We Need to Stop Drug-Resistant Malaria at Its Source, Right Now
Immediate, targeted interventions in Southeast Asia could prevent a pandemic
By Colin Ohrt on January 31, 2019

Global investments in malaria control and elimination are now at risk of being rapidly reversed. Cambodia is where malarial drug resistance historically emerges and spreads globally; it appears we are currently watching history repeat itself. Radical action must be taken immediately to stop these nearly incurable strains of the disease from evolving and spreading.

Considerable investments have averted millions of malaria-attributable deaths since 2000. Nevertheless, one person (usually a child) still dies every 1.2 minutes from this disease. There was no reduction in mortality overall between 2015 and 2016, and mortality actually increased in some regions. In the most recent World Malaria Report, 219 million cases were reported in 2017, an increase of two million.

Information generated and compiled by the Consortium for Health Action, a U.S.-, Cambodia- and Vietnam-based organization I founded to eliminate emerging incurable malaria from the source in Southeast Asia, suggests the risk of spread of drug-resistant malaria from Asia into Sub-Saharan Africa significantly increases the likelihood of the next global pandemic.

Despite large investments and recent success in driving down overall rates of malaria, high levels of resistance to nearly all antimalarial drugs are now widespread in Cambodia, the main source of drug-resistant strains previously. Malaria cases were again rising in forested areas of Cambodia in 2017 and early 2018. Plasmodium falciparum, the parasite species that causes the deadly form of the disease, is also a species against which most drugs are ineffective. Incurable malaria spreading from this region is a real and present threat that must be stopped.

https://blogs.scientificamerican.com/ob ... right-now/

Drug-resistant malaria parasites 'spreading aggressively' across south-east Asia
Up to 80% of the most common carriers of the disease are immune to the most common treatments, researchers find
Agence France-Presse
Tue 23 Jul 2019 02.34 BST
Last modified on Tue 23 Jul 2019 04.07 BST
Drug-resistant forms of malaria-causing parasites are spreading across south-east Asia leading to “alarmingly high” treatment failure rates of frontline medication, researchers have warned.

In twin studies published in the Lancet Infectious Diseases journal, they revealed that in parts of Thailand, Vietnam and Cambodia up to 80% of the most common malaria parasites were now resistant to the two most common antimalarial drugs.

The Plasmodium falciparum parasites have also acquired resistance linked to the failure of treatment in half of cases to one of the newest and most potent frontline drug combinations, they said.

“These worrying findings indicate that the problem of multi-drug resistance in P falciparum has substantially worsened in south-east Asia since 2015,” said Olivo Miotto from the Wellcome Sanger Institute and University of Oxford, who co-led the study. “This highly successful resistant parasite strain is capable of invading new territories and acquiring new genetic properties.”
https://www.theguardian.com/world/2019/ ... -east-asia

Despite the recent good news of a future malaria cure, in the meantime, Cambodia is struggling with outbreaks of malaria in seven provinces.

Minister tackles malaria amid breakout in seven provinces
Khorn Savi | Publication date 23 October 2019 | 23:22 ICT
Amid a malaria outbreak in seven Cambodian provinces, Health Minister Mam Bun Heng urged provincial authorities to implement the National Strategic Plan for Elimination of Malaria (2011-2025) efficiently to combat the vector-borne disease.

The National Centre for Parasitology, Entomology and Malaria Control said the provinces of Pursat, Kampong Speu, Stung Treng, Mondulkiri, Preah Vihear, Kratie and Ratanakkiri have seen a high number of malaria cases.

The centre urged the provinces to follow the minister’s instruction to conduct blood tests and provide treatment.

The malaria outbreak has raised concerns that the government’s plans to eliminate Plasmodium falciparum malaria by 2020 and all types of malaria by 2025 would not be achieved.
https://www.phnompenhpost.com/national/ ... -provinces

After contracting malaria (P.Vivax) this time last year, I was unable to receive the correct antimalarial medication (primaquine) to fully rid my body of the parasite as it stays dormant in the liver. Whilst my blood was cleansed of the parasite during a 3 day stint at the local military hospital in PP, my symptoms came back with a vengeance during a trip to Laos. This was expected, but not expected so soon.
Luckily for me (and anyone with malaria) proper medication is free in Laos. Vientiane also has a comprehensive centre for malaria and other infectious diseases. Let's just say it was an odd holiday.

Malaria and dengue remain major health issues in Cambodia.

Battambang Malaria Cases May be Linked to Rare, but Treatable, Parasite
09 July 2020
Sokummono Khan
Hean Socheata
VOA Khmer
BATTAMBANG — Since February, Yom Nob has been in the Ta Sanh Health Center observing samples taken from malaria patients in six nearby villages. The laboratory officer has twenty years of experience working with malaria, but he was seeing something new.

Rapid diagnostic tests in the area were equipped to detect more common kinds of malaria-causing parasites – Plasmodium falciparum and Plasmodium vivax. But the tests were unable to detect malaria in some of the district’s patients, even though they exhibited all the symptoms of the illness.

“We havnever seen this in our villages before,” Yom Nob told VOA Khmer last month.

