Molecular identification of Opisthorchis viverrini among the northeastern Cambodian population by internal transcribed spacer 2 based polymerase chain reaction

@#The southeast Asian fluke Opisthorchis viverrini remains endemic, particularly in Thailand, Lao PDR, Cambodia, Vietnam, and Myanmar. However, there is a lack of data on the prevalence of liver fluke infection in Kratie Province in northeastern Cambodia. The present study aimed to detect O. viverrini DNA in fecal specimens by using the internal transcribed spacer 2 (ITS2) region of ribosomal DNA (rDNA) based on polymerase chain reaction (PCR). The prevalence and percentage of O. viverrini infection were described by data analysis. Bivariate binary logistic regression analysis was used to look at the related prevalence of O. viverrini infection. A total of 6.89% from 377 fecal samples were found positive of O. viverrini DNA. The prevalence of O. viverrini infection was found to be higher in men (8.92%) than in women (5.45%), and to be associated more frequently with younger age groups (13.40%), illiteracy (8.74%), participation in other careers (non-specific occupations) (11.63%), and residence in the Trapaing Srae village (9.94%) of the Snuol district, Kratie Province. Age groups under 20 years old were significantly linked with O. viverrini infection, with ORadj=0.601, 95% CI=0.410-0.882, p=0.009 and significant value established at (P<0.05). This study demonstrates that O. viverrini infection is distributed in rural areas located near freshwater reservoirs. Therefore, active surveillance, clinical examination of association with hepatobiliary, cholangiocarcinoma, and health education are needed.

Nutrition Improvement of Pediatric Cancer Patients through Hospital Meals and Nutrition education in Cambodia / 国際保健医療

Introduction  NPO Japan Heart opened a children’s medical center in Cambodia in 2018 to treat pediatric cancer. In many public hospitals in Cambodia, patients’ meals must be prepared by their families with little knowledge about hygiene and nutrition, so patients may not always receive sufficient nutrition for their treatment. We considered a hygienic and nutritious diet essential for effective pediatric cancer treatment.  Therefore, the “Japan Heart Children’s Medical Center Meal Project” was launched. The objectives of this study were as follows; (1) to describe that patients receive hygienic and nutritious meals during their hospitalization and after discharge, (2) to measure the effects of providing hospital meals and nutrition education by Cambodian staff who are not qualified dietitians, and to clarify the changes in the nutritional status of pediatric cancer patients as a result of these activities.Methods  The target group was pediatric cancer patients and their families.  Japanese dietitians and chefs conducted study sessions, created menu standards based on the Minimum Dietary Diversity (MDD) , and trained local staff to provide meals and nutrition education.   To provide hospital meals, local staff conducted hygiene management, prepared menus based on standards, and measured eating rates. They also provided nutrition education to the patients and their families, and connected survey before and after education. Nutrition assessment was conducted based on WHO Growth Chart BMI for age by measuring height and weight.Results  The MDD achievement rate for the menu increased from 72% to 100% (after intervention 1week-2 week (January, 2020)), and the eating rate increased from 45.9% to a maximum of 80.5% (April, 2020-January, 2022). Surveys before and after nutrition education showed that 89.1% of patient families improved their knowledge and awareness. Height and weight were assessed by BMI, and the percentage of patients with ≤−2SD decreased from 28.1% at admission to 15.9% at discharge.  Conclusions  In Cambodia where there is no dietitian system, it is important to do activities with contents that is feasible for local staff who have never studied nutrition.  In order to further support treatment from the nutritional aspect, it is desirable to develop nutritional human resources in Cambodia.

