News

Village workers lead malaria fight

Associate Professor Jack Richards

21 June, 2016

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IMAGE: Honorary Burnet Institute Fellow Dr Sara Canavati with Mr Long Vuthy

The emergence in recent years of artemisinin-resistant malaria in Pailin Province, Cambodia, poses a serious threat not only to the affected vicinity, but the entire region. Senior research scientist and Honorary Burnet Institute Fellow Dr Sara Canavati reports on the efforts of village malaria worker (VMW) Long Vuthy to reduce the impact of malaria in his community.

A small province near the Thai border, Pailin is recognised as the epicentre of the emergence of Plasmodium falciparum multidrug-resistance. Artemisinin resistance has been observed in this area since 2008–2009.

One of more than 200 VMWs in the province, Mr Long is based in the epicentre of the artemisinin resistance. He has witnessed a vast decline in the number of malaria cases, however those who are left are proving almost impossible to treat.

“In 2002 there was no Health Centre and malaria mortality was very high in my village, Phnom Dam Bong,” Mr Long said.

“I saw first hand many villagers dying from malaria. Morbidity was even higher and there were no malaria services available. All malaria patients sought health care through the private system and had to pay high amounts of money.

“Malaria patients did not know that the fever was caused by the malaria parasite; they thought it came from spirits, ghosts or land curse.

“This terrible situation made me become a VMW.

“In April 2003, my first volunteer month, there were 155 malaria cases in my village that I had to look after. I was extremely busy. Today, the number of cases has been reduced, but those with malaria are not responding to treatment.”

VMWs are the backbone of all malaria activities in Cambodia. A recent health system assessment has highlighted their critical role in relation to the elimination of artemisinin-resistant malaria.

Mr Long has persistently asked me: “How can I help my patients who come back to me every month with parasites?”

Sadly, currently there is no answer to that question. The emergence and spread of multidrug-resistant parasites is a major challenge, not only in Cambodia, but beyond.

Artemisinin-resistant malaria is now present throughout much of the Greater Mekong Sub-region. Artemisinin-resistant parasites are now found in much of Myanmar. If they spread to the Indian subcontinent and Africa, where malaria is deeply entrenched, it is possible that millions of children will die.

Cambodia is making malaria elimination a priority at the top as demonstrated by its political commitment to World Malaria Day (WMD).

A recent report described The Kingdom of Cambodia’s 2016 WMD celebrations as a prime of example of how political will is currently being exercised in Cambodia through high-level governmental support for malaria elimination.

But no less valuable is the outstanding support and commitment at community level of VMWs like Mr Long.

Contact Details

For more information in relation to this news article, please contact:

Associate Professor Jack Richards

Group Head, NHMRC Postdoctoral Fellow, Infectious Diseases Physician

Telephone

+61385062405

Email

jack.richards@burnet.edu.au

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