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This paper is based on the ReFashion study which used mixed‐method longitudinal research to track and amplify the experiences and coping mechanisms of 200 women garment workers in Cambodia as they navigated the financial repercussions of the COVID‐19 pandemic. It develops the idea and practice of ‘feminist longitudinal research' (FLR) through re‐centring the too often marginalised knowledges and ways of knowing of Cambodian researchers and research participants. Hearing and learning from their experiences reveal the labours and care‐work involved in the ‘doing' of longitudinal research during a time of extraordinary crisis, and the potential for feminist consciousness raising and solidarity that can arise both within and beyond the confines of an academic study. The paper advocates for geographers and other social scientists to go beyond technically‐framed issues of participant ‘attrition' and ‘retention' in longitudinal studies to think more creatively and critically about the process of longitudinal research and what it means for those taking part in it. FLR not only evidences the temporally contingent gendered impacts of a phenomenon, but can be distinguished by its intentionality and/or potential to challenge the patriarchal status quo, both in the lives of researchers and participants. [ FROM AUTHOR] Copyright of Area is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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In this paper I share insights and thoughts on the ‘doing' of creative practice for representing and communicating lived experiences of slow violence. Reflecting on two UKRI GCRF studies I have been part of in Cambodia, and which both harnessed creative practice in their methodologies, I focus specifically on the slow violence of over-indebtedness effecting garment workers and farmers during, but also pre-dating, the COVID-19 pandemic. The paper intentionally ‘makes space' for the films and portraiture photography from these studies to be viewed and exalted – the aim being to encourage political geographers to become more attuned to, and themselves embrace, the ‘doing' of creative practice. Together they show first how the ‘doing' of creative practice can deepen and add new dimensions to growing work on embodied relations and temporalities of debt and over-indebtedness. Second, the insights offered in this paper underscore the ethical importance of care, responsibility, and trust in geographical knowledge creation and the management of research projects concerned with slow violence. The paper ultimately impresses the dual value of the ‘doing' of creative practice and its myriad politics, and being more attentive to what can be learned through creative practice itself about the political geographies of slow violence encountered in people's lives.
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Influenza infection is asymptomatic in up to 75% of cases, but outbreaks result in significant morbidity. Reports found that severe influenza complications tend to occur among the very young (<5 years) and very old (>65 years), especially those with underlying co-morbidities like diabetes mellitus and heart disease. Even with no co-morbidity, some older persons with severe influenza may require hospitalisation or intensive care, with increased risk of myocardial infarction and stroke. In South-East Asia, influenza was often seen as a mild problem and was not deemed notifiable until the appearance of the Influenza A(H1N1) pandemic in 2009. For decades the data made available were based on extrapolated estimates collected mainly from paediatric populations, resulting in inconsistent findings. Following expanded surveillance across the region using national surveillance systems for influenza-like illness (ILI) and severe acute respiratory illness (SARI), and better diagnostic methods, improved estimates of disease burden was achieved in South-East Asia. However, two studies conducted in 2008-2010 reported findings ranging from 2-3% to 11%. With regards to increased risk of complications, the estimated global annual attack rates for influenza were 5-10% in adults and 20-30% in children, resulting in 3-5 million cases of severe illness and 290,000-650,000 deaths. A study In Singapore