Intestinal parasitic infections and risk factors among the population in Cambodia

@#Many species of helminths and protozoa caused intestinal parasitic infections (IPIs). It belongs to neglected tropical diseases (NTDs) and remains a major public health problem in several Southeast Asian countries. The present study aimed to investigate the prevalence of IPIs and associated risk factors among the population in Kratie Province in northeastern Cambodia and Phnom Penh is the capital that locates in southern Cambodia. Fecal specimens (n=366) were collected in 10 villages in Kratie Province and Phnom Penh from 2019 to 2021. They were processed using the formalin ethyl-acetate concentration technique (FECT) to investigate parasites at egg and cyst stages and then examined under a light microscope. The results revealed that the prevalence of IPIs among the population in Kratie Province (n=317) and Phnom Penh (n=49) was 16.12% (n=59); of Kratie Province (n=50, 13.66%) and Phnom Penh (n=9, 2.46%), 12.02% (n=44) were helminths and 4.10% (n=15) were protozoa. The parasitic infection rate was higher in males (9.02%) than in females (7.10%) and more likely to be due to helminths (7.38%) than protozoa (1.64%). Prevalence of Opisthorchis viverrini was the highest (5.74%), followed by those of Entamoeba coli (4.10%), hookworm (3.83%), Ascaris lumbricoides (1.10%), Hymenolepis nana (1.09%), Taenia spp. (0.54%), Trichuris trichiura (0.55%), and Enterobius vermicularis (0.27%), respectively. Moreover, O. viverrini infection was the most common infection in the >20-year age group in Kratie Province. In addition, the bivariate and multivariate analyses showed that the association between gender. Gender was a significant risk factor positively associated with O. viverrini and hookworm infections (ORadj=0.318, 95% CI=0.122-0.8270, P=0.019 and ORadj=0.085, 95% CI=0.017-0.436, P=0.003, respectively). In conclusion, the IPIs were highly prevalent, especially O. viverrini and hookworm infections, among the population in Cambodia. These IPIs impact the public health burden but can be prevented by education regarding good sanitary practices in this community.

Difference of sociodemographic characteristics among the disabled population in Cambodia: a cross-sectional study of the demographic and health survey data / Journal of Rural Medicine

Objective: There is an urgent need to raise awareness of the significance of the social security system for vulnerable populations in developing countries and identify the widening disparities among people with disabilities. This study determined the sociodemographic characteristics of people with disabilities in Cambodia.Materials and Methods: This was a cross-sectional study. Data from the Cambodia Demographic and Health Survey were used to determine the association between disability and sociodemographic characteristics such as age, gender, number of family members, residence (rural/urban), and economic status.Results: The results showed that the proportion of people with disabilities greatly increased with age. The rural-urban residence difference affected the disability proportion in univariate analysis; however, the effect was not significant after adjusting for covariables in multivariate analysis. The odds of having a disability were 0.85 times lower for the high economic status group than for the low economic status group.Conclusion: Raising awareness to expand the capacity of social support for older adults with disabilities, especially those who do not receive care from their families, may be an urgent issue in Cambodia. Therefore, a well-designed and disease-specific study is required. This study was the first to determine the sociodemographic disparities among people with disabilities in Cambodia.

Molecular identification and efficacy analysis of herbs at Orussey Herbal Market, Phnom Penh, Cambodia / 中国中药杂志

Cambodia is rich in medicinal plant resources. One hundred and thirty-three medicinal material samples, including the hole herb, root, stem/branch, leaf, flower, fruit, seed, and resin, were collected from the Orussey Herbal Market in Phnom Penh, Cambodia, and then authenticated by ITS and psbA-trnH. A total of 46 samples were identified based on ITS sequences, belonging to 24 families, 40 genera, and 42 species. A total of 100 samples were identified by psbA-trnH sequences to belong to 42 families, 77 genera, and 84 species. A total of 103 samples were identified by two DNA barcodes. According to the morphological characteristics of the medicinal materials, 120 samples classified into 50 species, 86 genera, and 86 families were identified, and the majority of them were from Zingiberaceae, Fabaceae, and Acanthaceae. Such samples have been commonly used in traditional Cambodian medicine, Ayurvedic medicine, Unani medicine, traditional Chinese medicine, and ethnomedicine, but different medical systems focus on different functional aspects of the same medicinal material. The results of this study have demonstrated that DNA barcoding has a significant advantage in identifying herbal products, and this study has provided basic data for understanding the traditional medicinal materials used in Cambodia.

