Experiences, perceptions and ethical considerations of the malaria infection study in Thailand

Abstract Background Thailand has made significant progress in malaria control efforts in the past decade, with a decline in the number of reported cases. However, due to cross-border movements over the past 5 years, reported malaria cases in Thailand have risen. The Malaria Infection Study in Thaila...

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Main Authors: Bhensri Naemiratch, Natinee Kulpijit, Supanat Ruangkajorn, Nicholas P. J. Day, Jetsumon Prachumsri, Phaik Yeong Cheah
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Medical Ethics
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Online Access:https://doi.org/10.1186/s12910-024-01160-7
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author Bhensri Naemiratch
Natinee Kulpijit
Supanat Ruangkajorn
Nicholas P. J. Day
Jetsumon Prachumsri
Phaik Yeong Cheah
author_facet Bhensri Naemiratch
Natinee Kulpijit
Supanat Ruangkajorn
Nicholas P. J. Day
Jetsumon Prachumsri
Phaik Yeong Cheah
author_sort Bhensri Naemiratch
collection DOAJ
description Abstract Background Thailand has made significant progress in malaria control efforts in the past decade, with a decline in the number of reported cases. However, due to cross-border movements over the past 5 years, reported malaria cases in Thailand have risen. The Malaria Infection Study in Thailand (MIST) involves deliberate infection of healthy volunteers with Plasmodium vivax malaria parasites, and the assessment of the efficacy of potential vaccine and drug candidates in order to understand acquired protection against malaria parasites. Methods This paper drew from ethics and social science qualitative study called MIST-ETHICS embedded within the MIST studies. MIST-ETHICS aimed to describe and understand the experiences, perceptions and ethical considerations of the MIST studies. Data were obtained from semi-structured interviews and a focus group discussion. A total of 46 participants participated in MIST-ETHICS . Results Three major themes emerged: experiences and perceptions of MIST, reasons for joining MIST, and ethical considerations. We found that although compensation was a motivation for participation, this was secondary to it being beneficial to self (health checks; link to health networks; building merit) and others (medical research contribution; altruism). Participants expressed varied opinions regarding the requirement of a university degree as one of the inclusion criteria for MIST. Conclusions Our study revealed widespread concerns about long-term health effects and safety. Ethical considerations, including obtaining valid informed consent and ensuring participant inclusivitiy, were deem essential. Despite some debate regarding eligibility criteria, most participants agreed that the informed consent process was robust, accompanied by a strong sense of responsibility to contribute to the greater good. We emphasize the importance of continuously gathering participants’ feedback for quality control, such as improving information materials to clarify the purpose of initial phases, their contributing to later phases, and the rationale behind each selection criterion. Trial registration This manuscript is part of the clinical trials registered under ClinicalTrials.gov IDs NCT04083508 (MIST1) registered on 5 Sep 2019 and NCT05071079 (MIST2) registered on 28 July 2021. However, the manuscript pertains to a qualitative study that does not require trial registration.
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spelling doaj-art-d0a1ef9bc15340018854d53b688bdf2c2025-02-02T12:41:40ZengBMCBMC Medical Ethics1472-69392025-01-0126111310.1186/s12910-024-01160-7Experiences, perceptions and ethical considerations of the malaria infection study in ThailandBhensri Naemiratch0Natinee Kulpijit1Supanat Ruangkajorn2Nicholas P. J. Day3Jetsumon Prachumsri4Phaik Yeong Cheah5Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityAbstract Background Thailand has made significant progress in malaria control efforts in the past decade, with a decline in the number of reported cases. However, due to cross-border movements over the past 5 years, reported malaria cases in Thailand have risen. The Malaria Infection Study in Thailand (MIST) involves deliberate infection of healthy volunteers with Plasmodium vivax malaria parasites, and the assessment of the efficacy of potential vaccine and drug candidates in order to understand acquired protection against malaria parasites. Methods This paper drew from ethics and social science qualitative study called MIST-ETHICS embedded within the MIST studies. MIST-ETHICS aimed to describe and understand the experiences, perceptions and ethical considerations of the MIST studies. Data were obtained from semi-structured interviews and a focus group discussion. A total of 46 participants participated in MIST-ETHICS . Results Three major themes emerged: experiences and perceptions of MIST, reasons for joining MIST, and ethical considerations. We found that although compensation was a motivation for participation, this was secondary to it being beneficial to self (health checks; link to health networks; building merit) and others (medical research contribution; altruism). Participants expressed varied opinions regarding the requirement of a university degree as one of the inclusion criteria for MIST. Conclusions Our study revealed widespread concerns about long-term health effects and safety. Ethical considerations, including obtaining valid informed consent and ensuring participant inclusivitiy, were deem essential. Despite some debate regarding eligibility criteria, most participants agreed that the informed consent process was robust, accompanied by a strong sense of responsibility to contribute to the greater good. We emphasize the importance of continuously gathering participants’ feedback for quality control, such as improving information materials to clarify the purpose of initial phases, their contributing to later phases, and the rationale behind each selection criterion. Trial registration This manuscript is part of the clinical trials registered under ClinicalTrials.gov IDs NCT04083508 (MIST1) registered on 5 Sep 2019 and NCT05071079 (MIST2) registered on 28 July 2021. However, the manuscript pertains to a qualitative study that does not require trial registration.https://doi.org/10.1186/s12910-024-01160-7Controlled human infection model (CHIM)MalariaThailandSocial ScienceBioethics
spellingShingle Bhensri Naemiratch
Natinee Kulpijit
Supanat Ruangkajorn
Nicholas P. J. Day
Jetsumon Prachumsri
Phaik Yeong Cheah
Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
BMC Medical Ethics
Controlled human infection model (CHIM)
Malaria
Thailand
Social Science
Bioethics
title Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
title_full Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
title_fullStr Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
title_full_unstemmed Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
title_short Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
title_sort experiences perceptions and ethical considerations of the malaria infection study in thailand
topic Controlled human infection model (CHIM)
Malaria
Thailand
Social Science
Bioethics
url https://doi.org/10.1186/s12910-024-01160-7
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