reported that influenza is associated with annual excess mortality rates (EMR) of 11-14.8 per 100 000 person-years, especially affecting the elderly;these rates are comparable to that of the USA. As for hospitalisation rates of children under 5 years with seasonal influenza, the USA estimated a rate of 1.4 per 100,000. Comparable rates were reported in Singapore (0.7-0.9), Thailand (2.4), Viet Nam (3.9-4.7), and the Philippines (4.7). In 2018, an updated study reported a mean annual influenza-associated respiratory EMR of 4.0-8.8 per 100 000 individuals, with South-East Asia showing a high mortality rate of 3.5-9.2 per 100,000 individuals. It was already estimated in Thailand in 2004 that influenza resulted in USD23-63 million in economic costs, with the main contribution from lost productivity due to missed workdays. Thus, comparable to countries in temperate climate, the clinical and socioeconomic impact of influenza in South-East Asia appear to be just as substantial. With the emergence of the COVID-19 pandemic in 2020, global influenza incidence dropped dramatically. In South-East Asia, the trend in influenza detections was similar to the rest of the world, with numbers slightly higher than average in early 2020, followed by a quick drop-off by the end of April 2020. After April 2020, the detection rate remained low until late July 2020, when Influenza A(H3N2) predominated in Cambodia, Malaysia, the Philippines, Singapore, Thailand and Timor-Leste;influenza B in Lao People's Democratic Republic but with an upsurge in A(H3N2) activity. Following a two-year hiatus, influenza outbreaks began to re-emerge significantly since early 2022. From February through August 2022, influenza activity in the southern hemisphere remained lower than in pre-COVID-19 pandemic years, but was at the highest level compared to similar periods since the start of the COVID-19 pandemic. Reasons for the reduction during the COVID-19 pandemic include non-pharmaceutical interventions (NPIs), reduced population mixing and reduced travel, and possibly viral interference between SARS-CoV-2 and influenza virus in the same host. In general, the reduction in influenza detections however does not appear to be associated with lack of testing. The World Health Organisation (WHO) continues to recommend that vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses. Although influenza vaccine is not commonly used in most countries in South-East Asia, its burden is similar in other parts of the world where influenza vaccine is now routinely used. Currently, the countries in South-East Asia that are providing free influenza vacc na ion for those at high risk include Thailand, Singapore, the Philippines and Lao People's Democratic Republic.Copyright © 2023
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Intro: Recent evidence shows the Greater Mekong Subregion to be a hotspot for Sarbecoviruses in bats, especially insectivorous Horseshoe bats (genus Rhinolophus). However, prevalence, maintenance, and evolution of these viruses in Rhinolophids is still poorly understood. Sampling efforts are still limited and generally only cover cross-sectional surveillance at single points in time. Following the detection of Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2)-related viruses in Rhinolophus shameli from 2010 in Steung Treng, Cambodia, further active longitudinal surveillance in the same area between 2020-2021 continued the detection of these viruses. Method(s): Live bat capture and sampling has been implemented in several sites located in Stung Treng province. All rectal swabs of bats were tested for the detection of SARS-CoV-2 or Sarbecoviruses by real time RT-PCR. RNA samples from positive RT-PCR bats were then sequenced using a highly multiplexed PCR amplicon approach using new designed primers set guided by the ARTIC Network multiplex PCR primers set (https://artic.network/ncov-2019), on Oxford Nanopore technology. Finding(s): The sarbecoviruses were detected in four Rhinolophus shameli bats, a percentage of similarity ranging at the nucleotide level between 98.8% - 99.1% when compared to two other Cambodian bat sarbecoviruses from 2010 and between 92.4% - 94.5% when compared to human SARS-CoV-2 across the whole genome. Discussion(s): The bat SARS-CoV-2 related virus recently detected in four positive bats in 2020-2021 are genetically homologous with the virus detected in 2010, indicating a geographically/host limited population that is stable over time in the past ten years. Conclusion(s): Overall, our findings indicate further complexity in the diversity and evolution of sarbecoviruses and add intricacy to the search for the origins of the Coronavirus Disease 2019 (COVID-19) pandemic.Copyright © 2023
