Cambodia Plagued by Different Types of Malaria

For so tiny a creature with such an odd name and appearance, the anopheles has sure done an enormous amount of damage in Cambodia.

The culprit, to be more precise, is the female member of the anopheles--the type of mosquito whose bite is responsible for malaria.

To be more precise still, there are different distinct varieties of malaria recognized in Cambodia--plasmodium vivax and plasmodium falciparum.

The first type, p. vivax, produce symptoms most commonly associated with malaria -- fever, chills, sweating and aches. While such symptoms might easily be mistaken for the flu, treatment guidelines published jointly by Cambodia's Ministry of Health and the World Health Organization warn that the use of aspirin by malaria sufferers can be dangerous, actually worsening the effects of the disease.

As is widely known about p. vivax, after the initial outbreak of the disease, it goes dormant, then reoccurs in six to 11 months. This pattern repeats itself indefinitely.

But it is the other type of malaria, p. falciparum, which most worries medical authorities. By far the most common variety of the disease in Cambodia--accounting for more than 70 percent of all malaria cases here--p. falciparum is not reoccuring, which means that it is gone for good once treated.

The symptoms it produces, however, are typically far more serious than p. vivax or p. ovalae, including coma.

Dr. Ferdie Cruz, a malaria specialist at the Sihanouk Hospital--Center of Hope, says that each type of malaria can appear either as an uncomplicated case, or as a complicated or severe case.

Dr. Cruz adds that Cambodia is home to some of the most drug resistant forms of malaria ever known, which accounts for a set of Ministry of Health and WHO treatment methods which differ from those in other parts of the world. The most common treatment involves a widely used drug called Mefloquine.

If that proves unsuccessful--or for severe cases of p. falciparum, the third type of malaria--Quinine Dihydrochloride is used instead. For extreme cases of drug resistant malaria, medical authorities in Cambodia have begun using a new Chinese drug, Artemether, which has not seen widespread use elsewhere in the world. For children, there is an effective new drug called Artemisinin, which is available in suppository form.

Dr. Cruz says that one of the drugs used for the treatment of malaria, Chloroquine is also useful as a preventative measure against the disease.

He goes on to say, however, that it is effective primarily for people who do not ancticipate lengthly exposure to malaria--such as travelers passing through Cambodia--and not for residents.

"The idea is that if you're coming here, you take the drug weeks, or even months, beforehand," he says.

As far as Cambodians go, Dr. Cruz says that the favoured approach to prevention is to avoid mosquito bites-a combination of repellants and proper clothing, mosquito nets at night, and avoiding build up of stagnant waters where mosquitos will easily breed.