{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T17:05:40Z","timestamp":1775581540383,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"US Defense Health Program Work Unit","award":["Number D1430"],"award-info":[{"award-number":["Number D1430"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>With the decline in local malaria transmission in Vietnam as a result of the National Malaria Control Program (NMCP) elimination activities, a greater focus on the importation and potential reintroduction of transmission are essential to support malaria elimination objectives.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a multi-method assessment of the demographics, epidemiology, and clinical characteristics of imported malaria among international laborers returning from African or Southeast Asian countries to Vietnam. Firstly, we conducted a retrospective review of hospital records of patients from January 2014 to December 2016. Secondly, we conducted a mixed-methods prospective study for malaria patients admitted to the study sites from January 2017 to May 2018 using a structured survey with blood sample collection for PCR analysis and in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>International laborers were young (median age 33.0\u00a0years IQR 28.0\u201339.5\u00a0years), predominantly male (92%) adults returning mostly from the African continent (84%) who stayed abroad for prolonged periods (median time 13.5\u00a0months; IQR 6.0\u2013331.5\u00a0months) and were involved in occupations that exposed them to a higher risk of malaria infection. Epidemiological trends were also similar amongst study strands and included the importation of <jats:italic>Plasmodium falciparum<\/jats:italic> primarily from African countries and <jats:italic>P. vivax<\/jats:italic> from Southeast Asian countries. Of 11 <jats:italic>P. malariae<\/jats:italic> and <jats:italic>P. ovale<\/jats:italic> infections across two study strands, 10 were imported from the African continent. Participants in the qualitative arm demonstrated limited knowledge about malaria prior to travelling abroad, but reported knowledge transformation through personal or co-worker\u2019s experience while abroad. Interestingly, those who had a greater understanding of the severity of malaria presented to the hospital for treatment sooner than those who did not; median of 3\u00a0days (IQR 2.0\u20137.0\u00a0days) versus 5\u00a0days (IQR 4.0\u20139.5\u00a0days) respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>To address the challenges to malaria elimination raised by a growing Vietnamese international labor force, consideration should be given to appropriately targeted interventions and malaria prevention strategies that cover key stages of migration including pre-departure education and awareness, in-country prevention and prophylaxis, and malaria screening upon return.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07322-5","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T10:04:30Z","timestamp":1652436270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Understanding the epidemiology, clinical characteristics, knowledge and barriers to treatment and prevention of malaria among returning international laborers in northern Vietnam: a mixed-methods study"],"prefix":"10.1186","volume":"22","author":[{"given":"Kimberly A.","family":"Edgel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Canavati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoi Thi","family":"Le","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tho Huy","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinh","family":"Van Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trung Vu","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nga Thi","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoa Mai","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thang Duc","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duong Thanh","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binh Thi Huong","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long Khanh","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thu Minh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalie J.","family":"Whedbee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekaterina I.","family":"Milgotina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2030-8702","authenticated-orcid":false,"given":"Nicholas J.