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*Presenting author Emerging infectious diseases have been causing outbreaks in humans for centuries and most infectious diseases originate in animals. Re-emerging zoonotic pathogens are rapidly increasing in prevalence or geographic range and causing a significant and growing threat to global health. The present work provides an insight of zoonotic viruses risk at human-bat/rodent interfaces in Cambodia. We conducted studies to investigate the circulation of zoonotic viruses and the risk of exposure in human living at the interfaces with bats and rodents. Rodent's samples were collected in rural and urban areas of Cambodia. Organs were tested for Hantavirus, Orthohepevirus species C and Arenavirus. Bat's samples were collected in Steung Treng for Sarbecovirus and in Battambang and Kandal for Nipah virus detection. People working/living at the human-animal interfaces were screened for IgG antibodies. In rodents (750), hantavirus was detected in 3.3% rodents from urban areas only. Seoul orthohantavirus was the most predominant virus followed by Thottapalayam virus. HEV-C was detected only in rodents from urban settings (1.8%). Arenavirus was detected in both rural (6.8%) and urban (2.5%) areas. In humans (788), the seroprevalence of IgG antibodies against hantavirus, HEV-A and Arenavirus was 10.0%, 24% and 23.4% respectively. NiV was detected in flying fox's urines collected between 2013-2016 in Kandal (0.63%) and in Battambang (1.03%). Blood samples collected in both provinces were negative for NiV antibodies. SARS-CoV-2 related virus was detected in Rhinolphus shameli in Steung Treng in 2010, 2020 and 2021. Blood samples from people living at the vicinity of positive bats were positive for antibodies against CoV (7.7%), but no specific neutralizing SARS-CoV2 antibodies were detected. Our studies provided insight of the risk of zoonoses in Cambodia and highlighted the importance of zoonotic surveillance and further One Health effort to prevent, detect, and respond to future cross-species transmission.Copyright © 2023
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BACKGROUND: Maintaining oral health is essential for improving overall health of children living with HIV. Therefore, we evaluated the effectiveness of an oral health intervention for improving their oral and overall health. In addition, we examined their longitudinal association between changes in oral and overall health. METHODS: We conducted a 2-year randomized controlled trial involving children living with HIV in Cambodia. Children aged 3-15 years and their caregivers were randomly allocated either to the intervention (group A) or control (group B) arm. A second control arm (group C) included children without HIV. The group A children received oral health education sessions and practiced home-based daily care. RESULTS: In the baseline survey, 482 children participated (group A: n = 160, group B: n = 168, group C: n = 154), and 350 completed the endline survey. An interaction effect in teeth brushing duration was observed in children in group A relative to group B (AOR = 2.69, 95% CI: 1.37-5.31) and group C (AOR = 3.78, 95% CI: 1.70-8.40). Longitudinal associations were observed between changes in oral hygiene and overall health, as presented by alterations in dental caries in permanent teeth with viral load detection (adjusted odds ratio = 3.58, 95% CI: 1.10 - 11.73), in salivary flow quantity with the overall quality of life (ß = 0.07, 95% CI: < 0.01 - 0.13), as well as in dental caries, salivary pH, debris index with body mass index for age among group A children. CONCLUSIONS: Oral health intervention may improve oral care behaviors and potentially enhance overall health among children living with HIV in antiretroviral therapy in a resource-constrained setting. TRIAL REGISTRATION: ISRCTN 15177479.
