, Shay M, Shrestha, Biraj, Strauss, Kathy A, Johnson, Nicole Eddington, Oo, Khine Zaw, Hlaing, Tin Maung, Han, Zay Yar, Han, Kay Thwe, Thura, Si, Richards, Adam K, Huang, Fang, Nyunt, Myaing M, and Plowe, Christopher V
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Blood ,Humans ,Plasmodium falciparum ,Plasmodium vivax ,Malaria ,Falciparum ,Malaria ,Vivax ,DNA ,Protozoan ,DNA ,Ribosomal ,RNA ,Protozoan ,RNA ,Ribosomal ,18S ,Sensitivity and Specificity ,Reverse Transcriptase Polymerase Chain Reaction ,Myanmar ,Asymptomatic Infections ,Malaria ,Malaria elimination ,RT-PCR ,Limits of detection ,Nucleic acid ,Falciparum ,Vivax ,DNA ,Protozoan ,Ribosomal ,RNA ,18S ,Tropical Medicine ,Microbiology ,Medical Microbiology ,Public Health and Health Services - Abstract
BackgroundHighly sensitive, scalable diagnostic methods are needed to guide malaria elimination interventions. While traditional microscopy and rapid diagnostic tests (RDTs) are suitable for the diagnosis of symptomatic malaria infection, more sensitive tests are needed to screen for low-density, asymptomatic infections that are targeted by interventions aiming to eliminate the entire reservoir of malaria infection in humans.MethodsA reverse transcription polymerase chain reaction (RT- PCR) was developed for multiplexed detection of the 18S ribosomal RNA gene and ribosomal RNA of Plasmodium falciparum and Plasmodium vivax. Simulated field samples stored for 14 days with sample preservation buffer were used to assess the analytical sensitivity and specificity. Additionally, 1750 field samples from Southeastern Myanmar were tested both by RDT and ultrasensitive RT-PCR.ResultsLimits of detection (LoD) were determined under simulated field conditions. When 0.3 mL blood samples were stored for 14 days at 28 °C and 80% humidity, the LoD was less than 16 parasites/mL for P. falciparum and 19.7 copies/µL for P. vivax (using a plasmid surrogate), about 10,000-fold lower than RDTs. Of the 1739 samples successfully evaluated by both ultrasensitive RT-PCR and RDT, only two were RDT positive while 24 were positive for P. falciparum, 108 were positive for P. vivax, and 127 were positive for either P. vivax and/or P. falciparum using ultrasensitive RT-PCR.ConclusionsThis ultrasensitive RT-PCR method is a robust, field-tested screening method that is vastly more sensitive than RDTs. Further optimization may result in a truly scalable tool suitable for widespread surveillance of low-level asymptomatic P. falciparum and P. vivax parasitaemia.
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- 2015
5. Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016
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Kyi Thar Min, Thae Maung Maung, Myo Minn Oo, Tin Oo, Zaw Lin, Aung Thi, and Jaya Prasad Tripathy
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Insecticide treated net ,Under-five children ,Health care seeking ,Demographic and Health Survey ,SORT IT ,Myanmar ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Malaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks. Methods This was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey. Results Of 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7). Conclusions This study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.
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- 2020
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6. Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016
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Min, Kyi Thar, Maung, Thae Maung, Oo, Myo Minn, Oo, Tin, Lin, Zaw, Thi, Aung, and Tripathy, Jaya Prasad
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- 2020
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7. Barriers in distribution, ownership and utilization of insecticide-treated mosquito nets among migrant population in Myanmar, 2016: a mixed methods study
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Shwe Yi Linn, Thae Maung Maung, Jaya Prasad Tripathy, Hemant Deepak Shewade, Swai Mon Oo, Zaw Linn, and Aung Thi
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Insecticide-treated bed net ,Malaria ,Myanmar ,Structured Operational Research Training IniTiative (SORT IT) ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Sleeping under insecticide-treated mosquito nets/long-lasting insecticidal nets (ITNs/LLINs henceforth referred to as ITNs) is one of the core interventions recommended by the World Health Organization to reduce malaria transmission and prevent malaria in high-risk communities, such as migrants, by preventing mosquito bites. The malaria burden among the migrant population is a big challenge for malaria elimination in Myanmar. In this context, this study aimed to assess the ownership and utilization of ITNs and to understand the barriers to distribution and utilization of ITNs among the high-risk migrant communities in the Regional Artemisinin Resistance Initiative (RAI) project areas of Myanmar. Methods A sequential mixed methods study (quantitative component: cross-sectional study involving analysis of secondary data available from a survey conducted among migrant households in the RAI project areas of Myanmar in 2016 followed by a descriptive qualitative component in 2018). A total of 17 focus group discussions (involving 121 participants) with different groups of migrants and 17 key-informant interviews with key programme stakeholders were conducted in 4 selected townships of RAI project areas. Results Of 3230 migrant households, 63.3% had at least one ITN while 36% had sufficient ITNs (i.e., 1 ITN per 2 persons). Regarding ITN utilization, about 52% of household members reported sleeping under an ITN the previous night, which is similar among under-fives and pregnant women. Over half of all bed nets were ITNs, with nearly one-third having holes or already undergone repairs. The qualitative findings revealed that the key challenges for ITN utilization were insufficient ITNs in households and dislike of ITNs. The barriers to ITN distribution were incomplete migrant mapping due to resource constraints (time, money, manpower) and difficulties in transportation and carrying ITNs. Conclusion This study highlights poor ownership and utilization of ITNs among migrants in the RAI project areas of Myanmar and barriers to their ownership and utilization. To achieve universal coverage and utilization, more programmatic support by the programme is needed to carry out complete migrant mapping and continuous ITN distribution in remote locations.
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- 2019
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8. Bayesian spatiotemporal analysis of malaria infection along an international border: Hlaingbwe Township in Myanmar and Tha-Song-Yang District in Thailand
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Aung Minn Thway, Chawarat Rotejanaprasert, Jetsumon Sattabongkot, Siam Lawawirojwong, Aung Thi, Tin Maung Hlaing, Thiha Myint Soe, and Jaranit Kaewkungwal
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Malaria ,Border areas ,Spatiotemporal analysis ,Myanmar ,Thailand ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background One challenge in moving towards malaria elimination is cross-border malaria infection. The implemented measures to prevent and control malaria re-introduction across the demarcation line between two countries require intensive analyses and interpretation of data from both sides, particularly in border areas, to make correct and timely decisions. Reliable maps of projected malaria distribution can help to direct intervention strategies. In this study, a Bayesian spatiotemporal analytic model was proposed for analysing and generating aggregated malaria risk maps based on the exceedance probability of malaria infection in the township-district adjacent to the border between Myanmar and Thailand. Data of individual malaria cases in Hlaingbwe Township and Tha-Song-Yang District during 2016 were extracted from routine malaria surveillance databases. Bayesian zero-inflated Poisson model was developed to identify spatial and temporal distributions and associations between malaria infections and risk factors. Maps of the descriptive statistics and posterior distribution of predicted malaria infections were also developed. Results A similar seasonal pattern of malaria was observed in both Hlaingbwe Township and Tha-Song-Yang District during the rainy season. The analytic model indicated more cases of malaria among males and individuals aged ≥ 15 years. Mapping of aggregated risk revealed consistently high or low probabilities of malaria infection in certain village tracts or villages in interior parts of each country, with higher probability in village tracts/villages adjacent to the border in places where it could easily be crossed; some border locations with high mountains or dense forests appeared to have fewer malaria cases. The probability of becoming a hotspot cluster varied among village tracts/villages over the year, and some had close to no cases all year. Conclusions The analytic model developed in this study could be used for assessing the probability of hotspot cluster, which would be beneficial for setting priorities and timely preventive actions in such hotspot cluster areas. This approach might help to accelerate reaching the common goal of malaria elimination in the two countries.
