In Cambodia, malaria continues to be a major cause for public health and economic burden. Its elimination is given high priority by the government and partners. Forest villagers in the eastern and northern provinces are at high risk of malaria, with all age groups suffering infection; children under the age of five years are at highest risk of severe disease due to their lack of immunity. Elsewhere, malaria is an occupational disease with specific high-risk groups, including forestry workers, new settlers and mobile/migrant populations who have come into forested areas, and soldiers, and their families, serving in the forests.
The five Plasmodium species known to cause malaria in humans (P. falciparum, P. vivax, P. malariae, P. ovale and P. knowlesi) are present in Cambodia. Currently, the number of malaria cases recorded in the public sector is estimated to ~40,000. P. falciparum was the predominant species among confirmed malaria cases until 2010 (CNM data).
Although there has been a steady reduction in the total number of clinically diagnosed and treated malaria cases as well as in the severe case fatality rate over the last thirteen years, morbidity due to malaria remain high compared to other countries in the region. Malaria in Cambodia is also a key contributor to anaemia, complications during pregnancy, low-birth weight and poor child growth.
In addition, multidrug resistant strains of Plasmodium falciparum are common, particularly in the west of the country. As with earlier antimalarials, we are now facing to the emergence of artemisinin and piperaquine resistance while no suitable alternative currently exists for first-line treatments of falciparum malaria. As previously observed with chloroquine resistance in the last century, artemisinin-resistant parasites represent a major threat to worldwide goals of malaria eradication and the potential to devastate sub-Saharan Africa by increasing childhood mortality.
Major Areas of Research at IPC Scientific projects are built around the malaria elimination concept in Southeast Asia. They are mainly focused on four major areas of research:
- Supporting and evaluating the impact of strategies against malaria implemented by National Malaria Control Programmes.
- Conduct researches focused on P. falciparum artemisinin resistant parasites.
- Conduct researches on vivax malaria & other emerging Plasmodium sp.
- Transmission of Plasmodium by Anopheline mosquitoes
An open Pasteur conference was held the 24th of April 2018: “Eradicating Malaria: Why is Cambodia the center of the world ?”
24 Avril : Conference Pasteur Grand public “Elimination du Paludisme : Le Cambodge au centre du monde ?” REECOUTER LA CONFERENCE
By Benoit Witkowski, Head of the Malaria Epidemiology Unit at Institut Pasteur du Cambodge