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Dental Caries , HIV Infections , Humans , Child , Quality of Life , Cambodia/epidemiology , Dental Caries/epidemiology , Dental Caries/prevention & control , Oral Health , HIV Infections/drug therapy , HIV Infections/epidemiologyABSTRACT
Introduction: Although there are several reports of COVID-19 in patients on peritoneal dialysis (PD), all of them were retrospective and mono-national-state designs, and none reported vaccination profiles. Method(s): The incidence of COVID-19 infection among PD patients and vaccination profiles of COVID-19 from 1 January 2020 to 30 September 2021 were retrieved from the survey of PD leaders in the ASEAN countries. Countries were excluded if their infection rates (IR) in PD populations were smaller than the lower limit value of 95% confidence interval (CI) of the overall pooled prevalence of 1.25 reported in kidney failure patients with COVID-19 infection globally, considering the possibility of under-reporting and if the number of PD population is less than 50 cases. Thus, Burma (45 cases, unknown IR), Cambodia (1 case, IR 0%), Indonesia (2,692 cases, unknown IR), Laos PDR (3 cases, IR 33%), and Vietnam (PD 1,500 cases, IR <1%) were excluded. Result(s): Figure 1 demonstrates the incidence of COVID-19 infection in PD populations in selected ASEAN members. The cumulative incidence of COVID-19 has gradually increased in all reported countries. The cumulative incidence rate of Singapore reached a plateau in the second quarter of 2020 but has since seen a surge in the third quarter of 2021 with an average incidence of 0.5-1.5 cases per 100 population. Overall IR ranged from 0.1% in Singapore to 23.8% in the Philippines with an average ASEAN IR of 2.6%. The majority of ASEAN had less than half of their populations fully vaccinated, ranging from only 13% in Vietnam to 46% in Brunei. Despite Laos being a low-income country, it was the first ASEAN to vaccinate its population. Singapore had the highest vaccination rates, with 83% and 81% of its population partially and completely vaccinated, respectively. Brunei, albeit being a high-income country, is the last country to roll out vaccination with a tardy vaccination rate, possibly due to the under-preparedness of the government and a false sense of security as Brunei had 15 months of zero cases before the latest wave. The incidence of ASEAN PD patients with COVID-19 infection surged during the second and third quartiles of 2021 despite the vaccine roll-out (Table 1). [Formula presented] Abbreviations: Ad26, Ad26.COV2.S;BBIBP, BBIBP-CorV;BNT, BNT162b2;Covishield, ChAdOx1 nCoV-19 (Covishield);Gam, Gam-COVID-Vac;mRNA, mRNA-1273;Vaxzeria, ChAdOx1 nCoV-19 (Vaxzeria) Remarks: Yellow, Conventional inactivated vaccines (BBIBP-CorV [Sinopharm], CoronaVac [Sinovac]);Green, RNA vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna]);Pink, Viral vector vaccines (Gam-COVID-Vac [Sputnik], ChAdOx1 nCoV-19 [Covishield], ChAdOx1 nCoV-19 [Vaxzeria] and Ad26.COV2.S [Johnson & Johnson]) [Formula presented] Figure 1. Cumulative incidence of COVID-19 infected PD patients in selected ASEAN Conclusion(s): Overall IR of the ASEAN PD population varied widely among countries. However, the rollout rate of vaccination lagged behind that of western countries. This should increase efforts to educate their population on the benefits of timely vaccination. There remain a lot of uncertainties regarding COVID-19, and hence there is an urgent need for large prospective studies with international collaboration, to address these questions. No conflict of interestCopyright © 2023
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The year 2022 began with a newly anointed leader-in-waiting in Hun Manet, the eldest son of prime minister Hun Sen. This formalized a process of hereditary succession underway for several years. Notwithstanding the prospect of change at the top, the authoritarian modus operandi of Cambodian politics continued in much the same way as in previous years, with government harassment of the opposition, a series of politically motivated court cases, and repression of civil society. Cambodia managed a relatively uneventful year as chair of ASEAN, but its international reputation was badly tarnished when its centrality to a surge in international criminal scamming operations and associated trafficking in persons shone a light on the corrupted nature of the country's political economy. The economy began to recover from the effects of COVID-19, due in part to investment from China, but the consequences of the pandemic continued to be felt, particularly among poorer citizens.