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- 2018
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9. Low uptake of malaria testing within 24 h of fever despite appropriate health-seeking among migrants in Myanmar: a mixed-methods study
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Kyaw Thu Hein, Thae Maung Maung, Kyaw Ko Ko Htet, Hemant Deepak Shewade, Jaya Prasad Tripathy, Swai Mon Oo, Zaw Lin, and Aung Thi
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Malaria diagnosis and treatment ,Knowledge, health-seeking ,Barriers ,Suggestion ,Uptake of malaria testing, Myanmar ,SORT IT ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background There is limited information on uptake of malaria testing among migrants who are a ‘high-risk’ population for malaria. This was an explanatory mixed-methods study. The quantitative component (a cross sectional analytical study-nation-wide migrant malaria survey in 2016) assessed the knowledge; health-seeking; and testing within 24 h of fever and its associated factors. The qualitative component (descriptive design) explored the perspectives of migrants and health care providers [including village health volunteers (VHV)] into the barriers and suggested solutions to increase testing within 24 h. Quantitative data analysis was weighted for the three-stage sampling design of the survey. Qualitative data analysis involved manual descriptive thematic analysis. Results A total of 3230 households were included in the survey. The mean knowledge score (maximum score 11) for malaria was 5.2 (0.95 CI 5.1, 5.3). The source of information about malaria was 80% from public health facility staff and 21% from VHV. Among 11 193 household members, 964 (8.6%) had fever in last 3 months. Health-seeking was appropriate for fever in 76% (0.95 CI 73, 79); however, only 7% (0.95 CI 5, 9) first visited a VHV while 19% (0.95 CI 16, 22) had self-medication. Of 964, 220 (23%, 0.95 CI 20, 26) underwent malaria blood testing within 24 h. Stable migrants, high knowledge score and appropriate health-seeking were associated with testing within 24 h. Qualitative findings showed that low testing within 24 h despite appropriate health-seeking was due to lack of awareness among migrants regarding diagnosis services offered by VHV, delayed health-seeking at public health facilities and not all cases of fever being tested by VHV and health staff. Providing appropriate behaviour change communication for migrants related to malaria, provider’s acceptance for malaria testing for all fever cases and mobile peer volunteer under supervision were suggested to overcome above barriers. Conclusions Providers were not testing all migrant patients with fever for malaria. Low uptake within 24 h was also due to poor utilization of services offered by VHV. The programme should seriously consider addressing these barriers and implementing the recommendations if Myanmar is to eliminate malaria by 2030.
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- 2018
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10. Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
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Nay Yi Yi Linn, Soundappan Kathirvel, Mrinalini Das, Badri Thapa, Md. Mushfiqur Rahman, Thae Maung Maung, Aye Mon Mon Kyaw, Aung Thi, and Zaw Lin
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Health workforce ,Accessibility ,Quality of care ,Community health worker ,Performance ,Greater Mekong Sub-region ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the accessibility to- and quality of malaria care (treatment initiation, treatment within 24 h and complete treatment delivery) between VHV and BHS in Myanmar. Methods This was a retrospective cohort study using record review of routinely collected programme data available in electronic format. All patients with undifferentiated fever screened and diagnosed for malaria in January–December 2015 by VHV and BHS under National Malaria Control Programme in Myanmar were included in the study. Unadjusted and adjusted prevalence ratios (aPR) were calculated to assess the effect of VHV/BHS on receipt of treatment by patients. Results Of 978,735 undifferentiated fever patients screened in 2015, 11.0% of patients were found malaria positive and the malaria positivity in VHV and BHS group were 11.1 and 10.9% respectively. Access to malaria care: higher proportion of children aged 5–14 years (21.8% vs 17.3%) and females (43.7% vs 41.8%) with fever were screened for malaria by VHV compared to BHS. However, the same for children aged
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- 2018
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11. Understanding malaria treatment-seeking preferences within the public sector amongst mobile/migrant workers in a malaria elimination scenario: a mixed-methods study
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Aung Ye Naung Win, Thae Maung Maung, Khin Thet Wai, Tin Oo, Aung Thi, Rungrawee Tipmontree, Ngamphol Soonthornworasiri, Mondha Kengganpanich, and Jaranit Kaewkungwal
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Malaria elimination ,Migrant workers ,Mixed-methods design ,Voluntary health workers ,Rural health centers ,Public sector ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Migration flows and the emerging resistance to artemisinin-based combination therapy in the Greater Mekong Sub-region (GMS) create programmatic challenges to meeting the AD 2030 malaria elimination target in Myanmar. The National Malaria Control Programme (NMCP) targeted migrant workers based mainly on the stability of their worksites (categories 1: permanent work-setting; categories 2 and 3: less stable work-settings). This study aims to assess the migration patterns, malaria treatment-seeking preferences, and challenges encountered by mobile/migrant workers at remote sites in a malaria-elimination setting. Methods A mixed-methods explanatory sequential study retrospectively analysed the secondary data acquired through migrant mapping surveys (2013–2015) in six endemic regions (n = 9603). A multivariate logistic regression model was used to ascertain the contributing factors. A qualitative strand (2016–2017) was added by conducting five focus-group discussions (n = 50) and five in-depth interviews with migrant workers from less stable worksites in Shwegyin Township, Bago Region. The contiguous approach was used to integrate quantitative and qualitative findings. Results Among others, migrant workers from Bago Region were significantly more likely to report the duration of stay ≥ 12 months (63% vs. 49%) and high seasonal mobility (40% vs. 35%). Particularly in less stable settings, a very low proportion of migrant workers (17%) preferred to seek malaria treatment from the public sector and was significantly influenced by the worksite stability (adjusted OR = 1.4 and 2.3, respectively for categories 2 and 1); longer duration of stay (adjusted OR = 3.5); and adjusted OR
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- 2017
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12. Low uptake of malaria testing within 24 h of fever despite appropriate health-seeking among migrants in Myanmar: a mixed-methods study
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Hein, Kyaw Thu, Maung, Thae Maung, Htet, Kyaw Ko Ko, Shewade, Hemant Deepak, Tripathy, Jaya Prasad, Oo, Swai Mon, Lin, Zaw, and Thi, Aung
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- 2018
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13. Asymptomatic and sub-microscopic malaria infection in Kayah State, eastern Myanmar
