Volume 93, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Malaria control along the Vietnam–Cambodia border presents a challenge for both countries' malaria elimination targets as the region is forested, inhabited by ethnic minority populations, and potentially characterized by early and outdoor malaria transmission. A mixed methods study assessed the vulnerability to malaria among the Jarai population living on both sides of the border in the provinces of Ratanakiri (Cambodia) and Gia Lai (Vietnam). A qualitative study generated preliminary hypotheses that were quantified in two surveys, one targeting youth ( = 498) and the other household leaders ( = 449). Jarai male youth, especially in Cambodia, had lower uptake of preventive measures (57.4%) and more often stayed overnight in the deep forest (35.8%) compared with the female youth and the adult population. Among male youth, a high-risk subgroup was identified that regularly slept at friends' homes or outdoors, who had fewer bed nets (32.5%) that were torn more often (77.8%). The vulnerability of Jarai youth to malaria could be attributed to the transitional character of youth itself, implying less fixed sleeping arrangements in nonpermanent spaces or non-bed sites. Additional tools such as long-lasting hammock nets could be suitable as they are in line with current practices.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

Loading full text...

Full text loading...



  1. Erhart A, Thang ND, Hung NQ, Toi LV, Hung LX, Tuy TQ, Cong LD, Speybroeck N, Coosemans M, D'Alessandro U, , 2004. Forest malaria in Vietnam: a challenge for control. Am J Trop Med Hyg 70: 110118.
  2. Peeters Grietens K, Xuan XN, Van Bortel W, Duc TN, Ribera JM, Nhat TB, Van KP, Le Xuan H, D'Alessandro U, Erhart A, , 2010. Low perception of malaria risk among the Ra-glai ethnic minority in south-central Vietnam: implications for forest malaria control. Malar J 9: 19.
  3. Peeters Grietens K, Xuan XN, Ribera J, Duc TN, Van Bortel W, Ba NT, Van KP, Le Xuan H, D'Alessandro U, Erhart A, , 2012. Social determinants of long lasting insecticidal hammock use among the Ra-glai ethnic minority in Vietnam: implications for forest malaria control. PLoS One 7: e29991.
  4. Peeters Grietens K, Muela Ribera J, Soto V, Tenorio A, Hoibak S, Aguirre AR, Toomer E, Rodriguez H, Llanos Cuentas A, D'Alessandro U, Gamboa D, Erhart A, , 2013. Traditional nets interfere with the uptake of long-lasting insecticidal nets in the Peruvian Amazon: the relevance of net preference for achieving high coverage and use. PLoS One 8: e50294.
  5. Sluydts V, Heng S, Coosemans M, Van Roey K, Gryseels C, Canier L, Kim S, Khim N, Siv S, Mean V, Uk S, Peeters Grietens K, Tho S, Menard D, Durnez L, , 2014. Spatial clustering and risk factors of malaria infections in Ratanakiri Province, Cambodia. Malar J 13: 387.
  6. Thang ND, Erhart A, Speybroeck N, Hung LX, Thuan LK, Hung CT, Van Ky P, Coosemans M, D'Alessandro U, , 2008. Malaria in central Vietnam: analysis of risk factors by multivariate analysis and classification tree models. Malar J 7: 28.
  7. Greenwood B, , 1989. The micro-epidemiology of malaria and its importance to malaria control. Trans R Soc Trop Med Hyg 83: S25S29.
  8. Durnez L, Mao S, Denis L, Roelants P, Sochantha T, Coosemans M, , 2013. Outdoor malaria transmission in forested villages of Cambodia. Malar J 12: 329.
  9. Gaudart J, Poudiougou B, Dicko A, Ranque S, Toure O, Sagara I, Diallo M, Diawara S, Ouattara A, Diakite M, Doumbo OK, , 2006. Space-time clustering of childhood malaria at the household level: a dynamic cohort in a Mali village. BMC Public Health 6: 286.
  10. Bousema T, Drakeley C, Gesase S, Hashim R, Magesa S, Mosha F, Otieno S, Carneiro I, Cox J, Msuya E, Kleinschmidt I, Maxwell C, Greenwood B, Riley E, Sauerwein R, Chandramohan D, Gosling R, , 2010. Identification of hot spots of malaria transmission for targeted malaria control. J Infect Dis 201: 17641774.
  11. Bousema T, Griffin JT, Sauerwein RW, Smith DL, Churcher TS, Takken W, Ghani A, Drakeley C, Gosling R, , 2012. Hitting hotspots: spatial targeting of malaria for control and elimination. PLoS Med 9: e1001165.
