Risk factors for malaria infection among ethnic minorities in Binh Phuoc, Vietnam.

A cross-sectional study was undertaken to identify the prevalence of malaria infection, behavioral patterns of inhabitants and risk factors for malaria infection in a minority village in an area endemic for malaria in Vietnam. The target population were all the inhabitants of a village in Binh Phuoc Province, Vietnam. Interviews using a structured questionnaire and blood examination for malaria infection were conducted in house-to-house visits. Relationships between malaria infection and variables were examined using uni- and multivariate adjusted analysis. A total of 682 individuals from 159 households participated in both the interview and blood examinations. All households earned income through farming without forest activities at night, and the socio-economic status was generally not very low. The total prevalence of malaria infection was 6.2%, with a peak among 3- to 5-year-old children. Univariate analysis identified 3 - 5 year olds, a family size of > or =5 people, sleeping with >3 people in a bed, and living in a wooden/bamboo house as factors associated with malaria infection. Multivariate adjusted analysis after variable selection identified age 3 - 5 years old, a family size of > or =5 people and living in a wooden/bamboo house were significantly related to malaria infection. Malaria in this area can be controlled by basic activities, such as early diagnosis and treatment and prevention using bednets, since risk factors for malaria infection did not include forest activities, but were young age, living in a wooden/bamboo house and belonging to a large family. Continuous and intensive expansion of existing malaria control activities are required.

Intestinal parasitic infections in schoolchildren in a suburban area of Hanoi, Vietnam.

An epidemiological study on intestinal parasitic infections among schoolchildren in a suburban area of Hanoi, Vietnam, was conducted. Of the 217 schoolchildren involved in this study, 166 (76%) were positive for at least one of nine species of parasite (six helminths and three protozoa). Among the helminth parasites, Trichuris trichiura (67%) was detected the most frequently followed by Ascaris lumbricoides (34%) and hookworm (3%). In the case of protozoan parasites, Entamoeba coli (8%) was the most frequently detected followed by E. histolytica (2%). No Cryptosporidium parvum or Cyclospora sp were found. A questionnaire survey revealed that there was no positive relationship between parasite infection and the children's school records, educational background or parental income, which have been known to play a role.

Mekong malaria. II. Update of malaria, multi-drug resistance and economic development in the Mekong region of Southeast Asia.

In an expansion of the first Mekong Malaria monograph published in 1999, this second monograph updates the malaria database in the countries comprising the Mekong region of Southeast Asia. The update adds another 3 years' information to cover cumulative data from the 6 Mekong countries (Cambodia, China/Yunnan, Lao PDR, Myanmar, Thailand, Viet Nam) for the six-year period 1999-2001. The objective is to generate a more comprehensive regional perspective in what is a global epicenter of drug resistant falciparum malaria, in order to improve malaria control on a regional basis in the context of social and economic change. The further application of geographical information systems (GIS) to the analysis has underscored the overall asymmetry of disease patterns in the region, with increased emphasis on population mobility in disease spread. Of great importance is the continuing expansion of resistance of P. falciparum to antimalarial drugs in common use and the increasing employment of differing drug combinations as a result. The variation in drug policy among the 6 countries still represents a major obstacle to the institution of region-wide restrictions on drug misuse. An important step forward has been the establishment of 36 sentinel sites throughout the 6 countries, with the objective of standardizing the drug monitoring process; while not all sentinel sites are fully operational yet, the initial implementation has already given encouraging results in relation to disease monitoring. Some decreases in malaria mortality have been recorded. The disease patterns delineated by GIS are particularly instructive when focused on inter-country distribution, which is where more local collaborative effort can be made to rationalize resource utilization and policy development. Placing disease data in the context of socio-economic trends within and between countries serves to further identify the needs and the potential for placing emphasis on resource rationalization on a regional basis. Despite the difficulties, the 6-year time frame represented in this monograph gives confidence that the now well established collaboration is becoming a major factor in improving malaria control on a regional basis and hopefully redressing to a substantial degree the key problem of spread of drug resistance regionally and eventually globally.