Page 53 - The lraternational Journal of the Royal Society of Thailand.indd

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

Despite delays, approvals for new studies were granted (DeTACT study – June
2020, EFFORT study – August 2020 (UK) and October 2020 (Cambodia)) and the
Kravanh study site was reactivated after many months of dormancy. This presented
further logistic difficulties, as the MORU and Australian-based researchers were
unable to visit due to travel restrictions resulting in, the already-stretched, sole

MORU researcher having to relocate to Kravanh to set up the studies. MORU-based
researchers did explore the possibility of obtaining Cambodian visas, however,
despite malaria remaining a health priority, it ultimately proved too difficult and it

wasn’t until October 2021 that a 2 MORU investigator was able to enter Cambodia.
nd
By the end of 2020, it became apparent that COVID-19 transmission was

occurring in Cambodia. This resulted in the Ministry of Health quarantining and
testing over 9,000 high-risk contacts and Phnom Penh being considered a high-risk
zone for Cambodia. Nevertheless, confirmed cases remained relatively low (< 350),

with only 27 active cases but there were concerns that this increase in cases would
impact the new projects.

In spite of the COVID-19 issues, the PAL trial reached the recruitment target
by early December and completed all follow-ups by February 2021. The first batch
of study samples were finally shipped to Bangkok in December, four months after

the first contact with the courier service (due to COVID-19 restrictions).
Although the COVID-19 situation was worsening, research activities were able

to continue and the 2021 Annual CNM Malaria Conference went ahead in March.
Study training for the EFFORT study was delivered remotely via digital platforms by
researchers based in Australia and the first patient was recruited in April 2021.

However, with COVID-19 cases rising exponentially (Worldometer, 2023), it became
apparent, that research would be impacted as the government imposed a two-week
lockdown in Phnom Penh and the Prime minister warned that Cambodia was “on the
brink of death” (Johnson 2022). Fortunately, the EFFORT study was able to continue,
whilst adhering closely to the MoH COVID-19 guidelines, as they had an experienced

team managing Plasmodium vivax-infected patients, and had built a good relationship
with the local provincial health department. The DeTACT study similarly was able
to complete training and begin recruitment by July due to the research on multidrug-

resistant Plasmodium falciparum malaria being of great importance to Cambodia.
Unfortunately, another study, “Evaluating expanded roles for VMWs and

exploring the main causes of febrile illness” (CAM-VMW), that was to run in
Battambang/Pailin was delayed due to 1) delays in Cambodian Ethics approval
being granted, 2) restrictions of movements within Cambodia, 3) logistic difficulties

Dysoley Lek et al. 45