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Myo Thiha Zaw, Myo Thant, Tin Maung Hlaing, Naing Zin Aung, Min Thu, Kanit Phumchuea, Kanokwan Phusri, Teerawat Saeseu, Ritthideach Yorsaeng, Wang Nguitragool, Ingrid Felger, Jaranit Kaewkungwal, Liwang Cui, and Jetsumon Sattabongkot
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Asymptomatic ,Sub-microscopic ,Malaria ,Myanmar ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Myanmar has the heaviest burden of malaria in the Greater Mekong Sub-region. Asymptomatic Plasmodium spp. infections are common in this region and may represent an important reservoir of transmission that must be targeted for malaria elimination. Methods A mass blood survey was conducted among 485 individuals from six villages in Kayah State, an area of endemic but low transmission malaria in eastern Myanmar. Malaria infection was screened by rapid diagnostic test (RDT), light microscopy and real-time polymerase chain reaction (PCR), and its association with demographic factors was explored. Results The prevalence of asymptomatic Plasmodium spp. infection was 2.3% (11/485) by real-time PCR. Plasmodium vivax accounted for 72.7% (8/11) and Plasmodium falciparum for 27.3% (3/11) of infections. Men were at greater risk of infection by Plasmodium spp. than women. Individuals who worked as farmers or wood and bamboo cutters had an increased risk of infection. Conclusion A combination of RDT, light microscopy and PCR diagnostics were used to identify asymptomatic malaria infection, providing additional information on asymptomatic cases in addition to the routine statistics on symptomatic cases, so as to determine the true burden of disease in the area. Such information and risk factors can improve malaria risk stratification and guide decision-makers towards better design and delivery of targeted interventions in small villages, representative of Kayah State.
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- 2017
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14. Bayesian spatiotemporal analysis of malaria infection along an international border: Hlaingbwe Township in Myanmar and Tha-Song-Yang District in Thailand
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Thway, Aung Minn, Rotejanaprasert, Chawarat, Sattabongkot, Jetsumon, Lawawirojwong, Siam, Thi, Aung, Hlaing, Tin Maung, Soe, Thiha Myint, and Kaewkungwal, Jaranit
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- 2018
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15. Bayesian spatiotemporal analysis of malaria infection along an international border: Hlaingbwe Township in Myanmar and Tha-Song-Yang District in Thailand
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Tin Maung Hlaing, Aung Thi, Chawarat Rotejanaprasert, Siam Lawawirojwong, Thiha Myint Soe, Jaranit Kaewkungwal, Aung Minn Thway, and Jetsumon Sattabongkot
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Male ,Myanmar ,0302 clinical medicine ,Risk Factors ,030212 general & internal medicine ,Child ,Socioeconomics ,Aged, 80 and over ,Middle Aged ,Thailand ,Infectious Diseases ,Geography ,Spatiotemporal analysis ,Child, Preschool ,symbols ,Female ,Topography, Medical ,Adult ,Wet season ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Adolescent ,lcsh:RC955-962 ,030231 tropical medicine ,Posterior probability ,Bayesian probability ,Border areas ,Risk Assessment ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,symbols.namesake ,Spatio-Temporal Analysis ,parasitic diseases ,medicine ,Humans ,lcsh:RC109-216 ,Poisson regression ,Aged ,Descriptive statistics ,Research ,Public health ,Infant, Newborn ,Infant ,Bayes Theorem ,medicine.disease ,Malaria ,Tropical medicine ,Parasitology - Abstract
Background One challenge in moving towards malaria elimination is cross-border malaria infection. The implemented measures to prevent and control malaria re-introduction across the demarcation line between two countries require intensive analyses and interpretation of data from both sides, particularly in border areas, to make correct and timely decisions. Reliable maps of projected malaria distribution can help to direct intervention strategies. In this study, a Bayesian spatiotemporal analytic model was proposed for analysing and generating aggregated malaria risk maps based on the exceedance probability of malaria infection in the township-district adjacent to the border between Myanmar and Thailand. Data of individual malaria cases in Hlaingbwe Township and Tha-Song-Yang District during 2016 were extracted from routine malaria surveillance databases. Bayesian zero-inflated Poisson model was developed to identify spatial and temporal distributions and associations between malaria infections and risk factors. Maps of the descriptive statistics and posterior distribution of predicted malaria infections were also developed. Results A similar seasonal pattern of malaria was observed in both Hlaingbwe Township and Tha-Song-Yang District during the rainy season. The analytic model indicated more cases of malaria among males and individuals aged ≥ 15 years. Mapping of aggregated risk revealed consistently high or low probabilities of malaria infection in certain village tracts or villages in interior parts of each country, with higher probability in village tracts/villages adjacent to the border in places where it could easily be crossed; some border locations with high mountains or dense forests appeared to have fewer malaria cases. The probability of becoming a hotspot cluster varied among village tracts/villages over the year, and some had close to no cases all year. Conclusions The analytic model developed in this study could be used for assessing the probability of hotspot cluster, which would be beneficial for setting priorities and timely preventive actions in such hotspot cluster areas. This approach might help to accelerate reaching the common goal of malaria elimination in the two countries. Electronic supplementary material The online version of this article (10.1186/s12936-018-2574-0) contains supplementary material, which is available to authorized users.
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- 2018
16. Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016
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Jaya Prasad Tripathy, Tin Oo, Thae Maung Maung, Kyi Thar Min, Myo Minn Oo, Zaw Lin, and Aung Thi
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Male ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Fever ,lcsh:RC955-962 ,Cross-sectional study ,030231 tropical medicine ,Under-five children ,Psychological intervention ,Myanmar ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,Health facility ,Environmental health ,medicine ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Insecticide-Treated Bednets ,Demography ,Geography ,business.industry ,Research ,Public health ,Infant ,Odds ratio ,Patient Acceptance of Health Care ,medicine.disease ,Health Surveys ,Demographic and Health Survey ,Malaria ,Cross-Sectional Studies ,Infectious Diseases ,Caregivers ,SORT IT ,Child, Preschool ,Health care seeking ,Tropical medicine ,Female ,Parasitology ,Residence ,Insecticide treated net ,business - Abstract
Background Malaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks. Methods This was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey. Results Of 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7). Conclusions This study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.
