Malaria in Cambodia.

There are around half a million cases of malaria with 5-10,000 deaths per year in Cambodia. Incidence rates vary in different parts of the country. Malaria control is hampered by multiple drug resistance of Plasmodium falciparum, inaccessibility to the major vector, poor security in most malarious areas, and lack of resources. The control strategy emphasises improvement of clinical management and provision of prompt and accurate diagnosis in order to reduce morbidity and to prevent mortality. In addition health information and drug distribution systems are being improved. The use of pyrethroid-treated mosquito nets and health education are being promoted. Particular attention is given to returning refugees as they settle into the country.

Epidemiology of malaria in displaced Khmers on the Thai-Kampuchean border.

Malaria epidemiology from 1983 to 1985 in displaced Khmers living in camps on the Thai-Kampuchean border was studied for planning and evaluation of control measures. The annual parasite incidence per 1000 people fell from 359 in 1983 and 350 in 1984 to 116 in 1985. Incidence varied by camp according to the suitability of the habitat for the vectors. Camps with high incidence had a higher ratio of Plasmodium falciparum to P. vivax, a higher mortality rate, especially in young children and sometimes pregnant women, but a lower case fatality rate than camps with low incidence. Transmission occurred year round, but peaked in the rainy season in 1983 and 1984. In 1985 there was a steady decline in incidence, largely owing to evacuation of many camps away from forested areas. Mortality rates per 100,000 people were 62, 77 and 28 and case fatality rates 0.41, 0.31 and 0.42% in 1983, 1984 and 1985 respectively. The case fatality rate for cerebral malaria was 21 to 26%. Epidemiological information has been more useful for planning than for evaluating control measures.