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"7322_CR1","unstructured":"World Health Organization. Countries of the Greater Mekong are stepping up to end malaria. WHO. 2018."},{"key":"7322_CR2","unstructured":"World Health Organization. National Malaria Programme Review\u2014Vietnam. 2018."},{"key":"7322_CR3","unstructured":"World Health Organization. Methods for surveillance of anti-malarial drug efficacy. WHO. 2019."},{"key":"7322_CR4","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/bs.apar.2015.04.002","volume":"89","author":"K Wangdi","year":"2015","unstructured":"Wangdi K, Gatton ML, Kelly GC, Clements ACA. Cross-border malaria: a major obstacle for malaria elimination. Adv Parasitol. 2015;89:79\u2013107.","journal-title":"Adv Parasitol"},{"key":"7322_CR5","doi-asserted-by":"crossref","unstructured":"Hemingway J, Shretta R, Wells TNC, Bell D, Djimd\u00e9 AA, Achee N, et al. Tools and strategies for malaria control and elimination: what do we need to achieve a grand convergence in malaria? PLoS Biol. 2016;14(3).","DOI":"10.1371\/journal.pbio.1002380"},{"key":"7322_CR6","doi-asserted-by":"crossref","unstructured":"Jacobson JO, Cueto C, Smith JL, Hwang J, Gosling R, Bennett A. Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV? BioMed Central Ltd.; 2017. p. 1\u201317.","DOI":"10.1186\/s12936-017-1679-1"},{"key":"7322_CR7","unstructured":"World Health O. A framework for malaria elimination. Geneva; 2017."},{"issue":"1","key":"7322_CR8","doi-asserted-by":"publisher","first-page":"139","DOI":"10.4269\/ajtmh.14-0256","volume":"93","author":"HJW Sturrock","year":"2015","unstructured":"Sturrock HJW, Roberts KW, Wegbreit J, Ohrt C, Gosling RD. Tackling imported malaria: an elimination endgame. Am J Trop Med Hyg. 2015;93(1):139\u201344.","journal-title":"Am J Trop Med Hyg"},{"key":"7322_CR9","unstructured":"Dhiman S. Are malaria elimination efforts on right track? An analysis of gains achieved and challenges ahead."},{"issue":"1","key":"7322_CR10","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/S1473-3099(16)30326-7","volume":"17","author":"AJ Tatem","year":"2017","unstructured":"Tatem AJ, Jia P, Ordanovich D, Falkner M, Huang Z, Howes R, et al. The geography of imported malaria to non-endemic countries: a meta-analysis of nationally reported statistics. Lancet Infect Dis. 2017;17(1):98\u2013107.","journal-title":"Lancet Infect Dis"},{"key":"7322_CR11","unstructured":"International Organization for M. Vietnam Migration Profile. 2016."},{"issue":"1","key":"7322_CR12","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1186\/s12936-018-2478-z","volume":"17","author":"K Wangdi","year":"2018","unstructured":"Wangdi K, Canavati SE, Ngo TD, Tran LK, Nguyen TM, Tran DT, et al. Analysis of clinical malaria disease patterns and trends in Vietnam 2009\u20132015. Malaria J. 2018;17(1):332.","journal-title":"Malaria J"},{"issue":"1","key":"7322_CR13","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12936-015-0601-y","volume":"14","author":"PV Thanh","year":"2015","unstructured":"Thanh PV, Van Hong N, Van Van N, Van Malderen C, Obsomer V, Rosanas-Urgell A, et al. Epidemiology of forest malaria in Central Vietnam: the hidden parasite reservoir. Malaria J. 2015;14(1):86.","journal-title":"Malaria J"},{"issue":"3","key":"7322_CR14","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1128\/CMR.18.3.570-581.2005","volume":"18","author":"WE Collins","year":"2005","unstructured":"Collins WE, Jeffery GM. Plasmodium ovale: parasite and disease. Clin Microbiol Rev. 2005;18(3):570.","journal-title":"Clin Microbiol Rev"},{"issue":"7","key":"7322_CR15","doi-asserted-by":"publisher","first-page":"e0159968","DOI":"10.1371\/journal.pone.0159968","volume":"11","author":"PA Camargo-Ayala","year":"2016","unstructured":"Camargo-Ayala PA, Cubides JR, Ni\u00f1o CH, Camargo M, Rodr\u00edguez-Celis CA, Qui\u00f1ones T, et al. High Plasmodium malariae prevalence in an endemic area of the Colombian Amazon region. PLoS ONE. 2016;11(7):e0159968.","journal-title":"PLoS ONE"},{"key":"7322_CR16","doi-asserted-by":"crossref","unstructured":"Lover AA, Kevin Baird J, Gosling R, Price RN. Malaria elimination: time to target all species. American Society of Tropical Medicine and Hygiene; 2018. p. 17\u201323.","DOI":"10.4269\/ajtmh.17-0869"},{"key":"7322_CR17","unstructured":"World Health Organization. Malaria microscopy standard operating procedures. Regional Office for the Western Pacific. Manila: WHO Regional Office for the Western Pacific; 2016."