Insecticide-Treated Kramas To Help Fight Malaria on Border

The London-based Malaria Con­sortium will start treating kramas with insecticide in an effort to stem the spread of drug-resistant malaria along the Thai-Cambodian border, thanks to a $100,000 grant from the Bill and Melinda Gates Foundation, the charity said Monday.

Researchers started noticing tolerance to their best malaria drugs along the border in 2007. Without a replacement drug on standby, they fear the resistance will spread to Africa—where the parasite already claims most of its one million annual victims—an outcome that could prove disastrous.

By treating kramas—traditional Cambodian scarves—of mi­grant workers on the border, the program takes aim at those most likely to carry the resistant strain abroad.

David Sintasath, technical director of the Consortium’s Asia regional office in Bangkok, said Tuesday that most details, including where and when the treatment will begin, had yet to be worked out.

Mr Sintasath conceded that us­ing insecticide on the all-purpose kramas could pose its own health risks and said his office was looking for ways to mitigate them.

“We are looking at manufacturers of insecticide-treated materials” for help, he said.

According to the Gates Founda­tion’s website, the Consortium will follow up on the program by collecting infection rates from local health facilities and conducting surveys of participants.

Mr Sintasath said the government needs to sign off on the plan.

Duong Socheat, director of the National Malaria Center, referred questions to the center’s Kheng Sim, who said she was too busy to speak with a reporter.

Health officials in western prov­inces bordering Thailand could not be reached.

Pailin province information de­partment chief Kong Duong, however, welcomed the plan as a chance to protect those who work in the province’s forests.

“When they go into the forest they are careless, and sometimes they don’t sleep under the mosquito nets,” he said. “It is good,” he said of the insecticide-treated kramas, adding that the organization behind the plan would “bring a lot of money to help.”

The government and the World Health Organization kicked off a new initiative of their own along the border this month that aims to check all villagers in 10 of Pailin’s most malaria-infected villages for symptoms of the disease. The idea is to find infected patients who lack the disease’s fever-like symptoms but retain the potential to pass it on.

Malaria infected 83,777 Cambo­dians last year and killed 279, a 42 percent rise in infections and 33 percent increase in fatalities over 2008 levels, according to the NMC.

After a decade of falling numbers, health officials attributed the sudden rise to better reporting on infection, an early rainy season and increased migration to Cambodia’s malaria-endemic west. The NMC expects its containment efforts to bring the numbers down in 2010.

The Consortium project was among 78 recipients Monday of the Grand Challenges Explorations grant, an initiative of the Gates Foundation designed to spur innovative solutions to global health issues.

Successful projects have the chance to win an additional $1 million to carry on and expand on their work.


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