  12. Charlwood JD, Pinto J, Ferrara PR, Sousa CA, Ferreira C, Gil V, do Rosário VE, , 2003. Raised houses reduce mosquito bites. Malar J 2: 45.
  13. Konradsen F, Amerasinghe P, van der Hoek W, Amerasinghe F, Perera D, Piyaratne M, , 2003. Strong association between house characteristics and malaria vectors in Sri Lanka. Am J Trop Med Hyg 68: 177181.
  14. Lindsay SW, Jawara M, Paine K, Pinder M, Walraven GEL, Emerson PM, , 2003. Changes in house design reduce exposure to malaria mosquitoes. Trop Med Int Health 8: 512517.
  15. Lwetoijera DW, Kiware SS, Mageni ZD, Dongus S, Harris C, Devine GJ, Majambere S, , 2013. A need for better housing to further reduce indoor malaria transmission in areas with high bed net coverage. Parasit Vectors 6: 57.
  16. Prothero RM, , 1999. Malaria, forests and people in southeast Asia. Singap J Trop Geogr 20: 7685.
  17. Pindolia DK, Garcia AJ, Wesolowski A, Smith DL, Buckee CO, Noor AM, Snow RW, Tatem AJ, , 2012. Human movement data for malaria control and elimination strategic planning. Malar J 11: 205.
  18. Cotter C, Sturrock HJW, Hsiang MS, Liu J, Phillips A, Hwang J, Gueye CS, Fullman N, Gosling RD, Feachem RG, , 2013. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet 382: 900911.
  19. Nourein AB, Abass MA, Nugud AHD, El Hassan I, Snow RW, Noor AM, , 2011. Identifying residual foci of Plasmodium falciparum infections for malaria elimination: the urban context of Khartoum, Sudan. PLoS One 6: e16948.
  20. Bejon P, Williams TN, Liljander A, Noor AM, Wambua J, Ogada E, Olotu A, Osier FHA, Hay SI, Färnert A, Marsh K, , 2010. Stable and unstable malaria hotspots in longitudinal cohort studies in Kenya. PLoS Med 7: e1000304.
  21. Killeen GF, , 2014. Characterizing, controlling and eliminating residual malaria transmission. Malar J 13: 330.
  22. Durnez L, Coosemans M, Manguin S, , 2013. Residual transmission of malaria: an old issue for new approaches. In: , ed. Anopheles Mosquitoes—New Insights into Malaria Vectors. Available at: http://www.intechopen.com/books/anopheles-mosquitoes-new-insights-into-malaria-vectors/residual-transmission-of-malaria-an-old-issue-for-new-approaches.
  23. Delacollette C, D'Souza C, Christophel E, Thimasarn K, Abdur R, Bell D, Dai T, Gopinath D, Lu S, Mendoza R, Ortega L, Rastogi R, Tantinimitkul C, Ehrenberg J, , 2009. Malaria trends and challenges in the Greater Mekong Subregion. Southeast Asian J Trop Med Public Health 40: 674691.
  24. WHO, 2008. Malaria in the Greater Mekong Subregion. Available at: http://www.searo.who.int/myanmar/documents/malariainthegreatermekongsubregion.pdf.
  25. Pongvongsa T, Ha H, Thanh L, Marchand RP, Nonaka D, Tojo B, Phongmany P, Moji K, Kobayashi J, , 2012. Joint malaria surveys lead towards improved cross-border cooperation between Savannakhet Province, Laos and Quang Tri Province, Vietnam. Malar J 11: 262.
  26. Abe T, Honda S, Nakazawa S, Tuong T, , 2009. Risk factors for malaria infection among ethnic minorities in Binh Phuoc, Vietnam. Southeast Asian J Trop Med Public Health 40: 1829.
  27. Morrow M, Nguyen QA, Caruana S, Biggs BA, Doan NH, Nong TT, , 2009. Pathways to malaria persistence in remote central Vietnam: a mixed-method study of health care and the community. BMC Public Health 9: 85.
  28. Cui L, Yan G, Sattabongkot J, Cao Y, Chen B, Chen X, Fan Q, Fang Q, Jongwutiwes S, Parker D, Sirichaisinthop J, Kyaw MP, Su X, Yang H, Yang Z, Wang B, Xu J, Zheng B, Zhong D, Zhou G, , 2012. Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop 121: 227239.
  29. Sanh NH, Van Dung N, Thanh NX, Trung TN, Van Co T, Cooper RD, , 2008. Forest malaria in central Vietnam. Am J Trop Med Hyg 79: 652654.
  30. Trung HD, Van Bortel W, Sochantha T, Keokenchanh K, Briët OJT, Coosemans M, , 2005. Behavioural heterogeneity of Anopheles species in ecologically different localities in southeast Asia: a challenge for vector control. Trop Med Int Health 10: 251262.
  31. Trung HD, Van Bortel W, Sochanta T, Keokenchanh K, Quang NT, Cong LD, Coosemans M, , 2004. Malaria transmission and major malaria vectors in different geographical areas of southeast Asia. Trop Med Int Health 9: 230237.