- Published
- 2020
17. Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
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Badri Thapa, Mrinalini Das, Aye Mon Mon Kyaw, Thae Maung Maung, Nay Yi Yi Linn, Md. Mushfiqur Rahman, Zaw Lin, Soundappan Kathirvel, and Aung Thi
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Rural Population ,medicine.medical_specialty ,Community health worker ,lcsh:Arctic medicine. Tropical medicine ,lcsh:RC955-962 ,Performance ,030231 tropical medicine ,Myanmar ,lcsh:Infectious and parasitic diseases ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,parasitic diseases ,Medicine ,Humans ,Malaria screening ,lcsh:RC109-216 ,030212 general & internal medicine ,Retrospective Studies ,Community Health Workers ,Community level ,business.industry ,Public health ,Research ,Community Participation ,Quality of care ,Retrospective cohort study ,medicine.disease ,Health workforce ,Accessibility ,Confidence interval ,Malaria ,Infectious Diseases ,Treatment delivery ,Family medicine ,Tropical medicine ,Greater Mekong Sub-region ,Parasitology ,business ,Delivery of Health Care - Abstract
Background Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the accessibility to- and quality of malaria care (treatment initiation, treatment within 24 h and complete treatment delivery) between VHV and BHS in Myanmar. Methods This was a retrospective cohort study using record review of routinely collected programme data available in electronic format. All patients with undifferentiated fever screened and diagnosed for malaria in January–December 2015 by VHV and BHS under National Malaria Control Programme in Myanmar were included in the study. Unadjusted and adjusted prevalence ratios (aPR) were calculated to assess the effect of VHV/BHS on receipt of treatment by patients. Results Of 978,735 undifferentiated fever patients screened in 2015, 11.0% of patients were found malaria positive and the malaria positivity in VHV and BHS group were 11.1 and 10.9% respectively. Access to malaria care: higher proportion of children aged 5–14 years (21.8% vs 17.3%) and females (43.7% vs 41.8%) with fever were screened for malaria by VHV compared to BHS. However, the same for children aged
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- 2018
18. Barriers in distribution, ownership and utilization of insecticide-treated mosquito nets among migrant population in Myanmar, 2016: a mixed methods study
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Linn, Shwe Yi, primary, Maung, Thae Maung, additional, Tripathy, Jaya Prasad, additional, Shewade, Hemant Deepak, additional, Oo, Swai Mon, additional, Linn, Zaw, additional, and Thi, Aung, additional
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- 2019
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19. Barriers in distribution, ownership and utilization of insecticide-treated mosquito nets among migrant population in Myanmar, 2016: a mixed methods study
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Hemant Deepak Shewade, Zaw Linn, Swai Mon Oo, Thae Maung Maung, Aung Thi, Shwe Yi Linn, and Jaya Prasad Tripathy
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Male ,Health Knowledge, Attitudes, Practice ,Mosquito Control ,Psychological intervention ,Distribution (economics) ,Myanmar ,0302 clinical medicine ,Universal Health Insurance ,Surveys and Questionnaires ,030212 general & internal medicine ,Migrant population ,Socioeconomics ,Transients and Migrants ,Family Characteristics ,Insecticide-treated bed net ,Middle Aged ,Infectious Diseases ,Geography ,Child, Preschool ,Female ,Adult ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Adolescent ,lcsh:RC955-962 ,030231 tropical medicine ,Context (language use) ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,parasitic diseases ,medicine ,Humans ,lcsh:RC109-216 ,Insecticide-Treated Bednets ,Structured Operational Research Training IniTiative (SORT IT) ,Aged ,business.industry ,Research ,Public health ,Ownership ,equipment and supplies ,medicine.disease ,Focus group ,Malaria ,Cross-Sectional Studies ,Parasitology ,business ,Insecticide-treated mosquito nets - Abstract
Background Sleeping under insecticide-treated mosquito nets/long-lasting insecticidal nets (ITNs/LLINs henceforth referred to as ITNs) is one of the core interventions recommended by the World Health Organization to reduce malaria transmission and prevent malaria in high-risk communities, such as migrants, by preventing mosquito bites. The malaria burden among the migrant population is a big challenge for malaria elimination in Myanmar. In this context, this study aimed to assess the ownership and utilization of ITNs and to understand the barriers to distribution and utilization of ITNs among the high-risk migrant communities in the Regional Artemisinin Resistance Initiative (RAI) project areas of Myanmar. Methods A sequential mixed methods study (quantitative component: cross-sectional study involving analysis of secondary data available from a survey conducted among migrant households in the RAI project areas of Myanmar in 2016 followed by a descriptive qualitative component in 2018). A total of 17 focus group discussions (involving 121 participants) with different groups of migrants and 17 key-informant interviews with key programme stakeholders were conducted in 4 selected townships of RAI project areas. Results Of 3230 migrant households, 63.3% had at least one ITN while 36% had sufficient ITNs (i.e., 1 ITN per 2 persons). Regarding ITN utilization, about 52% of household members reported sleeping under an ITN the previous night, which is similar among under-fives and pregnant women. Over half of all bed nets were ITNs, with nearly one-third having holes or already undergone repairs. The qualitative findings revealed that the key challenges for ITN utilization were insufficient ITNs in households and dislike of ITNs. The barriers to ITN distribution were incomplete migrant mapping due to resource constraints (time, money, manpower) and difficulties in transportation and carrying ITNs. Conclusion This study highlights poor ownership and utilization of ITNs among migrants in the RAI project areas of Myanmar and barriers to their ownership and utilization. To achieve universal coverage and utilization, more programmatic support by the programme is needed to carry out complete migrant mapping and continuous ITN distribution in remote locations.
