Malaria Program Focuses on Training of Private Doctors

December 2, 2004
By Corinne Purtill
A pilot program under way at the National Malaria Center has trained private doctors in some of the country's most remote areas to provide appropriate treatment to malaria patients, center officials said Wednesday.

Improper treatment of malaria is rife in the private sector, doctors said.

Rather than the nationally prescribed three-day treatment with Malarine, a drug that combines the anti-malarials artesunate and mefloquine, many private practitioners over- or under-medicate patients with inappropriate drugs, Dr Seshu Babu, an adviser to the malaria center said.

"We would like the private practitioners not to indulge in malpractice," he said.

The pilot program will provide the twofold benefit of improving the treatment provided at private clinics and help the malaria center collect information from the private sector, where the vast majority of ill Cambodians seek treatment, said Dr Lon Chanthap of the malaria center.

"A lot of patients use the private sector. That's why we need to get data from the private sector," Lon Chanthap said.

The malaria center held a workshop Monday to update health officials on the progress of the program, which trained 199 doctors in Pailin municipality and Kampot, Pursat and Stung Treng provinces, Babu said.

The clinicians started treating patients and gathering data for use by the malaria center at the end of July, Babu said.

Before the program, the center was able to collect data only from patients who went to public health facilities which only a tiny number of ill Cambodians do.
According to a survey conducted in late 2003 by the social marketing firm PSI, 79 percent of people suffering from malaria symptoms sought treatment at a private clinic or pharmacy. Only 17 percent went to a public health center.

Many private clinicians in remote areas are not updated on modern methods of malaria treatment, said Dr Yos Phanita of the Naga Clinic in Phnom Penh.
Medications such as intravenous drips of quinine a drug largely phased out in Southeast Asia, as malaria parasites here have developed resistance to it are still frequently prescribed, he said.

Of the 71,258 confirmed cases of malaria in Cambodia in 2003, 3,762 were in Pailin, 4,640 in Kampot, 7,032 in Pursat and 2,935 in Stung Treng, according to figures from the National Malaria Center.

The pilot program cost $79,242, paid for by the German Agency for Technical Cooperation.

If successful, the malaria center will ask for money to expand the program nationwide in its proposal to the Global Fund an international financial fund contributed to by international donors in 2005, Babu said.