Southeast Asia's Slums Blamed for Recent Dengue Epidemic

23 September 2004
By Corinne Purtill

A nationwide survey of malaria control in Cambodia will begin soon in the country's most vulnerable areas, study organizers and health officials said this week.
Its results will help the Global Fund for AIDS, Tuberculosis and Malaria evaluate the country's progress against malaria, and consequently determine whether Cambodia receives the rest of the money it was conditionally promised.

"This study will show the malaria prevalence in the whole country," said Duong Socheat, director of the National Malaria Center, on Wednesday.
The eight-week study, which begins in early October, will interview residents of 90 randomly selected villages to determine who's getting malaria, when and how patients seek treatment and the ways villagers protect themselves, including the extent of bed net use.

In an additional 180 villages, only children will be tested for malaria to get a broader picture of the scope of the disease.

All of the 90 target villages and most of the 180 are located within 2 km of forest areas the country's hotbed of malaria transmission.

"We know that the mosquitoes that bite with malaria are closely associated with the forest. It's exactly how near is near [for villages to be at risk for malaria] that we're trying to quantify," said Jo Lines, head of the British aid agency DFID's Malaria Knowledge Program at the London School of Hygiene and Tropical Medicine.

Lines, team leader Sylvia Meek of the NGO Malaria Consortium and Jane Bruce, a statistician at the London School, are in Cambodia now to develop the study's methodology and interview process. The actual survey will be conducted by a separate agency.

The roughly $140,000 study funded by a pool of donors including the National Malaria Center and the World Health Organization was part of the country's second round proposal to the Global Fund, an independent financial body of international donors that gives money to programs fighting malaria, tuberculosis and AIDS, Duong Socheat said.

In 2003, the Global Fund awarded Cambodia $5 million for malaria over five years, with $2.7 million given in the first two years. The fund will review the country's progress at the end of that period and will release the remainder of the grant if satisfied.

With the enormous global shortfall in donor money for malaria, "the Global Fund itself is very anxious to determine that their money is effective," Meek said Tuesday. The study will serve as a baseline from which to measure the impact of Global Fund-supported projects, Duong Socheat said.

Although the study is the most comprehensive nationwide survey yet of the malaria-infested wooded areas, the rapid erosion of Cambodia's forests could have an impact on the survey's results.

The team is relying on a map of Cambodian forests that was last updated in 2002, Meek said. With the country's swift rate of deforestation, "it is possible" that villages located within 2 km of a forested area two years ago no longer are, Meek said.