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Catheter ablations of cardiac arrhythmias are nowadays frequently guided by electro-anatomic mapping systems. Technical staff with medical training, or medical staff with technical training, is needed to assist the operator. Travel restrictions because of current COVID-19 pandemics have limited the in person availability for technical support staff. These limitations make us to perform the feasibility of remote support with an internet based communication platform. A total cardiac arrhythmias 25 patients (Male: 10 cases, Female: 15 cases) with different arrhythmias such as Atrial fibrillation (1 case), Atrial flutter (5 cases), Atrial tachycardia (2 cases), Right and Left Ventricular Arrhythmias (19 cases), having undergone ablation procedures between 2020 to 2022. Acute procedure success was obtained 25 cases, no complications. Our experience with remote support for electro-anatomic mapping for complex electrophysiological ablation procedures, showed the feasibility and safety of this approach. It increases the availability of technical support for reducing the costs. Remote support for electroanatomic mapping may therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemics. As a result of its advantages beyond COVID-19 pandemics related problems, it will likely play a greater role in the future.
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Drawing on 203 quantitative surveys with women workers in Cambodia and a further set of semi-structured interviews with 60 original participants, this paper is one of the very first to present empirically grounded research from garment workers on the financial challenges of navigating the first year of the COVID-19 pandemic. We show how in the making of clothes to be worn by Western consumers, poorly paid garment workers are reducing their eating to repay long-term debts and those newly taken on to cope with wage reductions resulting from factory closures, suspensions, and cuts in working hours. In its examination of this phenomenon, the paper improves understanding of the gendered contingencies of the COVID-19 pandemic and the ‘wearing out' of garment workers through their attempts to reproduce life under (pre-existing) conditions of privation. We argue that the debt-hunger nexus is not new but reflects problems within Cambodia's capitalist development, and capitalism itself, as the costs of social reproduction and risk are privatised and financialised in the body politic. The COVID-19 pandemic is consolidating relations with financialised life such that they will outlast its duration and have long-lasting implications for workers and their families globally.
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SARS-CoV-2 was first identified in humans in December 2019 and has since affected almost 68 million people causing over 1.5 million deaths worldwide. Animal-to-human and animal-to-animal transmission has been documented within farmed minks in several countries. SARS-CoV-2 has been identified in a farmed mink population in a number of countries. Some of the affected farms reported also workers SARS-CoV-2 infection and it is hypothesized that the mink farms were infected through human-mink transmission proving SARS-CoV-2 capability of reverse zoonosis. This Tripartite Risk Assessment, as a joint effort under the GLEWS+ initiative, completed with the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (OIE), evaluates the risk of introduction and spread of SARS-CoV-2 within fur farming systems as well as whether farmed fur animals could play a significant role in the spread of SARS-CoV-2 to humans via spillover. Additionally, using a One Health approach, the Tripartite evaluated the risk of the escaped minks leading to the establishment of a viral reservoir in susceptible wildlife populations. This work provides guidance to Members on this newly emerging threat.
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Land relations in the Mekong Region are marked by the densely populated and intensively cultivated lowlands and the more extensive settlement and cultivation areas in the uplands. Land-use changes in the lowlands and uplands are interlinked and are a key process of agrarian and environmental transition. The ‘tenure-scape' approach is introduced as a qualitative analysis combining integrated landscape approaches, governance and rights-based approaches, while underlining the centrality of legitimate tenure rights, limitations and obligations. This approach is used to analyze the impact of the Green Revolution and the global commodity boom, in particular the growth of rubber and coffee, on sustainability in the Mekong countries, i.e., Cambodia, Lao People's Democratic Republic, Myanmar and Viet Nam. The way forward points to the use of the elements of the ‘tenure-scape' approach to re-valuate the potential contribution of smallholder farmers to the wider physical and societal landscape. The ultimate goal is to go from transition to transformation toward a more secure, equitable future for those at risk of being excluded from effective access to, use of, and control over land, fisheries, forests and water resources, which are providing the basis for their livelihoods if the concession model of land-based investments were to be continued.
