MALARIA: CAMBODIA: Incidence rises

BANGKOK, 27 April 2010 (IRIN) - The number of malaria cases recorded in Cambodia has increased significantly, say health officials, citing several reasons, including better detection and reporting.According to the National Center for Parasitology, Entomology and Malaria Control, there was a 41 percent increase in cases last year. The country - which has become an epicentre for malaria - recorded 83,217 malaria-infected persons in 2009, from 58,887 the previous year, after a steep drop in the number of cases over the past several years. The mosquito-borne disease killed 279 people in 2009 from 209 in 2008, Chea Nguon, the centre’s deputy director, told IRIN from Phnom Penh.
Multiple factors
Nguon cited several factors for the spike, including an earlier-than-usual rainy season, a late distribution of insecticide-impregnated bed nets, and internal migration to malaria-affected areas. He said there was also a natural cyclical rise in the number of cases every two to three years. In addition, the increase reflected a rise in the number of people with access to healthcare, he said.Since 2004, the government has trained malaria workers in 1,300 villages to detect and treat malaria, so a greater number of patients are being properly diagnosed and recorded than in previous years.
“Cambodia is establishing more and more village malaria workers, who are detecting more malaria that wasn’t detected previously,” said Steven Bjorge, technical officer for the World Health Organization (WHO) in Cambodia.“The populations most affected are people who work in the forest,” Bjorge said. Those include soldiers and their families, plantation workers, and even workers at a hydroelectric plant in the west of the country. Villagers hunting and gathering in the forests were also at risk, he said.Many malaria patients in areas with poor access to public health facilities attend private clinics, which do not report cases to the government.Nguon said the number of cases still might be higher than recorded, and as the government trained more village malaria workers, the figures may rise because of better reporting.
Drug resistanceCambodia in recent years has become one of the world’s malaria focal points after authorities detected along the country’s western border with Thailand a strain of the disease resistant to Artemisinin, one of the most effective drugs used to treat malaria.WHO has set up a special Artemisinin-resistant malaria containment project in the area.“As in the past, the Thai-Cambodian border is home to the emerging drug resistance.
The two countries and several partners, donors, as well as WHO, are working relentlessly to eliminate this dreadful parasite from this hot spot,” said Jai P. Narain, director of communicable diseases for the WHO Southeast Asia regional office.Nguon noted that the number of cases in 2009 was still dramatically lower than 12 years ago, when there were 170,387 infected persons and 865 deaths. “Compared to Vietnam or Thailand, the [numbers of] cases are still high,” he said. “We hope to eliminate malaria by 2025, and we are committed to that goal, but it’s still in the process.”
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