Thursday, July 08, 2010

Drug-resistant malaria contained in western Cambodia

July 8, 2010
ABC Radio Australia

The World Health Organisation says that measures to contain a dangerous strain of resistant malaria appear to be paying off.

That upbeat assessment comes as the Cambodian government and the WHO released the results of a malaria testing program in the west of the country.

Presenter: Robert Carmichael
Speakers: Dr Steven Bjorge, World Health Organisation; Dr Nguon Sokomar, Cambodian National Centre for Malaria Control



NGUON SOKOMAR: "As the result showing here, we have two sheets. One sheet showing about screening, and another sheet about the results from the laboratories and the treatment we provide."(FADES)

CARMICHAEL: That is the sound of good news.

Dr Nguon Sokomar, a malaria specialist, is talking me through two pages of statistics in his office at the National Centre for Malaria Control in Phnom Penh.

The gist of the conversation is this: Health teams have tested almost 2,800 villagers from seven villages in a highly malarial area in western Cambodia. Just two villagers tested positive for falciparum malaria.

The reason that is good news is because three years ago health workers in western Cambodia discovered that some patients with falciparum malaria were taking longer to respond to treatment. And that was because a new strain of falciparum malaria was showing resistance to a drug known as artemisinin.

Artemisinin-based drugs are the most effective treatment against malaria, and have been vital to efforts to counter the disease.

So experts were extremely worried that this resistant strain could spread from near the western Cambodian town of Pailin. The government and agencies like the World Health Organisation put in place a massive exercise to combat malaria.

The results announced on Tuesday look as though the effort is paying off.

Health experts feared - and still are concerned - that if the strain escapes western Cambodia, it could unleash a global health crisis and add to the one million deaths a year that malaria already causes.

It has happened before - the chloroquine resistant malaria strain came from western Cambodia.

NGUON SOKOMAR:You know historically Pailin is the area that we found resistant strain there. So it is a concern for us - not just only Cambodia, but a global concern - to stop spreading of that resistant strain.

CARMICHAEL: Dr Steven Bjorge is the malaria specialist at the World Health Organisation's office in Phnom Penh.

He says the Cambodian government and health partners like the WHO have spent two years and millions of dollars around the Pailin area combating malaria.

Those efforts include training two people in every village to test for malaria and treat for free anyone with the disease.

Other steps include distributing more than 500,000 mosquito nets, combating fake malaria medication, spraying for mosquitoes, and educating people how to avoid malaria.

That effort will shortly be replicated across Cambodia in a five-year project using $102 million dollars from the Global Fund.

Dr Bjorge says Tuesday's results indicate that the methods being used to combat this strain of falciparum malaria are working. So what was he expecting?

BJORGE :"We don't really have expectations, but I mean it's just phenomenally low - we feel it's very, very low. It looks like we are having success."

CARMICHAEL: And he says data from other sources such as hospitals and health clinics are showing similar results. Also village malaria workers are finding very few cases of falciparum malaria - most cases are vivax malaria, which is generally not fatal and has never shown resistance to artemisinin.

It is this combination of results that has health workers optimistic that they have the upper hand.

Dr Nguon Sokomar says his team will continue testing 13 more villages in western Cambodia over the coming three months. He is optimistic those results will be good too.

NGUON SOKOMAR: We expect that the positivity rate for the following villages will be as well low.

CARMICHAEL: But the battle is not yet won: Just last month a conference in Hanoi heard there were signs that the resistant malaria strain might have emerged in Vietnam and Myanmar.

But for now there is some rare good news on malaria emanating from western Cambodia. And health experts are hopeful this might mark the moment that Cambodia started to win its battle against the disease.

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