After further analysis, Yom Nob realized the malaria was likely caused by a rare malaria-causing parasite, sending his samples and findings to the Institut Pasteur du Cambodge in Phnom Penh.

Last month, the government and Institut Pasteur du Cambodge sent a team to Samlout district and collected at least 250 samples from villagers in Daun Troek, according to Yom Nob. Hundreds of other samples were taken from villagers in the neighboring villages of Phnom Rai, Chhak Roka, Srae Andoung, Ou Tontuem, and Ou Chrab.
https://www.voacambodia.com/a/battamban ... 5694.htmle

Some positive news concerning malaria outbreaks in Cambodia this year:

Malaria Cases Dropped by 70 Percent in First Nine Months
AKP Phnom Penh, November 04, 2020 --

Cambodia has noticed a significant drop of about 70 percent of Malaria cases for the first nine months of 2020, according to the Ministry of Health’s recent notification.

The ministry has recorded 7,668 cases of the disease, compared to 25,499 cases during the same period in the previous year, and more impressively no death reported.

The decline was also observed in areas with more of the cases in the past, such as Kampong Speu, Mondulkiri, Rattanakiri, and Stung Treng provinces.

With the move, Cambodia is three-year ahead of the targeted timing to completely eradicate death by Malaria.
- AKP

More positive news:
Royal Government of Cambodia commits to eliminating the deadliest strain of malaria
Download PDF Copy [Go to link below]

Reviewed by Emily Henderson, B.Sc.Nov 16 2020

The Royal Government of Cambodia (RGC) today committed to eliminating Plasmodium falciparum within the next few months, and to maintaining zero cases by 2023, through the launch of an innovative and targeted approach for the ‘last mile’ of malaria elimination in the country.

P. falciparum is the deadliest strain of malaria and is resistant to antimalarial drugs, which adds urgency to efforts to eliminate it.

According to the targets set out in the Malaria Elimination Action Framework, Cambodia is on the brink of success. We are now at the stage of reaching P. falciparum elimination by 2023, not only in Kampong Speu but also in all other remaining provinces.”

Dr Li Ailan, World Health Organization (WHO) Representative to Cambodia, commended the work that has been done.

“I am very impressed by the tremendous efforts made at the local, provincial and national levels for malaria elimination. We appreciate the partners’ collective action for this. Cambodia, being very close to the goal, can be the first country in the region to eliminate P. falciparum malaria, serving as a champion in the Greater Mekong Subregion.”
Full article: https://www.news-medical.net/news/20201 ... laria.aspx

The ‘last mile’ of malaria elimination in Cambodia
Health centre malaria workers play a pivotal role in eliminating the disease in malaria hotspots
1 April 2021

The sand coloured health centers dotted across Cambodia’s provinces are fairly recognizable, even to an untrained eye. Most sport a canopy of red tile roofs with verandas that serve as waiting areas for incoming patients. Ly Kanha grew up familiar with the ins and outs of Cambodia’s health centres. She spent most of her childhood in the care of her grandparents who were both working as health professionals at the time.

“When I was young, my grandfather took me to the health centre, and I saw medical staff wearing medical uniforms,” says Kanha as she recounts memories of observing the staff administering medication to patients.

The visits made enough of an impression that Kanha eventually followed in the steps of her grandmother to become a midwife. Having passed her exam two years ago, she now works and lives on-site in a room that overlooks the shaded veranda of her health centre. As the resident midwife she starts her mornings performing prenatal checkups to expectant mothers who arrive on motorbikes hailing from the areas surrounding Beng village, Kampong Speu. Last year she took on extra duties and was appointed as the health centre’s malaria worker. This is no easy task considering that Kampong Speu has the highest malaria incidence rate among Cambodia’s remaining endemic provinces.

“Being a midwife working at a health center where there is a high number of malaria cases, greater human resources were needed to help assist the malaria programme. That’s why I decided to be a part of the [“last mile” of malaria elimination].” says Kanha.
https://www.who.int/news-room/feature-s ... n-cambodia

Good news.

Anti-malaria effort three years ahead of planned goals
Lay Samean | Publication date 10 September 2021 | 20:26 ICT

In the first eight months of this year, the reported number of malaria cases in Cambodia was 2,428, a 62 per cent decrease compared to the same period last year when 6,313 cases were recorded, according to the National Centre for Parasitology, Entomology and Malaria Control (CNM).

CNM director Huy Rekol told The Post on September 9 that the reason for the significant decrease was due to improved public awareness about how malaria spreads and how it can be prevented through increased attention paid to the issue by partner organisations.

"The fight against malaria is the same as any other infectious disease. Malaria is an infectious disease spread by the bite of Anopheles mosquitoes.

"Therefore, the way to control the spread of the disease is by controlling the number of these mosquitoes, which can be accomplished when the community and all of the stakeholders involved work together,” he said.

Rekol also noted that there have been no deaths from malaria in Cambodia since 2018, demonstrating the success of the government’s National Strategic Plan for Elimination of Malaria in Cambodia (2011-2025).
https://www.phnompenhpost.com/national/ ... nned-goals