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Cambodia's Inspiring Journey to Malaria Elimination
Cambodia has made remarkable progress in its fight against malaria, reducing cases significantly from 7.4 per 1,000 population in 2006 to an astounding 0.02 per 1,000 population in 2024. With zero malaria-related deaths reported since 2018, Cambodia's commitment is inspiring and attaining malaria elimination by 2025 is within sight.
Focus on Forest Workers
While Cambodia has made significant strides in reducing malaria cases, the disease is now concentrated among high-risk groups, particularly forest-goers. These individuals face limited access to healthcare and increased exposure to infected mosquitoes, making them especially vulnerable. These challenges have prompted the launch of the Intensified Plan (IP) in 2018.
Targeted Approach on Hotspots
The IP targets malaria hotspots with enhanced coordination and aggressive efforts to reduce parasite reservoirs. Mobile Malaria Workers (MMWs) are dispatched to specifically focus on forest-goers, distributing insecticide-treated nets, "forest packs" along with providing rapid diagnostic tests and treatment.
As part of the IP, Trained Forest Malaria Workers (FMWs) also stepped up to administer Intermittent Preventive Treatment (IPTf) – filling the gaps that addressed challenges and limitations faced by MMWs. Over a two-year period, this has led to significant decrease in malaria prevalence. The impact has been profound as P. falciparum cases dropped sharply, culminating in zero indigenous cases reported in 2024.
Remaining Challenges
Despite these successes, the persistence of P. vivax, particularly in forested provinces, remains a concern. It requires continuous attention to ensure progress made is not undermined. In addition, the risk of malaria reintroduction underscores the need for continuous surveillance and robust tracking of cases. Strengthening local health systems and fostering community engagement are crucial steps to maintain achieved gains.
Social Inclusion
Social inclusion strategies too, have been vital to Cambodia's malaria elimination efforts. The National Center for Parasitology, Entomology and Malaria Control (CNM) and its partners have implemented a range of initiatives including the reconstitution of the village malaria workers program involving community health workers and mobile malaria to tailor resources for vulnerable populations. These socially inclusive approaches have been instrumental in reaching and protecting high-risk populations.
Conclusion
Cambodia's coordinated and targeted interventions thus far have been effective in reducing malaria incidence among forest-goers. However, addressing the challenges posed by P. vivax and the risk of reintroduction requires greater sustained commitment and innovative approaches. As Cambodia continues its journey towards being malaria-free by 2025, the dedication and efforts of all stakeholders will be crucial in safeguarding the health of its people, particularly those living in remote forested areas.
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