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- 2019
20. Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015
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Linn, Nay Yi Yi, primary, Kathirvel, Soundappan, additional, Das, Mrinalini, additional, Thapa, Badri, additional, Rahman, Md. Mushfiqur, additional, Maung, Thae Maung, additional, Kyaw, Aye Mon Mon, additional, Thi, Aung, additional, and Lin, Zaw, additional
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- 2018
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21. Understanding malaria treatment-seeking preferences within the public sector amongst mobile/migrant workers in a malaria elimination scenario: a mixed-methods study
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Win, Aung Ye Naung, primary, Maung, Thae Maung, additional, Wai, Khin Thet, additional, Oo, Tin, additional, Thi, Aung, additional, Tipmontree, Rungrawee, additional, Soonthornworasiri, Ngamphol, additional, Kengganpanich, Mondha, additional, and Kaewkungwal, Jaranit, additional
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- 2017
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22. Understanding malaria treatment-seeking preferences within the public sector amongst mobile/migrant workers in a malaria elimination scenario: a mixed-methods study
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Khin Thet Wai, Aung Ye Naung Win, Ngamphol Soonthornworasiri, Thae Maung Maung, Mondha Kengganpanich, Rungrawee Tipmontree, Aung Thi, Jaranit Kaewkungwal, and Tin Oo
- Subjects
Adult ,Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Adolescent ,lcsh:RC955-962 ,Health Behavior ,030231 tropical medicine ,Malaria elimination ,Qualitative property ,Resistance (psychoanalysis) ,Myanmar ,Migrant workers ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Environmental protection ,Environmental health ,Health care ,medicine ,Humans ,lcsh:RC109-216 ,Rural health centers ,030212 general & internal medicine ,Duration (project management) ,Transients and Migrants ,GMS ,Public Sector ,business.industry ,Research ,Rural health ,Public health ,Public sector ,Middle Aged ,medicine.disease ,Malaria ,Early Diagnosis ,Infectious Diseases ,Mixed-methods design ,Female ,Parasitology ,Voluntary health workers ,business - Abstract
Background Migration flows and the emerging resistance to artemisinin-based combination therapy in the Greater Mekong Sub-region (GMS) create programmatic challenges to meeting the AD 2030 malaria elimination target in Myanmar. The National Malaria Control Programme (NMCP) targeted migrant workers based mainly on the stability of their worksites (categories 1: permanent work-setting; categories 2 and 3: less stable work-settings). This study aims to assess the migration patterns, malaria treatment-seeking preferences, and challenges encountered by mobile/migrant workers at remote sites in a malaria-elimination setting. Methods A mixed-methods explanatory sequential study retrospectively analysed the secondary data acquired through migrant mapping surveys (2013–2015) in six endemic regions (n = 9603). A multivariate logistic regression model was used to ascertain the contributing factors. A qualitative strand (2016–2017) was added by conducting five focus-group discussions (n = 50) and five in-depth interviews with migrant workers from less stable worksites in Shwegyin Township, Bago Region. The contiguous approach was used to integrate quantitative and qualitative findings. Results Among others, migrant workers from Bago Region were significantly more likely to report the duration of stay ≥ 12 months (63% vs. 49%) and high seasonal mobility (40% vs. 35%). Particularly in less stable settings, a very low proportion of migrant workers (17%) preferred to seek malaria treatment from the public sector and was significantly influenced by the worksite stability (adjusted OR = 1.4 and 2.3, respectively for categories 2 and 1); longer duration of stay (adjusted OR = 3.5); and adjusted OR
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- 2017
23. The effect of parental rearing conditions on offspring life history in Anopheles stephensi
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Maung Liam, Grech Katrina, and Read Andrew F
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Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The environmental conditions experienced by parents are increasingly recognized to impact the success of offspring. Little is known on the presence of such parental effects in Anopheles. If present, parental effects could influence mosquito breeding programmes, some malaria control measures and have epidemiological and evolutionary consequences. Methods The presence of parental effects on offspring emergence time, size, survival, blood meal size and fecundity in laboratory reared An. stephensi were tested. Results Parental rearing conditions did not influence the time taken for offspring to emerge, or their size or survival as adults. However, parental effects were influential in determining the fecundity of daughters. Counter-intuitively, daughters of parents reared in low food conditions produced larger egg clutches than daughters of parents reared in high food conditions. Offspring reared in low food conditions took larger blood meals if their parents had also experienced a low food environment. Conclusion So far as we are aware, this is the first evidence of parental effects on progeny in Anopheles.
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- 2007
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24. Community engagement and the social context of targeted malaria treatment: a qualitative study in Kayin (Karen) State, Myanmar
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Christopher Pell, Aung Kyaw Phyo, Nicholas J. White, Frank Smithuis, Sai Maung Maung, Lorenz von Seidlein, Nicholas P. J. Day, Phaik Yeong Cheah, Kate Sahan, Chanida Indrasuta, and Arjen M. Dondorp
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Gerontology ,Health Knowledge, Attitudes, Practice ,Elimination ,030231 tropical medicine ,Population ,Context (language use) ,Myanmar ,Antimalarials ,03 medical and health sciences ,0302 clinical medicine ,Hospitality ,Health care ,Medicine ,030212 general & internal medicine ,education ,education.field_of_study ,Community engagement ,business.industry ,Research ,Community Participation ,1. No poverty ,Social environment ,Public relations ,Malaria ,3. Good health ,Local community ,Infectious Diseases ,Mass drug administration ,Parasitology ,business ,human activities ,Qualitative research - Abstract
BACKGROUND: The spread of artemisinin-resistance in Plasmodium falciparum is a threat to current global malaria control initiatives. Targeted malaria treatment (TMT), which combines mass anti-malarial administration with conventional malaria prevention and control measures, has been proposed as a strategy to tackle this problem. The effectiveness of TMT depends on high levels of population coverage and is influenced by accompanying community engagement activities and the local social context. The article explores how these factors influenced attitudes and behaviours towards TMT in Kayin (Karen) State, Myanmar. METHODS: Semi-structured interviews were conducted with villagers from study villages (N = 31) and TMT project staff (N = 14) between March and July 2015. RESULTS: Community engagement consisted of a range of activities to communicate the local malaria situation (including anti-malarial drug resistance and asymptomatic malaria), the aims of the TMT project, and its potential benefits. Community engagement was seen by staff as integral to the TMT project as a whole and not a sub-set of activities. Attitudes towards TMT (including towards community engagement) showed that developing trusting relationships helped foster participation. After initial wariness, staff received hospitality and acceptance among villagers. Offering healthcare alongside TMT proved mutually beneficial for the study and villagers. A handful of more socially-mobile and wealthy community members were reluctant to participate. The challenges of community engagement included time constraints and the isolation of the community with its limited infrastructure and a history of conflict. CONCLUSIONS: Community engagement had to be responsive to the local community even though staff faced time constraints. Understanding the social context of engagement helped TMT to foster respectful and trusting relationships. The complex relationship between the local context and community engagement complicated evaluation of the community strategy. Nonetheless, the project did record high levels of population coverage.