One new 2-(2-phenylethyl) chromone derivative from agarwood of Aquilaria crassna in Cambodia / 中草药

Objective: To study the chemical constituents of agarwood originating from Aquilaria crassna in Cambodia. Methods: The compounds were isolated and purified by silica gel column chromatography and semi-preparetive HPLC and so on. Their structures were identified by spectroscopic data. All compounds were tested for cytotoxic activities against two human cancer cell lines by MTT method. Results: Four compounds were isolated and elucidated as 6-methoxy-8-hydroxy-2-(2-phenylethyl) chromone (1), 6-methoxy-7-hydroxy-2-[2-(4-methoxyphenyl) ethyl] chromone (2), 7β,8β-epoxy-6α-hydroxy-5α-methoxy-5,6,7,8-tetrahydro-2-[2-(4- methoxyphenyl) ethyl] chromone (3), and rel-(1aR,2R,3R,7bS)-5,6-epoxy-7,8-dihydroxy-5,6,7,8-tetrahydro-2-[2-(4-methoxyphenyl) ethyl] chromone (4). Conclusion: Compound 1 is a new compound, while compounds 2-4 are isolated from this agarwood for the first time. Among them, compound 4 showed inhibitory activities against SGC-7901 and A549 cells.

Effect of artemisinin-piperaquine treatment on the electrocardiogram of malaria patients

Abstract INTRODUCTION: Concern regarding the cardiotoxicity of antimalarials has been renewed because of their potential to cause QT/QTc interval prolongation related to torsade de pointes (TdP). Artemisinin-piperaquine (AP) is considered an effective artemisinin-based combination therapy (ACT) for malaria. METHODS: This study involved a retrospective analysis of clinical data of 93 hospitalized malaria patients who had received AP orally. Electrocardiograms (ECGs) were obtained at specific time points in the original study. RESULTS: Some cases of QT prolongation were observed. However, no TdP was found. CONCLUSIONS: AP may cause QT interval prolongation in some malaria patients but may not lead to TdP.

Impact of Short Message Service (SMS) and Social Media on Sexual Intercourse of High School Students in Cambodia

PURPOSE: This study was conducted to investigate the relationship between short message service and social media use, and sexual intercourse of high school students in Cambodia. METHODS: Four hundred and eighty-three high school students from three schools in rural provinces were interviewed with structured questionnaires. RESULTS: Sexual intercourse was found significantly more frequent among male students than among female students (p=.001), among alcohol drinkers than among non-drinkers (p<.001), among those who were not taking pictures with mobile phones than among those who were (p=.045), and among those who were exchanging SMS between boyfriend and girlfriend than among those who were not (p=.006). The students who were sending SMS by mobile phones were 5.83 times as likely to have sexual intercourse as their counterparts (p=.020), who were taking pictures with mobile phone were 0.04 times as likely as those who were not (p=.045) and the odds ratio was 15.19 times as high in alcohol drinkers as in non-drinkers (p=.001). CONCLUSIONS: Efforts should be made to encourage positive and effective use of social media among adolescents to maintain their sexual health.

Four-year survey of the quality of antimicrobial medicines in Cambodia / 国際保健医療

Background and Objectives  Falsified or substandard antimicrobials present a health hazard to patients, and may promote antimicrobials resistance. We conducted a four-year study to evaluate the quality of selected antimicrobials and to examine the prevalence of falsified or substandard antimicrobials in Cambodia, aiming to promote efforts to improve the quality of medicines in Cambodia.Methods   We collected samples of clarithromycin, sulfamethoxazole/trimethoprim, ceftriaxone, cefuroxime, levofloxacin, gentamicin, ciprofloxacin, fluconazole, nalidixic acid, ofloxacin, phenoxymethyl penicillin and roxithromycin products from several different types of drug outlets in five provinces (rural areas) and Phnom Penh (an urban area), during 2011 to 2014. The authenticity of the collected medicines was investigated, and the medicines were analyzed to determine whether they met the appropriate pharmacopoeial standards.Results   We collected 647 samples, produced by 179 manufacturers, from 353 outlets. Only 51 (15%) of the outlets were air-conditioned. We found different-coloured packaging of the same brand (different lots) of products from some manufacturers. The insert information of one sample was different from the package information. Twelve (1.9%) samples were not officially registered with Department of Drug and Food (DDF). In authenticity investigation, 43 of 179 manufacturers replied and confirmed the authenticity of 154 samples (out of 647); also, 18 out of 40 Medicine Regulatory Authority (MRA) replied to enquiries about whether products were licensed or not (one was not). Among the samples, 424 (80.4%), 406 (86%) and 533 (90.6%) passed in dissolution, content uniformity and quantity tests, respectively. Samples of cefuroxime and roxithromycin that failed were significantly cheaper than those that passed.Conclusion  Poor-quality antimicrobials were found in Cambodian markets, though no falsified medicines were detected. Result of samples were not confirmed in authenticity, so it was possible to include falsified medicines. Manufacturers should be encouraged to improve GMP implementation. Storage conditions in the distribution chain may also need to be improved. Continuous efforts by stakeholders are needed to ensure that medicines are properly licensed.