  32. Coosemans M, Van Bortel W, Royal Academy of Overseas Sciences, 2006. Malaria vectors in the Mekong countries: a complex interaction between vectors, environment and human behaviour. In Proceedings of the International Conference Hubs, Harbours and Deltas in Southeast Asia: Multidisciplinary and Intercultural Perspectives, 6–8 Feb 2006, Phnom Penh. Edited by ; 2006: 551569.
  33. Erhart A, Ngo DT, Phan VK, Ta TT, Van Overmeir C, Speybroeck N, Obsomer V, Le XH, Le KT, Coosemans M, D'Alessandro U, , 2005. Epidemiology of forest malaria in central Vietnam: a large scale cross-sectional survey. Malar J 4: 58.
  34. Somboon P, Aramrattana A, Lines J, Webber R, , 1998. Entomological and epidemiological investigations of malaria transmission in relation to population movements in forest areas of north-west Thailand. Southeast Asian J Trop Med Public Health 29: 39.
  35. Kar NP, Kumar A, Singh OP, Carlton JM, Nanda N, , 2014. A review of malaria transmission dynamics in forest ecosystems. Parasit Vectors 7: 265.
  36. Obsomer V, Defourny P, Coosemans M, , 2007. The Anopheles dirus complex: spatial distribution and environmental drivers. Malar J 6: 26.
  37. Van Bortel W, Trung HD, Hoi LX, Van Ham N, Van Chut N, Luu ND, Roelants P, Denis L, Speybroeck N, D'Alessandro U, Coosemans M, , 2010. Malaria transmission and vector behaviour in a forested malaria focus in central Vietnam and the implications for vector control. Malar J 9: 373.
  38. Ministry of Foreign Affairs of Japan, 2004. Joint Press Release of Cambodia, Laos, Vietnam (CLV) and Japan Summit. Available at: http://www.mofa.go.jp/region/asia-paci/clv/joint0411.html.
  39. Gryseels C, Uk S, Erhart A, Gerrets R, Sluydts V, Durnez L, Muela Ribera J, Hausmann Muela S, Menard D, Heng S, Sochantha T, D'Alessandro U, Coosemans M, Peeters Grietens K, , 2013. Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia. PLoS One 8: e80343.
  40. Tashakkori A, Teddlie C, , 1998. Mixed Methodology: Combining Qualitative and Quantitative Approaches. Series: Applied Social Research Methods. London, United Kingdom: Sage.
  41. AAA. Code of Ethics of the American Anthropological Association. Available at: www.aaanet.org/committees/ethics/ethcode.html.
  42. Levine R, New R, , 2008. Anthropology and Child Development. London, United Kingdom: Wiley-Blackwell.
  43. Iwashita H, Dida G, Futami K, Sonye G, Kaneko S, Horio M, Kawada H, Maekawa Y, Aoki Y, Minakawa N, , 2010. Sleeping arrangement and house structure affect bed net use in villages along Lake Victoria. Malar J 9: 176.
  44. Toé LP, Skovmand O, Dabiré KR, Diabaté A, Diallo Y, Guiguemdé TR, Doannio JMC, Akogbeto M, Baldet T, Gruénais M-E, , 2009. Decreased motivation in the use of insecticide-treated nets in a malaria endemic area in Burkina Faso. Malar J 8: 175.
  45. Noor AM, Mutheu JJ, Tatem AJ, Hay SI, Snow RW, , 2009. Insecticide-treated net coverage in Africa: mapping progress in 2000–07. Lancet 373: 5867.
  46. Thang ND, Erhart A, Speybroeck N, Xa NX, Thanh NN, Van Ky P, Hung LX, Thuan LK, Coosemans M, D'Alessandro U, , 2009. Long-lasting insecticidal hammocks for controlling forest malaria: a community-based trial in a rural area of central Vietnam. PLoS One 4: e7369.
  47. Sochantha T, Hewitt S, Nguon C, Okell L, Alexander N, Yeung S, Vannara H, Rowland M, Socheat D, , 2006. Insecticide-treated bednets for the prevention of Plasmodium falciparum malaria in Cambodia: a cluster-randomized trial. Trop Med Int Health 11: 11661177.
  48. Hougard J-M, Martin T, Guillet PF, Coosemans M, Itoh T, Akogbéto M, Chandre F, , 2007. Preliminary field testing of a long-lasting insecticide-treated hammock against Anopheles gambiae and Mansonia spp. (Diptera: Culicidae) in west Africa. J Med Entomol 44: 651655.
  49. Zimmerman RH, Voorham J, , 1997. Use of insecticide-impregnated mosquito nets and other impregnated materials for malaria control in the Americas. Pan Am J Public Health 2: 1825.
  50. Magris M, Rubio-Palis Y, Alexander N, Ruiz B, Galván N, Frias D, Blanco M, Lines J, , 2007. Community-randomized trial of lambdacyhalothrin-treated hammock nets for malaria control in Yanomami communities in the Amazon region of Venezuela. Trop Med Int Health 12: 392403.

Data & Media loading...

Supplementary Data

Supplementary PDF

  • Received : 02 Apr 2015
  • Accepted : 29 May 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error