},{"issue":"1","key":"7322_CR18","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1186\/1475-2875-9-361","volume":"9","author":"A Rosanas-Urgell","year":"2010","unstructured":"Rosanas-Urgell A, Mueller D, Betuela I, Barnadas C, Iga J, Zimmerman PA, et al. Comparison of diagnostic methods for the detection and quantification of the four sympatric Plasmodium species in field samples from Papua New Guinea. Malar J. 2010;9(1):361.","journal-title":"Malar J"},{"issue":"2","key":"7322_CR19","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1128\/JCM.01800-09","volume":"48","author":"SM Taylor","year":"2010","unstructured":"Taylor SM, Juliano JJ, Trottman PA, Griffin JB, Landis SH, Kitsa P, et al. High-throughput pooling and real-time PCR-based strategy for malaria detection. J Clin Microbiol. 2010;48(2):512\u20139.","journal-title":"J Clin Microbiol"},{"issue":"7","key":"7322_CR20","doi-asserted-by":"publisher","first-page":"2523","DOI":"10.1128\/JCM.06859-11","volume":"50","author":"L Link","year":"2012","unstructured":"Link L, Bart A, Verhaar N, van Gool T, Pronk M, Scharnhorst V. Molecular detection of Plasmodium knowlesi in a Dutch traveler by real-time PCR. J Clin Microbiol. 2012;50(7):2523\u20134.","journal-title":"J Clin Microbiol"},{"issue":"6","key":"7322_CR21","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1080\/10410236.2013.873363","volume":"30","author":"CL Jones","year":"2015","unstructured":"Jones CL, Jensen JD, Scherr CL, Brown NR, Christy K, Weaver J. The health belief model as an explanatory framework in communication research: exploring parallel, serial, and moderated mediation. Health Commun. 2015;30(6):566\u201376.","journal-title":"Health Commun"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-022-07322-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-022-07322-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-022-07322-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T10:04:43Z","timestamp":1652436283000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-022-07322-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,13]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["7322"],"URL":"https:\/\/doi.org\/10.1186\/s12879-022-07322-5","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,13]]},"assertion":[{"value":"26 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 March 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Records included in the retrospective analysis were de-identified. All patients included in the quantitative prospective strand and its qualitative arm provided written informed consent prior to enrollment and could opt out of providing samples or answering questions. The study was approved by the Vietnam National Hospital for Tropical Diseases (NHTD) Institutional Review Board (IRB; Federal Wide Assurance number: FWA00016103; IRB number: 13A\/HDDD-NDTU 1 June 2017\u201330 May 2018) and was reviewed in accord with US Department of the Navy Human Research Protection Office (HRPO) guidelines (HRPO.NMRCA.2018.0002 reviewed 03 Jan 2018) in compliance with all applicable federal regulations governing the protection of human subjects. For the qualitative arm, the interviewers followed the Code of Ethics of the American Anthropological Association (AAA). As proposed by the AAA, all interviewees were informed before the start of the interview about project\u2019s goals, the topic and type of questions, the intended use of results for scientific publications, and their right to refuse the interview, interrupt the conversation at any time, and withdraw all given information during or after the interview. Anonymity was guaranteed and the confidentiality of interviewees assured by assigning a unique code number to each informant. Written consent was obtained. Each survey participant provided informed written consent before participation. Participant\u2019s approval and cooperation was sought in every aspect of data collection. Regular data collection meetings were conducted in Hanoi, where the researchers met to discuss progress and address challenges.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. We (KAE and NJM) are military Service members. This work was prepared as part of our official duties. Title 17, U.S.C., \u00a7105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C., \u00a7101 defines a U.S. Government work as a work prepared by a military Service member or employee of the U.S. Government as part of that person's official duties.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"460"}}