Artyfechinostomum malayanum: Metacercariae Encysted in Pila sp. Snails Purchased from Phnom Penh, Cambodia

The metacercariae of Artyfechinostomum malayanum (Leiper, 1911) Mendheim, 1943 were discovered in Pila sp. snails purchased from a market in Phnom Penh, Cambodia. They were isolated from the snails using the artificial digestion technique and were orally fed to 2 hamsters, 1 rat, and 2 mice to obtain the adult flukes. The metacercariae were round, 145–165 μm in diameter, having a cyst wall of 6–10 μm in thickness, a head collar and collar spines, and characteristic features of excretory granules. Adult flukes were recovered in the small intestines of the animals at days 14 and 32 post infection and were morphologically observed using a light microscope and a scanning electron microscope. They were plump or elongated, ventrally curved, 6.0–8.1×1.6–2.0 mm in size, and characterized by the head collar bearing 43 collar spines, including 5 end group ones on each side, a long cirrus sac extending beyond the posterior margin of the ventral sucker, a submedian ovary, and 2 deeply lobed testes. Eggs in uteri were operculate, ovoid to ellipsoid, and 120–135×68–75 μm in size. In scanning electron microscopy, the head collar was prominent with collar spines looking like horns. Scale-like tegumental spines were densely distributed on the ventral surface between the head collar and ventral sucker. Sensory papillae were distributed mainly on the tegument around suckers. By this study, it has been first confirmed that the life cycle of A. malayanum exists in Cambodia.

Epidemiology and Clinical Management of Traumatic Spine Injuries at a Major Government Hospital in Cambodia

STUDY DESIGN: Cross sectional study. PURPOSE: To characterize the pattern of injury, describe the current clinical management, and determine the outcomes in traumatic spine injury (TSI) patients presenting to a major government hospital in Phnom Penh, Cambodia. OVERVIEW OF LITERATURE: There is a paucity of literature on epidemiology or current clinical practices for TSIs in Cambodia. The findings from this study can thus serve as a valuable resource for future progress in treating TSIs in low-income countries. METHODS: This study was a cross-sectional study of TSI patients admitted to Preah Kossamak Hospital in Phnom Penh, Cambodia. Demographics, cause of spinal injury, spinal level of injury, surgical procedures and techniques, complications, and American Spinal Injury Association (ASIA) grades were recorded and analyzed. RESULTS: Eighty patients were admitted with TSI between October 2013 and June 2014. Falls from heights were the most common cause of TSI, followed by road traffic accidents. 78% of the admitted patients underwent at least one surgical procedure. Without intraoperative imaging, 4 patients (6%) had wrong level surgery, and 1 patient (2%) had misplacement of pedicle screws. Sacral decubitus ulcers were the most common non-surgically related complication. Antibiotics were administered to >90% of patients. There were no in-hospital mortalities. Of the 60 spinal cord injury (SCI) patients, 32% (19/60) showed improvement in their ASIA grade at the time of discharge, and 52% (31/60) showed no change. At follow-up, 32% (19/60) of SCI patients reported improvement, and 8% (5/60) reported no change. However, 36 SCI patients (60%) were lost to follow-up. CONCLUSIONS: Despite technological limitations, outcomes of TSI patients in Cambodia appear favorable with evidence of clinical improvement and low mortality.

Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics

Objective: To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. Methods: Using Cambodia’s influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two. With these parameters, four threshold levels (seasonal, moderate, high and alert) were established and transmission intensity was categorized based on a World Health Organization alignment method. Parameters were compared against their respective thresholds. Results: Distinct seasonality was observed using the two parameters that incorporated laboratory data. Thresholds established using the composite parameter, combining syndromic and laboratory data, had the least number of false alarms in declaring season onset and were most useful in monitoring intensity. Unlike in temperate regions, the syndromic parameter was less useful in monitoring influenza activity or for setting thresholds. Conclusion: Influenza thresholds based on appropriate parameters have the potential to provide timely triggers for public health measures in a tropical country where monitoring and assessing influenza activity has been challenging. Based on these findings, the Ministry of Health plans to raise general awareness regarding influenza among the medical community and the general public. Our findings have important implications for countries in the tropics/subtropics and in resource-limited settings, and categorized transmission intensity can be used to assess severity of potential pandemic influenza as well as seasonal influenza.

Stellantchasmus falcatus (Digenea: Heterophyidae) in Cambodia: Discovery of Metacercariae in Mullets and Recovery of Adult Flukes in an Experimental Hamster

Stellantchasmus falcatus (Digenea: Heterophyidae) is first reported from Cambodia through recovery of the metacercariae from mullet fish and adult flukes from an experimentally infected hamster. We purchased 7 mullets, Chelon macrolepis, in a local market of Phnom Penh, Cambodia, and each of them was examined by the artificial digestion method on May 2010. The metacercariae of S. falcatus were detected in all mullets (100%) examined, and their average density was 177 per fish. They were elliptical, 220×168 μm in average size. They were orally infected to an hamster to obtain adult flukes. Adults recovered at day 10 post infection were observed with a light microscope and a scanning electron microscope (SEM). They were small, 450×237 μm in average size, had a small oral sucker (41×50 μm), subglobular pharynx (29×21 μm), slender esophagus (57 μm), long and thick-walled expulsor (119×32 μm), spherical ovary (58×69 μm), and 2 ovoid testes (right: 117×74 μm; left: 114×63 μm). Eggs were small, yellow, and 23×12 μm in average size. In SEM observations, tegumental spines were densely distributed on the whole tegument, and single small type I sensory papillae were distributed around the lip of oral sucker. The small ventral sucker was dextrally located and had 8 type I sensory papillae on the left margin. It has been first confirmed in the present study that the mullet, C. macrolepis, is playing the role of a second intermediate host of S. falcatus in Cambodia.

Reference values of hematology, biochemistry, and blood type in cynomolgus monkeys from cambodia origin / 한국실험동물학회지

Cynomolgus monkeys as nonhuman primates are valuable animal models because they have a high level of human gene homology. There are many reference values for hematology and biochemistry of Cynomolgus monkeys that are needed for proper clinical diagnosis and biomedical research conduct. The body weight information and blood type are also key success factors in allogeneic or xenogeneic models. Moreover, the biological parameters could be different according to the origin of the Cynomolgus monkey. However, there are limited references provided, especially of Cambodia origin. In this study, we measured average body weight of 2,518 Cynomolgus monkeys and analyzed hematology and serum biochemistry using 119 males, and determined blood types in 642 monkeys with Cambodia origin. The average body weight of male Cynomolgus monkeys were 2.56±0.345 kg and female group was 2.43±0.330 kg at the age from 2 to 3 years. The male group showed relatively sharp increased average body weight from the 3 to 4 age period compared to the female group. In hematology and biochemistry, it was found that most of the data was similar when compared to other references even though some results showed differences. The ABO blood type result showed that type A, B, AB, and O was approximately 15.6, 33.3, 44.2, and 6.9%, respectively. The main blood type in this facility was B and AB. These biological background references of Cambodia origin could be used to provide important information to researchers who are using them in their biomedical research.