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- 2017
25. Acceptability of insecticide-treated clothing for malaria prevention among migrant rubber tappers in Myanmar: a cluster-randomized non-inferiority crossover trial
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Crawshaw, Alison F., primary, Maung, Thae Maung, additional, Shafique, Muhammad, additional, Sint, Nyan, additional, Nicholas, Sarala, additional, Li, Michelle S., additional, Roca-Feltrer, Arantxa, additional, and Hii, Jeffrey, additional
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- 2017
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26. Community engagement and the social context of targeted malaria treatment: a qualitative study in Kayin (Karen) State, Myanmar
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Sahan, Kate, primary, Pell, Christopher, additional, Smithuis, Frank, additional, Phyo, Aung Kyaw, additional, Maung, Sai Maung, additional, Indrasuta, Chanida, additional, Dondorp, Arjen M., additional, White, Nicholas J., additional, Day, Nicholas P. J., additional, von Seidlein, Lorenz, additional, and Cheah, Phaik Yeong, additional
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- 2017
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27. The role of early detection and treatment in malaria elimination
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Jordi Landier, Craig A. Bonnington, Khin Maung Lwin, Gilles Delmas, Verena I. Carrara, Aung Myint Thu, Daniel M. Parker, François Nosten, and Sasithon Pukrittayakamee
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medicine.medical_specialty ,Primaquine ,Combination therapy ,030231 tropical medicine ,Review ,03 medical and health sciences ,Antimalarials ,Lactones ,0302 clinical medicine ,Pharmacotherapy ,parasitic diseases ,medicine ,Disease Transmission, Infectious ,Secondary Prevention ,Humans ,030212 general & internal medicine ,Artemisinin ,Disease Eradication ,Intensive care medicine ,business.industry ,Transmission (medicine) ,Diagnostic Tests, Routine ,Public health ,medicine.disease ,Artemisinins ,3. Good health ,Surgery ,Malaria ,Infectious Diseases ,Early Diagnosis ,Parasitology ,Drug Therapy, Combination ,business ,medicine.drug - Abstract
Falciparum malaria persists in hard-to-reach areas or demographic groups that are missed by conventional healthcare systems but could be reached by trained community members in a malaria post (MP). The main focus of a MP is to provide uninterrupted and rapid access to rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) too all inhabitants of a village. RDTs allow trained community members to perform malaria diagnosis accurately and prescribe appropriate treatment, reducing as much as possible any delay between the onset of fever and treatment. Early treatment with ACT and with a low-dose of primaquine prevents further transmission from human to mosquito. A functioning MP represents an essential component of any malaria elimination strategy. Implementing large-scale, high-coverage, community-based early diagnosis and treatment through MPs requires few technological innovations but relies on a very well structured organization able to train, supervise and supply MPs, to monitor activity and to perform strict malaria surveillance. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1399-y) contains supplementary material, which is available to authorized users.
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- 2016
28. Parasite clearance rates in Upper Myanmar indicate a distinctive artemisinin resistance phenotype: a therapeutic efficacy study
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Cholrawee Promnarate, Elizabeth A. Ashley, Min Min Thein, Sai Soe Moe Aung, Tin Maung Hlaing, Mehul Dhorda, Frank Smithuis, Nicholas P. J. Day, Atthanee Jeeyapant, Kyaw Myo Tun, Prayoon Yuentrakul, Mallika Imwong, Charles J. Woodrow, Arjen M. Dondorp, and Nicholas J. White
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Male ,0301 basic medicine ,Primaquine ,Kelch 13 propeller ,Drug Resistance ,Protozoan Proteins ,Administration, Oral ,Myanmar ,Drug resistance ,Parasitemia ,0302 clinical medicine ,Prospective Studies ,Malaria, Falciparum ,Artemisinin ,Child ,Middle Aged ,Artemisinins ,3. Good health ,Infectious Diseases ,Artemisinin resistance ,Child, Preschool ,Quinolines ,Female ,Clearance rate ,medicine.drug ,Adult ,Adolescent ,Combination therapy ,Plasmodium falciparum ,030106 microbiology ,030231 tropical medicine ,Mutation, Missense ,Biology ,Antimalarials ,Young Adult ,03 medical and health sciences ,parasitic diseases ,medicine ,Humans ,Parasite clearance half-life ,Aged ,Research ,Infant ,biology.organism_classification ,medicine.disease ,Immunology ,Parasitology ,Malaria - Abstract
Background Artemisinin resistance in Plasmodium falciparum extends across Southeast Asia where it is associated with worsening partner drug resistance and a decline in the efficacy of frontline artemisinin-based combination therapy. Dihydroartemisinin-piperaquine (DP) is an essential component of preventive and curative treatment in the region, but its therapeutic efficacy has fallen in Cambodia. Methods A prospective clinical and parasitological evaluation of DP was conducted at two sites in Upper Myanmar between August 2013 and December 2014, enrolling 116 patients with acute uncomplicated falciparum malaria. Patients received DP orally for 3 days together with primaquine 0.25 mg/kg on admission. Parasite clearance half-lives based on 6 hourly blood smears, and day 42 therapeutic responses were assessed as well as parasite K13 genotypes. Results Median parasite clearance half-life was prolonged, and clearance half-life was greater than 5 h in 21 % of patients. Delayed parasite clearance was significantly associated with mutations in the propeller region of the parasite k13 gene. The k13 F446I mutation was found in 25.4 % of infections and was associated with a median clearance half-life of 4.7 h compared with 2.7 h for infections without k13 mutations (p
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- 2016
29. Asymptomatic and sub-microscopic malaria infection in Kayah State, eastern Myanmar
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Zaw, Myo Thiha, primary, Thant, Myo, additional, Hlaing, Tin Maung, additional, Aung, Naing Zin, additional, Thu, Min, additional, Phumchuea, Kanit, additional, Phusri, Kanokwan, additional, Saeseu, Teerawat, additional, Yorsaeng, Ritthideach, additional, Nguitragool, Wang, additional, Felger, Ingrid, additional, Kaewkungwal, Jaranit, additional, Cui, Liwang, additional, and Sattabongkot, Jetsumon, additional
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- 2017
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30. Parasite clearance rates in Upper Myanmar indicate a distinctive artemisinin resistance phenotype: a therapeutic efficacy study
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Tun, Kyaw Myo, primary, Jeeyapant, Atthanee, additional, Imwong, Mallika, additional, Thein, Min, additional, Aung, Sai Soe Moe, additional, Hlaing, Tin Maung, additional, Yuentrakul, Prayoon, additional, Promnarate, Cholrawee, additional, Dhorda, Mehul, additional, Woodrow, Charles J., additional, Dondorp, Arjen M., additional, Ashley, Elizabeth A., additional, Smithuis, Frank M., additional, White, Nicholas J., additional, and Day, Nicholas P. J., additional
- Published
- 2016
- Full Text
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31. The epidemiology of subclinical malaria infections in South-East Asia: findings from cross-sectional surveys in Thailand–Myanmar border areas, Cambodia, and Vietnam
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Imwong, Mallika, primary, Nguyen, Thuy Nhien, additional, Tripura, Rupam, additional, Peto, Tom J., additional, Lee, Sue J., additional, Lwin, Khin Maung, additional, Suangkanarat, Preyanan, additional, Jeeyapant, Atthanee, additional, Vihokhern, Benchawan, additional, Wongsaen, Klanarong, additional, Van Hue, Dao, additional, Dong, Le Thanh, additional, Nguyen, Tam-Uyen, additional, Lubell, Yoel, additional, von Seidlein, Lorenz, additional, Dhorda, Mehul, additional, Promnarate, Cholrawee, additional, Snounou, Georges, additional, Malleret, Benoit, additional, Rénia, Laurent, additional, Keereecharoen, Lilly, additional, Singhasivanon, Pratap, additional, Sirithiranont, Pasathorn, additional, Chalk, Jem, additional, Nguon, Chea, additional, Hien, Tran Tinh, additional, Day, Nicholas, additional, White, Nicholas J., additional, Dondorp, Arjen, additional, and Nosten, Francois, additional
- Published
- 2015
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32. Elimination of Plasmodium falciparum in an area of multi-drug resistance
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Lwin, Khin Maung, primary, Imwong, Mallika, additional, Suangkanarat, Preyanan, additional, Jeeyapant, Atthanee, additional, Vihokhern, Benchawan, additional, Wongsaen, Klanarong, additional, Snounou, Georges, additional, Keereecharoen, Lilly, additional, White, Nicholas J, additional, and Nosten, Francois, additional
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- 2015
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33. Triangular test design to evaluate tinidazole in the prevention of Plasmodium vivax relapse
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Macareo, Louis, primary, Lwin, Khin Maung, additional, Cheah, Phaik Yeong, additional, Yuentrakul, Prayoon, additional, Miller, R Scott, additional, and Nosten, Francois, additional
- Published
- 2013
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34. Parasite clearance rates in Upper Myanmar indicate a distinctive artemisinin resistance phenotype: a therapeutic efficacy study.
