Japan Keeps Funds Flowing into Mekong Health Efforts

Japan has agreed to dedicate thousands of dollars to curb schistosomiasis infections in the upper Mekong River basin after last month’s pullout of Medecins Sans Frontieres, which launched a preventative campaign in 1993.

Schistosomiasis is a parasitic disease transported primarily by the tiger snail.

The World Health Organiza­tion recently brokered a deal with the Sasakawa Memorial Health Foundation to provide $40,000 to continue funding the program through 2000, according to Dr Duong Socheat, deputy director of the National Malaria Center and chief of the National Schisto­somiasis Control Pro­gram.

The money will be used to help pay for the drug Praziquantel, which is taken orally and helps slow the transmission of the disease. The schistosomiasis infection rate has dropped from 70 percent in 1993 to less than 17 percent this year and as few as 20 deaths have been reported.

But health officials estimate thousands of uncontrolled cases still exist in northern Cambodia where the Mekong River supports most of the villages along its banks.

According to a National Ma­laria Center report released earlier this year, treatment has been re­ceived by fewer than 14,500 people in the Stung Treng pro­vince, where re­mote villages and local ignorance about the spread of the disease have hampered prevention efforts.

Approximately 42,000 people have been treated in Kra­tie province, but in both provinces al­most all the children under the age of 20 are infected, Doung Socheat said.

Though many people live with the disease for years, schistosomiasis, which causes severe inflammation of the liver and spleen, can lead to the rupturing of these organs if untreated. The patient eventually hemorrhages to death, health officials said.

The disease is spread by neotricula aperta, or tiger snail, which plays host to the worm, schistosoma mekongi, a subtype specific to the northern Mekong River. The microscopic worm larvae usually enter hu­mans through the skin around the ankles and, after maturing, are re­leased through fe­ces.

The practice of defecating in the Mekong, where many villagers also bathe and swim, has contributed to the spread of the disease.

Some health officials have said that perhaps more rapid rural development in Stung Treng and Kratie provinces, with an emphasis on personal hygiene and the importance of drinking clean water, would best combat the spread of schistosomiasis.


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