Discrepancy between the national protocol and healthcare providers’ knowledge, attitude, and practice regarding induction and augmentation of labor with oxytocin in Cambodia / 国際保健医療

<p><b>Objectives</b></p><p>  The aim of this study was to investigate the knowledge, attitude, and practice (KAP) of healthcare providers regarding the utilization of oxytocin for induction or augmentation of labor.</p><p><b>Methods</b></p><p>  A qualitative study composed of direct observation and individual interview was conducted at a national tertiary maternity hospital in Phnom Penh, Cambodia in January and February 2013. The progress of labor in women who received oxytocin for induction or augmentation of labor was directly observed to confirm the healthcare providers’ management of oxytocin infusion. The attending doctors and midwives were individually interviewed after the women delivered. </p><p><b>Results</b></p><p>  During the study period, 10 women were observed, and 12 healthcare providers (three doctors and nine midwives) were interviewed individually. Indications for labor induction or augmentation seemed to be appropriate for nine women. However, we found discrepancies between the national protocol and healthcare providers’ knowledge and actual practices. For example, 11 healthcare providers had never read the national protocol for the management of labor induction and augmentation, which implied limited access to the correct knowledge. A misconception was noted in that the sudden increase of oxytocin was not dangerous during the second stage of labor, despite the establishment of a good contraction pattern. Furthermore, a lack of unified initial dose and extremely high maximum dose above that recommended by the national protocol were observed. About half of observed women were not monitored for more than 2 hours from the beginning of oxytocin infusion.</p><p><b>Conclusion</b></p><p>  　In the present study, lack of knowledge, misconceptions regarding the management of oxytocin infusion, and a large gap between the national protocol and the actual clinical practices were confirmed. To maximize patient safety and therapeutic benefit, dissemination of the national protocol through in-service training is required.</p>

Dynamic Modeling to Assess Natural Wetlands Treatment of Wastewater in Phnom Penh, Cambodia: Towards an Eco-City Planning Tool.

Aims: A personal computer version of the Stormwater Management Model (PCSWMM) was applied to seamlessly link urban runoff, sanitary flow, pump station operations, and a natural wastewater treatment wetland in Phnom Penh, Cambodia, as a step towards developing a planning tool that could be used to explore urban development or climate change scenarios. Study Design: PCSWMM was calibrated with measured flow and water quality data and used to estimate total phosphorus, total nitrogen, detergents, and E. coli levels at the outlet of the wastewater treatment wetland for the period May 15 to July 1, 2011. Place and Duration of Study: Phnom Penh, Cambodia; January, 2011 to March, 2012. Methodology: In support of model development, a limited water quality sampling program and bathymetric survey were conducted for the sewer and wetland system in both the dry and rainy seasons, 2011. Samples were analyzed for total nitrogen, total phosphorus, detergents, and E. coli. Sewer flow was measured continuously at 5 minute intervals to determine sanitary flow characteristics as input to the model and pump operation rules were determined through interviews with the pump operators and analysis of their data log books. Results: Consistent with past studies, the sampling showed that the wetland was effective in treating municipal waste, particularly with respect to E. coli (99% reduction from sewage inputs) and detergents (86% reduction from sewage inputs). A lower treatment efficiency was observed for total phosphorus, at around 31%, while the treatment efficiency for total nitrogen was around 71%. The wetland was divided into four zones and PCSWMM was run in continuous mode for the period May 2-July 1, 2011. The mean levels of E. coli, detergents, total phosphorus, and total nitrogen estimated by the model for that time period compared favorably with sample results from the field campaign in August, 2011. Conclusion: The naturally-occurring wetland treatment system in Phnom Penh is effective and fits well with the concepts of green infrastructure and eco-cities. PCSWMM is a useful decisionsupport and planning tool to explore various development and climate change scenarios in Phnom Penh.

Prevalence and Associated Risk Factors of Toxocara vitulorum Infections in Buffalo and Cattle Calves in Three Provinces of Central Cambodia

The prevalence and associated risk factors of Toxocara vitulorum infection in buffalo and cattle calves was studied in 3 provinces in central Cambodia. Fecal samples were collected from 517 calves between the age of 1-15 weeks and processed for nematode egg counts by a modified McMaster method. A total of 64 calves were found to excrete T. vitulorum eggs in their feces (12.4%; 95% exact CI: 9.7-15.5). The mean fecal egg count was 2,798 EPG (SD=16,351; range=0-224,400). A multivariable generalized linear mixed model showed higher odds of T. vitulorum infection for buffalo versus cattle, for animals aged 4-8 weeks versus younger and older ones, and for animals with strongyle infection. There was no association with fecal consistency. Farmers should be aware of the potential impact of T. vitulorum, and treat their calves at the age of 2-3 weeks with anthelmintics such as benzimidazoles or pyrantel.

