Displaying publications 1 - 20 of 21 in total

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  1. La N, Leng M, Rattanapitoon K, Pechdee P, Boonsuya A, Arunsan P, et al.
    Trop Biomed, 2022 Dec 01;39(4):539-546.
    PMID: 36602213 DOI: 10.47665/tb.39.4.009
    Many species of helminths and protozoa caused intestinal parasitic infections (IPIs). It belongs to neglected tropical diseases (NTDs) and remains a major public health problem in several Southeast Asian countries. The present study aimed to investigate the prevalence of IPIs and associated risk factors among the population in Kratie Province in northeastern Cambodia and Phnom Penh is the capital that locates in southern Cambodia. Fecal specimens (n=366) were collected in 10 villages in Kratie Province and Phnom Penh from 2019 to 2021. They were processed using the formalin ethyl-acetate concentration technique (FECT) to investigate parasites at egg and cyst stages and then examined under a light microscope. The results revealed that the prevalence of IPIs among the population in Kratie Province (n=317) and Phnom Penh (n=49) was 16.12% (n=59); of Kratie Province (n=50, 13.66%) and Phnom Penh (n=9, 2.46%), 12.02% (n=44) were helminths and 4.10% (n=15) were protozoa. The parasitic infection rate was higher in males (9.02%) than in females (7.10%) and more likely to be due to helminths (7.38%) than protozoa (1.64%). Prevalence of Opisthorchis viverrini was the highest (5.74%), followed by those of Entamoeba coli (4.10%), hookworm (3.83%), Ascaris lumbricoides (1.10%), Hymenolepis nana (1.09%), Taenia spp. (0.54%), Trichuris trichiura (0.55%), and Enterobius vermicularis (0.27%), respectively. Moreover, O. viverrini infection was the most common infection in the <20-year age group in Kratie Province. In addition, the bivariate and multivariate analyses showed that the association between gender. Gender was a significant risk factor positively associated with O. viverrini and hookworm infections (ORadj=0.318, 95% CI=0.122-0.8270, P=0.019 and ORadj=0.085, 95% CI=0.017-0.436, P=0.003, respectively). In conclusion, the IPIs were highly prevalent, especially O. viverrini and hookworm infections, among the population in Cambodia. These IPIs impact the public health burden but can be prevented by education regarding good sanitary practices in this community.
    Matched MeSH terms: Cambodia/epidemiology
  2. Loo KW, Gan SH
    Int J Stroke, 2013 Aug;8(6):475-8.
    PMID: 22973861 DOI: 10.1111/j.1747-4949.2012.00868.x
    In Cambodia, stroke is not ranked among the top 10 leading causes of death, but infectious disease are among the top three leading causes of death. This finding could be attributed to a lack of awareness among Cambodians of the signs and symptoms of stroke or to poor reporting, incomplete data, lack of neurologists and neurosurgeons, or low accessibility to the hospitals. The only study of stroke in Cambodia is the Prevalence of Non-Communicable Disease Risk Factors in Cambodia survey, which identified several stroke-related risk factors in the population. Tobacco chewing or smoking is the main risk factor for stroke in Cambodia. Traditional therapies, such as oyt pleung (moxibustion) and jup (cupping), are widely practiced for stroke rehabilitation. In Cambodia, there are few neurologists and few important equipment, such as magnetic resonance imaging machines and computed tomography scanners. The Cambodian government should cooperate with the World Health Organization and the United Nations Children's Fund to attract foreign expertise and technologies to treat stroke patients.
    Matched MeSH terms: Cambodia/epidemiology
  3. La N, Leng M, Arunsan P, Pechdee P, Boonsuya A, Thanchonnang C, et al.
    Trop Biomed, 2023 Dec 01;40(4):383-391.
    PMID: 38308824 DOI: 10.47665/tb.40.4.002
    The southeast Asian fluke Opisthorchis viverrini remains endemic, particularly in Thailand, Lao PDR, Cambodia, Vietnam, and Myanmar. However, there is a lack of data on the prevalence of liver fluke infection in Kratie Province in northeastern Cambodia. The present study aimed to detect O. viverrini DNA in fecal specimens by using the internal transcribed spacer 2 (ITS2) region of ribosomal DNA (rDNA) based on polymerase chain reaction (PCR). The prevalence and percentage of O. viverrini infection were described by data analysis. Bivariate binary logistic regression analysis was used to look at the related prevalence of O. viverrini infection. A total of 6.89% from 377 fecal samples were found positive of O. viverrini DNA. The prevalence of O. viverrini infection was found to be higher in men (8.92%) than in women (5.45%), and to be associated more frequently with younger age groups (13.40%), illiteracy (8.74%), participation in other careers (non-specific occupations) (11.63%), and residence in the Trapaing Srae village (9.94%) of the Snuol district, Kratie Province. Age groups under 20 years old were significantly linked with O. viverrini infection, with ORadj=0.601, 95% CI=0.410-0.882, p=0.009 and significant value established at (P<0.05). This study demonstrates that O. viverrini infection is distributed in rural areas located near freshwater reservoirs. Therefore, active surveillance, clinical examination of association with hepatobiliary, cholangiocarcinoma, and health education are needed.