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Between 2020 and 2021, the COVID-19 pandemic severely strained health systems across countries, leaving millions without access to essential healthcare services. Immunization programs experienced a 'double burden' of challenges: initial pandemic-related lockdowns disrupted access to routine immunization services, while subsequent COVID-19 vaccination efforts shifted often limited resources away from routine services. The latest World Health Organization (WHO) and United Nations Children's Fund (UNICEF) estimates suggest that 25 million children did not receive routine vaccinations in 2021, six million more than in 2019 and the highest number witnessed in nearly two decades. Recovering from this sobering setback requires a united push on several fronts. Intensifying the catch-up of routine immunization services is critical to reach children left behind during the pandemic and bridge large immunity gaps in countries. At the same time, we must strengthen the resilience of immunization systems to withstand future pandemics if we hope to achieve the goals of Immunization Agenda 2030 to ensure vaccinations are available for everyone, everywhere by 2030. In this article, leveraging the key actions for sustainable global immunization progress as a framework, we spotlight examples of strategies used by five countries-Cambodia, Cameroon, Kenya, Nigeria, and Uganda-who have exhibited exemplar performance in strengthening routine immunization programs and restored lost coverage levels in the last two years of the COVID-19 pandemic. The contents of this article will be helpful for countries seeking to maintain, restore, and strengthen their immunization services and catch up missed children in the context of pandemic recovery and to direct their focus toward building back a better resilience of their immunization systems to respond more rapidly and effectively, despite new and emerging challenges.
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The years between 2018 and 2021 continued a pattern for Cambodia of a rolling back of democracy, human rights, and civil liberties, and saw the completion of the transition from a multi-party illiberal democracy to a one-party, authoritarian state. As attacks against political opposition increased, and political space was progressively closed, most commentators agreed that Cambodia had transitioned from competitive to authoritarian hegemony. The global COVID-19 pandemic saw a marked contraction of the economy, and its ability to recover remains to be seen. Foreign relations with the US and EU, already seriously deteriorated by 2018, continued to decline, and dependence on China increased, bringing unease to nations in the region and further afield. Recognising growing dissatisfaction among the population, the ruling party took measures to secure future control through varying means, including some efforts to address corruption, widening patronage networks, and co-opting youth groups to the party. A cabinet reshuffle brought younger blood into key political positions, and health diplomacy due to the pandemic offered means for Cambodia to smooth over tense international relations. However, at the end of 2021, the Cambodian Prime Minister remained defiant of international opinion and pressure, and looks set to continue his authoritarian, politically violent, rule.
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The temporary shift from face-to-face instruction to online teaching at North American universities as an alternative solution in response to the COVID-19 pandemic brought significant challenges to international students who had to study abroad from their home countries. Studies on how international students perceive their study-abroad-from-home experiences in such an emergency remote teaching (ERT) context remain scarce. Through the lens of community of inquiry and an additional perspective of emotional presence, this study explored 13 first-year international graduate students' perceptions and experiences of their learning in ERT. Based on the analyses of the pre-learning questionnaire survey results and a series of three reflection journal entries, the study finds that teaching presence has played a vital role in shaping students' understanding and experiences when they participated in a study-abroad graduate program from their home countries. In addition, the participants demonstrated mixed emotions of both frustration and appreciation/thankfulness as well as an isolation-connectedness emotional trajectory during their learning process. The study inspires an exploration of more diverse options for international education programs and continued effort in providing institutional support to ensure better learning experiences in a post-COVID community of inquiry.
