A Change of Guard

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Wednesday, 19 August 2009

Sharp rise in Malaria deaths in Cambodia

Updated Tue Aug 18, 2009

The number of reported Malaria fatalities in Cambodia has almost doubled since the start of the year, with authorities citing early rains and the delayed distribution of mosquito nets as possible reasons for the increase. But some of the blame has also gone to the global financial crisis.

Presenter: Matt Conway
Speakers: Dr Duong Socheat, director, National Centre of Parasitology and Malaria, Cambodia; Dr Habib Najibullah, World Health Organisation, Cambodia

CONWAY: Cambodia has tried desperately to fend off the malaria parasite for decades and in recent years has appeared to be making some progress.

Efforts by Cambodia's National Malaria Control Program have led to a reduction of malaria cases, but the number of reported actual deaths is on the rise.

The Cambodian health ministry says the number of fatal malaria cases rose by 58 per cent in the first six months of this year as compared to the same six month period in 2008.

And it could be because the Cambodian government was slow to distribute mosquito nets in time for the wet season.

Dr Duong Socheat is the director of the national centre of Parasitology and Malaria.

SOCHEAT: This year the rains started in April but the nets came out in June, so it was a bit late to protect the people.

Dr Socheat says the lack of nets in areas where the mosquito population is high is the reason for some of the deaths - but that's not the only reason.

Job opportunities in the cities have dried up - partly because of the global financial downturn - and that's forced many workers to migrate to remote forrest areas on the Cambodian Thai border - where there is work.

But that's also where there's a higher risk of getting malaria.

SOCHEAT: This year we have also had a lot of migrants moving from the east to the west, so it is a big problem for the people who don't have the immunity at all for malaria, and they contract malaria very quickly.

CONWAY: And it's not just those lacking immunity that are falling victim to the parasite.

A study published by the new england journal of medicine says Malaria parasites in western Cambodia have become resistant to the drug most commonly used as a first line treatment.

The study says resistance to Artemisinin is becoming more common and the drug could become obsolete, putting even more lives at risk.

Dr Habib Najibullah from the World Health Organisation in Cambodia explains:

NAJIBULLAH: Basically after about 36 to 40 hours normally if you use Artemisinin it should disappear, but when you have longer parasite clearance times, meaning they are still present in the blood a long time after taking the drug, there is evidence of resistance, just germs develop resistance against antibiotics.

However he says there's no cause for alarm because the figures are slightly distorted.

Dr Najibullah says the methods of recording malaria related data have greatly improved vastly, meaning that more cases are being identified - and that in itself is one reason for the rising figures.

NAJIBULLAH: Now as more people are aware of Malaria - if you have fever you might have malaria as a disease - more people are being referred to hospitals and clinics where diagnosis can be done and as you know we can see if there are large amounts of parasites in the blood this person more than likely has malaria so we need to treat this person, but also some people arrive too late so that person gets noted down as a malaria fatality.

But, still, the number of fatalities from malaria is going up, and medical experts will want to be just as quick to step up the speed at which people are treated.

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