Tuberculosis case-finding in Cambodia: analysis of case notification data, 2000 to 2013

The routine tuberculosis (TB) surveillance system in Cambodia has been strengthened under the National TB Programme (NTP). This paper provides an overview of the TB surveillance data for Cambodia at the national level for the period 2000 to 2013 and at the subnational level for 2013. The proportion of the total population that were screened for TB rose from 0.4% in 2001 to 1.1% in 2013, while the smear-positivity rate decreased from 28.9% to 8.1% in the same period. The total number of notified TB cases increased steadily from 2000; this has stabilized in recent years with 39 055 cases notified in 2013. The proportion of all TB cases that were smear-positive decreased from 78% in 2000 to 36% in 2013. Case notification rates (CNRs) for all forms of TB and new smear-positive TB in 2013 were 261 and 94 per 100 000 population, respectively. Higher CNRs were found in the north-west and south-east parts of the country and were higher for males especially in older age groups. The increase in TB screening, decline in the smear-positive rate and decline in notified smear-positive TB cases likely reflect a long-term positive impact of the NTP. A negative correlation between the proportion of the population screened and the smear-positivity rate at the subnational level helped identify where to find undiagnosed cases. Subnational differences in case notification of the elderly and in children provide more specific targets for case-finding and further encourage strategic resource allocation.

Improving Education Opportunity, Health, and Quality of Life of Orphans and Vulnerable Children: The Sustainable Action against HIV and AIDS in Communities (SAHACOM).

Aims: This study evaluated the impact of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project in improving education opportunity, health, and quality of life of orphans and vulnerable children (OVC) in Cambodia. Study Design: Operational intervention study. Place and Duration of the Study: Five provinces in Cambodia, from 2010 to 2014. Methodology: A two-stage cluster sampling method was used to select 756 OVC at midterm and 785 OVC at end line for face-to-face interviews. Outcome indicators from end line (2014) were compared to those obtained at midterm (2012). Where possible, the data were also compared with data obtained from baseline documentation (2010). Results: The percentage of OVC receiving external support for child care surged from 30.0% at baseline to 84.0% at midterm but decreased to 76.8% at end line. Compared to children at midterm, children at end line were significantly more likely to report having attended school regularly in the past 12 months, less likely to suspend study in order to work to help feed the family in the past 12 months, less likely to respond that food supports and other basic needs such as clothes and other household materials were the most important needs for their family today, more likely to perceive that supports for child education were the most important for their family today, less likely to report that their family reduced times for daily meals due to the shortage of food in the past 12 months, and more likely to rate their general health and overall quality of life as fair, good, or very good. Conclusion: This study indicates significant impact of the SAHACOM on education, health, and quality of life of OVC in Cambodia. This community-based model should be adapted for future interventions, taking into account the available resources.

Construction of a Structural Model Incorporating Nurse Image, Image Determinants, and Self-esteem for Evaluation of Cambodian Nursing Students / 한국간호교육학회지

PURPOSE: This study, on the basis of a structural model that includes nurse image, image determinants, and self-esteem of Cambodian nursing students influenced by the Korean nursing education system, demonstrates distinctions between senior and junior according to experience in clinical practice. METHODS: Data were collected via a questionnaire from 194 nursing students in Cambodia and subsequently analyzed using the STATA IC 12 program. RESULTS: First, image determinants and their sub-factors-subjective, institutional, and media-effect both the nurse image and self-esteem of nursing students. Second, the study confirms that nurse image has no significant effect on self-esteem. Also, the individual factor, a sub-factor of nurse image, possesses a weak relationship with nurse image. Third, the structural model mediating between senior and junior reveals differences resulting from experiences derived from clinical practice. CONCLUSION: The study has significance in that Cambodian nursing students, who are rarely studied in terms of nurse image, have been systemically analyzed via a structural model incorporating image determinants and self-esteem.