Malaria Center Completes Major Study of Medicine Usage

The National Malaria Center has just completed field work for a major study on malaria-drug use in the country. About 1,400 villagers and 150 medicine providers and health care workers were interviewed in four provinces along the Thai border to find out the steps people take when they get malaria.

Boukheng Thavrin, chief of health education for the center, said that the survey should shed light on people’s treatment be­havior, which should help devise programs to better control malaria in the country and to find out how drug resistance develops.

The study, which involved a staff of about 70 people, was conducted in cooperation with US-based Management Sciences for Health, the World Health Organi­zation, and the European Com­mission Malaria Control Project in Cam­bodia, through USAID funding, said Kim Sovann Yadany, medical officer for WHO and a survey coordinator.

A total of nine districts were selected in high malaria-risk areas of Battambang, Pailin, Preah Vihear and Pursat prov­inces.

In each district, interviewers visited two remote villages and two villages close to that district’s health center.

Officials are conducting the survey along the Thai border because the area “has been the birthplace of drug resistance,” going back to 1959, said Stefan Hoyer, medical officer for malaria control at WHO.

Gem mining has attracted people from Thailand, Burma and Cambodia to the area—a transient population with enough money to buy medicine, but who often do not follow a proper regimen or consult health workers.

“This enabled the parasites to survive sub-lethal levels of the drugs, develop biological defenses to these drugs, and transmit those defenses to future generations of parasites,” Hoyer said.

Questions in the survey were meant to determine people’s  knowledge of malaria symptoms and ways they treat them—the medicine they prefer and whether they follow the prescribed dosage, if they go to health centers, private practitioners or just buy drugs from medicine outlets, and how much they can afford to spend.

The survey started in mid-October. Its scope and time constraint complicated matters, Kim Sovann Yadany said. For practical reasons, as well as to make comparisons between districts and villages valid, coordinators had decided to do all interviews during the same 15 days.

“Local conditions were difficult,” Kim Sovann Yadany said.

Peak malaria season takes place at the same time as the rainy season, which means that muddy roads often hamper access to villages, she said.

A malaria survey of this extent had never been done, said Boukheng Thavrin.

In most cases, local teachers served as interviewers; they had to be trained both on the disease and on survey techniques, she said.

Still, the information was collected, and will be analyzed by Man­age­ment Sciences for Health, Kim Sovann Yadany said.

Preliminary results should be ready in early December, in time to be presented at the Inter­national Symposium on Malaria Control in the Mekong Region, which will take place in Siem Reap in mid-December.

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