- Author
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Kyaw Myo Tun, Atthanee Jeeyapant, Mallika Imwong, Min Thein, Sai Soe Moe Aung, Tin Maung Hlaing, Prayoon Yuentrakul, Cholrawee Promnarate, Mehul Dhorda, Woodrow, Charles J., Dondorp, Arjen M., Ashley, Elizabeth A., Smithuis, Frank M., White, Nicholas J., and Day, Nicholas P. J.
- Subjects
ARTEMISININ ,ANTIMALARIALS ,PLASMODIUM falciparum ,DRUG resistance ,DRUG efficacy - Abstract
Background: Artemisinin resistance in Plasmodium falciparum extends across Southeast Asia where it is associated with worsening partner drug resistance and a decline in the efficacy of frontline artemisinin-based combination therapy. Dihydroartemisinin-piperaquine (DP) is an essential component of preventive and curative treatment in the region, but its therapeutic efficacy has fallen in Cambodia. Methods: A prospective clinical and parasitological evaluation of DP was conducted at two sites in Upper Myanmar between August 2013 and December 2014, enrolling 116 patients with acute uncomplicated falciparum malaria. Patients received DP orally for 3 days together with primaquine 0.25 mg/kg on admission. Parasite clearance half-lives based on 6 hourly blood smears, and day 42 therapeutic responses were assessed as well as parasite K13 genotypes. Results: Median parasite clearance half-life was prolonged, and clearance half-life was greater than 5 h in 21 % of patients. Delayed parasite clearance was significantly associated with mutations in the propeller region of the parasite k13 gene. The k13 F446I mutation was found in 25.4 % of infections and was associated with a median clearance halflife of 4.7 h compared with 2.7 h for infections without k13 mutations (p < 0.001). There were no failures after 42 days of follow-up, although 18 % of patients had persistent parasitaemia on day 3. Conclusion: The dominant k13 mutation observed in Upper Myanmar, F446I, appears to be associated with an intermediate rate of parasite clearance compared to other common mutations described elsewhere in the Greater Mekong Subregion. Discerning this phenotype requires relatively detailed clearance measurements, highlighting the importance of methodology in assessing artemisinin resistance. [ABSTRACT FROM AUTHOR]
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- 2016
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35. The epidemiology of subclinical malaria infections in South-East Asia: findings from cross-sectional surveys in Thailand–Myanmar border areas, Cambodia, and Vietnam.
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Mallika Imwong, Thuy Nhien Nguyen, Rupam Tripura, Peto, Tom J., Lee, Sue J., Khin Maung Lwin, Preyanan Suangkanarat, Atthanee Jeeyapant, Benchawan Vihokhern, Klanarong Wongsaen, Dao Van Hue, Le Thanh Dong, Tam‑Uyen Nguyen, Lubell, Yoel, von Seidlein, Lorenz, Dhorda, Mehul, Cholrawee Promnarate, Snounou, Georges, Malleret, Benoit, and Rénia, Laurent
- Subjects
MALARIA transmission ,PLASMODIUM ,POLYMERASE chain reaction ,PARASITES ,GENETICS ,VACCINATION - Abstract
Background: The importance of the submicroscopic reservoir of Plasmodium infections for malaria elimination depends on its size, which is generally considered small in low transmission settings. The precise estimation of this reservoir requires more sensitive parasite detection methods. The prevalence of asymptomatic, sub-microscopic malaria was assessed by a sensitive, high blood volume quantitative real-time polymerase chain reaction method in three countries of the Greater Mekong Sub-region. Methods: Cross-sectional surveys were conducted in three villages in western Cambodia, four villages along the Thailand-Myanmar border and four villages in southwest Vietnam. Malaria parasitaemia was assessed by Plasmodium falciparum/pan malaria rapid diagnostic tests (RDTs), microscopy and a high volume ultra-sensitive real-time polymerase chain reaction (HVUSqPCR: limit of detection 22 parasites/mL). All villagers older than 6 months were invited to participate. Results: A census before the surveys identified 7355 residents in the study villages. Parasite prevalence was 224/5008 (4 %) by RDT, 229/5111 (5 %) by microscopy, and 988/4975 (20 %) when assessed by HVUSqPCR. Of these 164 (3 %) were infected with P. falciparum, 357 (7 %) with Plasmodium vivax, 56 (1 %) with a mixed infection, and 411 (8 %) had parasite densities that were too low for species identification. A history of fever, male sex, and age of 15 years or older were independently associated with parasitaemia in a multivariate regression model stratified by site. Conclusion: Light microscopy and RDTs identified only a quarter of all parasitaemic participants. The asymptomatic Plasmodium reservoir is considerable, even in low transmission settings. Novel strategies are needed to eliminate this previously under recognized reservoir of malaria transmission. [ABSTRACT FROM AUTHOR]
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- 2015
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36. Clinically uncomplicated Plasmodium falciparum malaria with high schizontaemia: A case report
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Lwin, Khin Maung, primary, Ashley, Elizabeth A, additional, Proux, Stephane, additional, Silamut, Kamolrat, additional, Nosten, François, additional, and McGready, Rose, additional
- Published
- 2008
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37. The effect of parental rearing conditions on offspring life history in Anopheles stephensi
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Grech, Katrina, primary, Maung, Liam Aye, additional, and Read, Andrew F, additional
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- 2007
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38. Elimination of Plasmodium falciparum in an area of multi-drug resistance.
