Page 49 - The lraternational Journal of the Royal Society of Thailand.indd

The International Journal of the Royal Society of Thailand
Volume XV-2023

during the height of the first wave of the pandemic (spring 2020 to January 2021), and
the intervention proved to be highly efficacious (Tripura et al, 2023; Maude et al, 2021).
This study to assess efficacy of artemether-lumefantrine prophylaxis against forest
malaria in Cambodia (ClinicalTrials.gov Identifier: NCT04041973) was completed on
time despite initial concerns that it would need to be postponed or abandoned due to

COVID-19. In total, 1400 participants joined the study and treatment adherence and
re-enrolment rates were considerably higher than anticipated despite the challenges.

The Cham Bok health centre field station
In the context of declining malaria transmission in Cambodia due to successful

control measures, to increase recruitment into the EFFORT and DeTACT trials, during
2021 a new research station was established at Cham Bok in western Cambodia, close
to forested areas and national parks in which malaria transmission persists. Beginning
work in a new province involved developing new relationships with local partners

and high-level support from CNM to explain the need to continue research while
other activities were being closed due to the pandemic.

The development of triple artemisinin combination therapy trial
Resistance to artemisinins and partner drugs used in artemisinin combination

therapies is a risk to malaria control and elimination in Southeast Asia. In Cambodia
and elsewhere, MORU and partners have trialled triple artemisinin combination
therapies to address this (van der Pluijm et al, 2019; Peto et al, 2022; van der Pluijm
et al, 2020). A trial to compare the efficacy, safety and tolerability of combinations
of 3 anti-malarial drugs against combinations of 2 anti-malarial drugs (ClinicalTrials.

gov Identifier: NCT03939104) was scheduled to begin in 2020 but its start was delayed
until 2021 due to constraints on training and logistics at the remote study sites in
Pursat and Stung Treng. The ongoing study was able to take measures to catch up due

to intensive efforts and support from partners, and it is now on course to achieve
close to the initial target sample size of participants.

Kravanh research site in Pursat Province during COVID-19
Kravanh district is located within the Pursat province that consists of villages
nestling along the periphery of Kravnah mountain (part of the Cardamom mountain

range) with some areas tht are densely forested. Recognized as one of the major
endemic districts for malaria, Kravanh as a research site for MORU was established
in 2018 that coincided with the decline in malaria in Pailin and Battambang.
MORU’s research office was built within the confines of the Kravanh referral hospital

where CNM, PHD and district hospital authorities generously offered a space.

Dysoley Lek et al. 41