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Introduction: As COVID-19 spread across Southeast Asia (SEA) in 2020-2021, healthcare systems in Cambodia, Laos and Myanmar braced as public health officials closed many outpatient diabetes clinics and healthcare professionals (HCPS) were redeployed to COVID-treatment zones. Action 4 Diabetes (A4D) is a UK non-profit organisation that has been providing free insulin and medical supplies to LMICs in SEA since 2016. With historically limited healthcare coverage in Cambodia, Laos and Myanmar, patients enrolled on A4D's programme travel hundreds of miles to diabetes clinics to collect free insulin, blood glucose strips and other medication. Due to COVID-19 lockdowns, insulin often arrived with short expiry dates due to delays in shipments caused by bottlenecks at international logistic hubs, and patients were known to ration insulin due to lack of supply. For disadvantaged people with Type 1 diabetes (T1D) in SEA low-middle-income countries (LMICs), this posed a serious threat due to inaccessible insulin and medical supplies. Method(s): A4D developed a strategic plan to maintain insulin and medical supplies to LMICs in collaboration with local HCPs on the ground to ensure that the T1D community regained access to insulin and essential medical supplies, as well as supporting the development of remote-consultation with patients. Result(s): Access to medical supplies A4D initiated networks of couriers to rural parts of Myanmar, Laos and Cambodia to deliver medical supplies. In Cambodia, TukTuk drivers who ferried tourists around Angkor Wat were used to deliver insulin to the T1D in farming communities. In Myanmar, truck drivers that transported vegetable crops were used to transport medical supplies to remote areas. During COVID-19, A4D used local suppliers for insulin and had to purchase insulin and blood testing strips at a premium rate. Access to education and consultation Prior to COVID-19, clinic visits were a primary source of advice and management for the patient and family. With clinic closures, A4D initiated remote access consultation working with local HCPs to support disadvantaged families. By end 2021, 3 deaths were reported of patients on the A4D programme as result of the pandemic, and incidence of diabetic ketoacidosis rose sharply among the 350 people with T1D on A4D's programme. Conclusion(s): For many disadvantaged people with T1D in SEA, the COVID-19 pandemic reinforced the fragile nature of their T1D management. Through collaborating closely with HCP and partners on the ground, A4D has developed a more dynamic and resilient logistical system to maintain key life-saving medical supplies.
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Background: Since the beginning of the coronavirus 2 pandemic in 2019, incidence of influenza infections has significantly decreased mainly due to the COVID-19-related protective measures. We aimed to evaluate the prevalence of serum antibodies against Influenza A and B in kidney transplant recipients (KTRs) and health-care workers (HCWs) before and after receiving the 2021-2022 season vaccine. Methods or Case description: In prospectively collected preand postvaccination sera from KTRs (n = 75) and HCWs (n = 28), vaccinated with Fluarix tetra, IgG antibodies against influenza hemagglutinins of the strains included in the 2021-2022 vaccine (A/Victoria/H1N1;A/Cambodia/H3N2;B/Washington;B/PHUKET) were measured by ELISA. Same measurements were performed in the sera from unvaccinated KTRs (n = 28) and HCWs (n = 11) at 3-month interval during the same season. The half maximal effective dilution (ED50) was measured for all sera and fold-change variation of ED50 values before and after vaccination were calculated. Results or Learning points: ED50 values of IgG against each strain from the serially collected sera are shown in Figure 1. Almost all study participants showed antibodies to all four strains prior to vaccination, whereby the ED50 values were mostly higher in the HCWs. There was no significant increase of ED50 values after vaccination in both KTRs and HCWs, and the increase was comparable in KTRs and HCWs. Unvaccinated subjects, especially HCWs, showed a slight increase of ED50 values over a 3-month interval, although this variation was not significant. During the study period no influenza infection was selfreported or diagnosed in all the enrolled subjects. Conclusion(s): In our cohorts of KTRs and HCWs, we were able to show a wide prevalence of pre-vaccination antibodies against influenza vaccine strains of 2021-2022 season. IgG levels were significantly higher in HCWs compared to KTRs. There was no significant increase of antibodies after vaccination in both KTRs and HCWs.
