The number of reported malaria cases and deaths in Cambodia rose last year, according to the National Malaria Center, with six provinces noting particularly sharp increases.
But while health officials are examining these cases to understand how to prevent further outbreaks ahead of the 2004 rainy season, they are also quick to note that bigger numbers do not necessarily mean more cases—and might even be a sign that the program’s efforts are working.
There were 132,571 treated cases of malaria in 2003, more than the 110,762 in 2002, according to the Ministry of Health figures released at the NMC annual conference last week.
The number of deaths from malaria also increased to 492 from 457, and the average incidence rate in the provinces rose to 10.3 percent from 8.6 percent in 2002.
Health officials buttressed the numbers with two arguments: First, the increase could indicate that more provinces reported cases, thanks to education campaigns that led more people to seek treatment at public centers; and second, the numbers may not accurately reflect the real prevalence of the disease because of imperfect reporting systems.
“If we rely solely on reporting of cases and deaths through the system, that can be difficult to interpret,” said Jim Tulloch, World Health Organization representative in Cambodia.
“The apparent increase in 2003 may be real, or it may mean more health centers are reporting, more people are going” for treatment, he said.
He cited the need for a population-based survey—an independent study of the number of people infected in a given area, as opposed to reliance on the numbers of people seeking treatment—as a more accurate gauge of the disease’s prevalence.
At a workshop last Wednesday, representatives from the six provinces hardest hit by malaria last year—Battambang, Kompong Speu, Oddar Meanchey, Pursat, Preah Vihear and Siem Reap—discussed possible reasons for of the spread of the disease.
Common to nearly all was the increase in mobility of residents—a preponderance of people venturing to border areas for jobs in Thailand or to forested areas (high-risk sites for malaria) to make money in logging.
Despite the potentially discouraging numbers, center officials encouraged accurate reporting from the provinces, playing down health officials’ fears that an increase would somehow reflect negatively on their compliance.
“Never mind if the cases go up,” Dr Seshu Babu, adviser to the NMC, said to an audience of provincial health and NGO workers.
“Please give us a real picture. Don’t think you will be punished if the cases go up.”