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Khin Maung Lwin, Mallika Imwong, Suangkanarat, Preyanan, Jeeyapant, Atthanee, Vihokhern, Benchawan, Wongsaen, Klanarong, Snounou, Georges, Keereecharoen, Lilly, White, Nicholas J., and Nosten, Francois
- Subjects
- *
ARTEMISININ derivatives , *PLASMODIUM falciparum , *MULTIDRUG resistance , *MALARIA , *DISEASE prevalence - Abstract
Background: Resistance to the artemisinin derivatives in Plasmodium falciparum has emerged in Cambodia and is now spreading throughout South-East Asia. The rapid elimination of P. falciparum seems to be the only viable option to avoid a public health disaster but this is difficult because even in low transmission settings many residents have asymptomatic parasitaemias. Methods: In response to a large number of malaria cases reported in three remote villages on the Thai-Myanmar border where malaria is endemic and the disease is seasonal, surveys were conducted using an ultra-sensitive qPCR assay (LOD 22 parasites per mL). In one of the villages where it was feasible, mass anti-malarial drug administration was proposed to the population as a potential solution, and this was adopted. Results: In the three villages 204/356 (57.3 %), 212/385 (55.1 %) and 195/286 (68.2 %) of the resident populations were positive by qPCR (approximately one-third P. falciparum and two-thirds P. vivax). Of those positive for P. falciparum 62 % carried single point mutations in the P. falciparum kelch protein (a marker of artemisinin resistance). In one of the villages 217 of 674 inhabitants received at least one dose of dihydroartemisinin-piperaquine chemoprevention in June 2012, 155 (71.4 %) received two consecutive months, and 98 (45.2 %) received three treatment doses. The chemoprevention was generally well tolerated. The sub-microscopic reservoir of P. falciparum malaria was eliminated during the six-month follow-up period (prevalence fell from 7 to 0 %); P. vivax malaria persisted (prevalence fell from 35 to 8 %). From June to October 2012 (rainy season) the number of clinical episodes of P. falciparum was six times lower (46), than during the same period in the previous year (290). Conclusion: Mass drug administration with dihydroartemisinin-piperaquine may be an effective strategy to eliminate P. falciparum rapidly where multi-drug resistance is present. [ABSTRACT FROM AUTHOR]
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- 2015
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39. The effect of parental rearing conditions on offspring life history in Anopheles stephensi
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Liam Aye Maung, Andrew F. Read, and Katrina Grech
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0106 biological sciences ,Male ,lcsh:Arctic medicine. Tropical medicine ,Offspring ,lcsh:RC955-962 ,media_common.quotation_subject ,030231 tropical medicine ,Fertility ,010603 evolutionary biology ,01 natural sciences ,lcsh:Infectious and parasitic diseases ,immunology ,03 medical and health sciences ,0302 clinical medicine ,Anopheles ,Animals ,Body Size ,lcsh:RC109-216 ,Life history ,Anopheles stephensi ,media_common ,biology ,Ecology ,biological sciences ,Research ,digestive, oral, and skin physiology ,biology.organism_classification ,High food ,Blood meal ,Fecundity ,3. Good health ,Infectious Diseases ,Blood ,Sample Size ,Parasitology ,Female ,Demography - Abstract
Background The environmental conditions experienced by parents are increasingly recognized to impact the success of offspring. Little is known on the presence of such parental effects in Anopheles. If present, parental effects could influence mosquito breeding programmes, some malaria control measures and have epidemiological and evolutionary consequences. Methods The presence of parental effects on offspring emergence time, size, survival, blood meal size and fecundity in laboratory reared An. stephensi were tested. Results Parental rearing conditions did not influence the time taken for offspring to emerge, or their size or survival as adults. However, parental effects were influential in determining the fecundity of daughters. Counter-intuitively, daughters of parents reared in low food conditions produced larger egg clutches than daughters of parents reared in high food conditions. Offspring reared in low food conditions took larger blood meals if their parents had also experienced a low food environment. Conclusion So far as we are aware, this is the first evidence of parental effects on progeny in Anopheles.
- Published
- 2007
40. Acceptability of insecticide-treated clothing for malaria prevention among migrant rubber tappers in Myanmar: a cluster-randomized non-inferiority crossover trial
- Author
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Michelle S. Li, Nyan Sint, Alison F Crawshaw, Thae Maung Maung, Arantxa Roca-Feltrer, Jeffrey Hii, Muhammad Shafique, and Sarala Nicholas
- Subjects
Adult ,Male ,Insecticides ,medicine.medical_specialty ,Mosquito Control ,030231 tropical medicine ,Psychological intervention ,Qualitative property ,Myanmar ,Rubber tappers ,Extraction and Processing Industry ,Clothing ,Young Adult ,03 medical and health sciences ,Acceptability ,0302 clinical medicine ,Double-Blind Method ,Protective Clothing ,Environmental health ,parasitic diseases ,medicine ,Cluster Analysis ,Humans ,030212 general & internal medicine ,Insecticide-Treated Bednets ,Recreation ,Transients and Migrants ,2. Zero hunger ,Cross-Over Studies ,Insecticide-treated clothing ,business.industry ,Research ,Public health ,Middle Aged ,Crossover study ,Focus group ,Outdoor transmission ,Malaria ,3. Good health ,Occupational Diseases ,Mosquito control ,Infectious Diseases ,Personal protection ,Female ,Parasitology ,Rubber ,business - Abstract
Background Insecticide-treated clothing (ITC) has long been used for military and outdoor recreational purposes and there is substantial evidence to show that it can protect against arthropod biting. As a complementary vector control measure, ITC could be used to address outdoor transmission of malaria, particularly among mobile and migrant populations and night-time workers such as rubber tappers, who may be beyond the reach of core interventions. However, more information is required on acceptability and preferences of target groups towards ITC to understand whether it could be a viable strategy in Myanmar. Methods A cluster-randomized, double-blind, non-inferiority crossover trial was performed to determine acceptability of ITC versus identical, untreated clothing (NTC) among migrant rubber tappers. The study took place between January and May 2015 with 234 participants in 16 clusters in Thanbyuzayat Township, Mon State, Myanmar. Participants were randomly assigned to the order of clothing distribution and followed up at 2, 4 and 6 week intervals. Acceptability was assessed through structured questionnaires, focus group discussions and in-depth interviews. A cluster-level non-inferiority analysis was conducted using STATA, while qualitative data were digitally recorded, transcribed and content-analysed to identify patterns and themes, and managed thematically in Excel 2010®. Results Acceptability of both types of clothing was high. ITC was deduced to be non-inferior to NTC for seven out of eight indicators regarding perceptions (looks nice, is durable, is pleasant to wear for nighttime work, reduces mosquito bites, would recommend the clothing, would buy the clothing, like the clothing overall). A high proportion of respondents reported that the clothing reduced mosquito bites (ITC-98%; NTC-94%). Clothing was worn regularly (about 11 times in the previous two weeks). The most common reasons for not wearing the clothing every night were that it was being washed or dried, or the participant did not go to work. Conclusions The high level of acceptability suggests that ITC could be an appropriate strategy for personal protection amongst migrant rubber tappers in outdoor transmission settings in Myanmar. However, more research is needed into the feasibility and protective efficacy of ITC before it can be considered for wider roll-out. Trial registration Clinical trials ACTRN12615000432516
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