    Matched MeSH terms: Cambodia/epidemiology
  4. Hashim JH, Radzi RS, Aljunid SM, Nur AM, Ismail A, Baguma D, et al.
    Sci Total Environ, 2013 Oct 1;463-464:1210-6.
    PMID: 23759330 DOI: 10.1016/j.scitotenv.2013.04.084
    Natural, inorganic arsenic contamination of groundwater threatens the health of more than 100 million people worldwide, including residents of the densely populated river deltas of South and Southeast Asia. Contaminated groundwater from tube wells in Cambodia was discovered in 2001 leading to the detection of the first cases of arsenicosis in 2006. The most affected area was the Kandal Province. The main objective of this study was to determine the prevalence of arsenicosis in Cambodia based on acceptable criteria, and to investigate the use of hair arsenic as a biomarker not only for arsenicosis-related signs but also for associated symptoms. A cross-sectional epidemiological study of 616 respondents from 3 purposely selected provinces within the Mekong River basin of Cambodia was conducted. The Kandal Province was chosen as a high arsenic-contaminated area, while the Kratie Province and Kampong Cham Province were chosen as moderate and low arsenic-contaminated areas, respectively. The most prevalent sign of arsenicosis was hypomelanosis with a prevalence of 14.5% among all respondents and 32.4% among respondents with a hair arsenic level of ≥1 μg/g. This was followed by hyperkeratosis, hyperpigmentation and mee's lines. Results also suggest a 1.0 μg/g hair arsenic level to be a practical cut off point for an indication of an arsenic contaminated individual. This hair arsenic level, together with the presence of one or more of the classical signs of arsenicosis, seems to be a practical criteria for a confirmed diagnosis. Based on these criteria, the overall prevalence of arsenicosis for all provinces was found to be 16.1%, with Kandal Province recording the highest prevalence of 35.5%. This prevalence is comparatively high when compared to that of other affected countries. The association between arsenicosis and the use of Chinese traditional medicine also needs further investigation.
    Matched MeSH terms: Cambodia/epidemiology
  5. Singh PN, Kheam T, Lopez J, Job JS, Yel D
    Asia Pac J Public Health, 2013 Sep;25(5 Suppl):54S-63S.
    PMID: 23666842 DOI: 10.1177/1010539513487014
    Although current trends indicate that the rate of cigarette smoking tends to be low among women in the Western Pacific Region (<10%), recent epidemiologic data from South Asia (India, Bangladesh) and Southeast Asia (Cambodia, Vietnam, Indonesia, Malaysia) identify that a large proportion of women of reproductive age and older chew tobacco--often as part of a betel quid mixture that includes other potentially harmful ingredients (eg, areca nut). Our findings from currently pregnant women identified during a nationwide survey of adult tobacco use in Cambodia indicate that 13.0% (95% confidence interval [CI] = 8% to 17%) were current users of smoked or smokeless (in the form of a betel quid) tobacco. Most pregnant women who used tobacco indicated that their habit was either initiated (29.1%; 95% CI = 16.3-46.3) or increased (33.7%; 95% CI = 18.3-53.5) during pregnancy. Pregnancy-related symptoms such as morning sickness were reported as the reason for more than half (54.9%; 95% CI = 34.8-73.4) of the currently pregnant users to have started a tobacco habit during their lifetime. Among those pregnant women who did not use tobacco, we found strong associations (odds ratios from 2 to 14) with beliefs about the harmful effects of tobacco on adult health, faith-based beliefs in addictive substances, and beliefs that influential members of the community, health professionals, and children should not use tobacco. Our findings indicate that tobacco cessation and prevention programs in Cambodia should specifically target pregnant and reproductive-age women.
    Matched MeSH terms: Cambodia/epidemiology
  6. Phan K, Kim KW, Huoy L, Phan S, Se S, Capon AG, et al.
    Environ Geochem Health, 2016 Jun;38(3):763-72.
    PMID: 26298061 DOI: 10.1007/s10653-015-9759-z
    To evaluate the current status of arsenic exposure in the Mekong River basin of Cambodia, field interview along with urine sample collection was conducted in the arsenic-affected area of Kandal Province, Cambodia. Urine samples were analyzed for total arsenic concentrations by inductively coupled plasma mass spectrometry. As a result, arsenicosis patients (n = 127) had As in urine (UAs) ranging from 3.76 to 373 µg L(-1) (mean = 78.7 ± 69.8 µg L(-1); median = 60.2 µg L(-1)). Asymptomatic villagers (n = 108) had UAs ranging from 5.93 to 312 µg L(-1) (mean = 73.0 ± 52.2 µg L(-1); median = 60.5 µg L(-1)). About 24.7 % of all participants had UAs greater than 100 µg L(-1) which indicated a recent arsenic exposure. A survey found that females and adults were more likely to be diagnosed with skin sign of arsenicosis than males and children, respectively. Education level, age, gender, groundwater drinking period, residence time in the village and amount of water drunk per day may influence the incidence of skin signs of arsenicosis. This study suggests that residents in Kandal study area are currently at risk of arsenic although some mitigation has been implemented. More commitment should be made to address this public health concern in rural Cambodia.
    Matched MeSH terms: Cambodia/epidemiology
  7. