Malaria Deaths Down, But Obstacles Remain, Experts Say

Reported malaria deaths dropped by nearly one third last year compared to the year be­fore, to the lowest level in five years, the Ministry of Health’s National Malaria Center said Monday.

Malaria remains one of Cam­bodia’s top killers of adults. But in 2000, only 608 malaria cases resulted in death, according to a malaria center report distributed to health officials at the annual National Malaria Conference. The number of deaths from the mosquito-borne disease de­creas­ed from 891 the year before, and were even lower than the 621 deaths reported in 1998.

The malaria center credited an expanding program, the use of new materials like “dip stick” tests and medicine, and a “considerable increase in the knowledge of people about malaria.”

But the report also pointed out some of the weaknesses that remain.

Low morale from poor salaries among staff workers at the center, bad roads, lack of human resources and problems with coordination were all cited as obstacles to an effective malaria campaign.

Even with improvements to all those areas, the report noted, there are other inherent flaws that surround Cambodia’s malaria problem. Drug resistance was at the top of the list.

Resistance of the malaria parasite to chlorquine and Meflo­quine, two popular treatments, has been on the rise, said Dr Kheng Sim of the National Mal­aria Center.

The Ministry of Health has now begun distribution of “blister packs,” an innovative combination therapy that uses a three-day treatment of both Mefloquine and Artesunate in a user-friendly package.

So far, though, Kheng Sim said, that therapy has had problems, too.

Private health-care providers, for example, are using the medicine, but taking them from the packages, she said.

And pharmacists sometimes do not explain the therapy properly.

A “social marketing” campaign will be reviewed and improved to educate people on the proper use of the blisters, said Dr Ros Sieyha, also from the malaria center.

The report recommends more training for the staff, role clarification and additional research of malaria prone areas to help im­prove the program.

Other strategies in the report include a continued effort to distribute chemically treated mosquito nets, which ward off the nocturnal mosquitoes that carry malaria.

The nets remain an important part of the campaign, said Dr Stefan Hoyer, the World Health Organization’s malaria adviser to the Health Ministry.

The nets also act as a vehicle to provide other health care to remote areas, including Vitamin A and iodine supplements, Hoyer said.

 

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