In remote northeastern Cambodia last month, health workers pricked fingers, took blood samples, tested for malaria and prescribed medicines for a village—all while sitting cross-legged in the back of a dusty pickup truck.
Lack of facilities and equipment often forces workers from the Ministry of Health’s National Malaria Center to stretch the limits of creativity, setting up impromptu labs on things like folding chairs and boats.
A major aid to anti-malaria work comes from an unlikely source: a product sometimes advertised to help international travelers detect malaria quickly.
ParaSight F is a quick and simple blood test that can detect the presence of the parasite plasmodium falciparum, the most dangerous of the four malaria species that infect humans.
Known as a “dipstick,” the product has allowed Cambodian health workers to treat patients more quickly and accurately while in the field, health officials said.
“Number 93!” shouted one health worker, her hands in rubber gloves, her legs folded underneath her from the back of the pickup truck in Ratanakkiri last month. A young girl named Nek with ‘93’ written in black marker on her hand was pushed to the side of the truck.
The 10-year-old said she had been feeling ill for about two days, and on this day she had a fever of about 39 celsius. The symptoms indicated malaria, but the health worker had to be sure before prescribing medicine. Ordinarily, a microscope and lab technician would be needed. But this worker had a dipstick.
Nek grimaced her way through having her finger pricked by a provincial malaria official. Then she sat back to wait.
The test is relatively simple. A drop of blood is placed on a specially treated stick. The stick is treated with reaction and fixing solutions. After about 10 minutes, positive malaria tests are shown by a red line on the stick.
“Dipsticks are very useful in remote areas where we have no microscope and no qualified staff to do the tests,” said Dr Duong Socheat, vice director of the National Malaria Center. Malaria is usually diagnosed by examining a patient’s blood under a microscope. It takes considerable skill and experience to accurately identify various species of malaria parasites, Duong Socheat said.
In Cambodia, the problem of treating malaria in remote areas ,is exacerbated by the fact that there are few health centers, poor transportation systems and varied lab training.
The National Malaria Center began using the dipstick test last year. Since then, 100 health centers around the country have received dipstick and treatment training, Duong Socheat said. The test costs about $1.20 a person, paid for by aid agencies.
After the tests are done in the field, results are re-examined in the National Malaria Center’s Phnom Penh labs. Other species of malarial parasites are also diagnosed back in the labs under microscopes. The US-based medical technology company that produces the dipstick, Becton Dickinson, boasts an approximate 90-percent accuracy rate.
In the case of little Nek, the test turned up positive. A small crowd of children and mothers cleared a space near the truck for her to stand on a scale. The girl’s weight determined how much medicine she should take.
Quicker and easier detection of malaria in the field has contributed to an increase in reported cases nationwide, Duong Socheat said.