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While several agricultural technologies have been successfully piloted on research stations or with small numbers of early adopters in Cambodia, questions remain on how to extend these technologies to large numbers of resource-poor smallholders. The objectives of the Scaling Suitable Sustainable Technologies Project (S3-Cambodia) are to examine pathways for scaling sustainable intensification (SI) technologies to smallholder farmers by promoting vegetable grafting, post-rice secondary cropping, and wild food plant gardens. S3-Cambodia is scaling these technologies through two pathways: the private sector and youth engagement. The private sector pathway involves strengthening the participation of farmers, women's groups, cooperatives, and community organizations in local and regional value chains for SI-produced horticulture crops. The youth engagement pathway involves piloting "green labs” in secondary schools to provide students with experiential learning and training on these SI technologies, allowing school communities to evaluate new practices before applying them at the field- or farm-scale. Early results indicate that both pathways are a viable approach to scaling agricultural technologies to new users. To date, 345 individuals have received training on SI technologies and three nurseries have been supported to expand their SI production. Market survey data from farmers and retailers suggest a significant market demand for grafted tomato plants during the wet season and traditional wild food plants (WFP) year-round. Household survey and interview data from high school parents, principals, and teachers point to the likelihood of agricultural knowledge transfer from student "green labs” to school communities. While COVID-19 has disrupted certain scaling efforts, initial project activities provide a research and evidence base to support the next steps in the long term scaling up of SI among rice-based farming systems throughout Cambodia and the wider Southeast Asia region. © 2022 International Society for Horticultural Science. All rights reserved.
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Cambodia is among the countries with the lowest incidence rate of reported COVID-19 cases. However, the global economic turmoil is generating deep economic and social implications within its borders. This chapter discusses the emerging socioeconomic challenges along with the government intervention in response to the new scenario. The macroeconomic analysis covers the main channels whereby the Cambodian economy is deteriorating and discusses how the country's rebound is subject to the performance of its major allies. Likewise, the chapter delves into the microeconomic effects, emphasising the subsequent social ramifications, especially among the most vulnerable demographics. It is argued that the current government measures are insufficient to mitigate the growing poverty levels and needs of the population. © 2022 by World Scientific Publishing Co. Pte. Ltd.
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Background. There is growing recognition of metagenomic next-generation sequencing (mNGS) as a valuable diagnostic tool capable of providing unbiased pathogen detection, but data on performance in low-resource settings remains scant. Here, we use mNGS of nasopharyngeal (NP) swabs taken from subjects in Cambodia to identify potential pathogens causing acute febrile illness. Methods. Febrile subjects aged 2 months to 65 years were enrolled in a crosssectional study conducted across 4 tertiary hospitals in Cambodia. NP swabs were collected at hospital presentation. Depending on reported symptom constellations, sera was also taken in a subset of subjects for comparison of mNGS results. RNA was isolated from biosamples, converted to cDNA libraries, and sequenced on a NextSeq2000 (Illumina). Raw sequence reads were stripped for host reads and aligned to NCBI nucleotide and protein databases using a cloud-based bioinformatics platform (CZID). Results. NP swabs were collected from 97 subjects between April 2020 and June 2021. Subjects were predominantly male (53.6%) and young (median age 3 years [IQR 1-25]). Pathogens were identified in 42 (43.2%) NP swabs;of these, 26 (61.9%) were respiratory viruses including 9 rhinovirus, 7 coronavirus (1 SARS-CoV-2), and 5 respirovirus cases. Co-infection was identified in 3 subjects with coronavirus and respirovirus (N=2) and coronavirus and rhinovirus (N=1). Of subjects with paired sera and NP samples (N=61), 18 (29.5%) had positive NP swabs but negative sera, 7 (11.5%) had negative NP swabs but positive sera, 12 (19.7%) had positive NP swabs and sera, and 24 (39.3%) had negative NP swabs and sera. Pathogen hits correlated in NP swabs and sera in 10 of 12 subjects, including six subjects with chikungunya. Conclusion. mNGS can be successfully implemented in low-resource settings to identify emerging pathogens and common respiratory pathogens, including coinfecting pathogens, from NP swabs of febrile patients. mNGS may also be able to detect chikungunya from NP swab alone, raising the possibility of non-invasive diagnostics for infections associated with high viremic states.