Diagnostic practices and treatment for P. vivax in the interethnic therapeutic encounter of South-Central Vietnam: A mixed-methods study

Thuan Thi Nguyen, Xa Xuan Nguyen, Maya Ronse, Quynh Truc Nguyen, Phuc Quang Ho, Duong Thanh Tran, Rene Gerrets, Kamala Thriemer, Benedikt Ley, Jutta Marfurt, Ric N. Price, Koen Peeters Grietens, Charlotte Gryseels

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    Abstract

    Malaria elimination in the Greater Mekong Sub-Region is challenged by a rising proportion of malaria attributable to P. vivax. Primaquine (PQ) is effective in eliminating the parasite’s dormant liver stages and can prevent relapsing infections, but it induces severe haemolysis in patients with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, highlighting the importance of testing enzyme activity prior to treatment. A mixed-method study was conducted in south-central Vietnam to explore the factors that affect acceptability of G6PD testing, treatment-seeking behaviors, and adherence to current regimens. The majority of respondents (75.7%) were unaware of the different parasite species and rather differentiated malaria by perceived severity. People sought a diagnosis if suspected of malaria fever but not if they perceived their fevers as mild. Most respondents agreed to take prescribed medication to treat asymptomatic infection (94.1%) and to continue medication even if they felt better (91.5%). Health professionals did not have G6PD diagnostic tools nor the means to prescribe PQ safely. Adherence to treatment was linked to trust in public providers, who were perceived to make therapeutic decisions in the interest of the patient. Greater focus on providing acceptable ways of assessing G6PD deficiency will be needed to ensure the timely elimination of malaria in Vietnam.

    Original languageEnglish
    Article number26
    Pages (from-to)1-20
    Number of pages20
    JournalPathogens
    Volume10
    Issue number1
    DOIs
    Publication statusPublished - Jan 2021

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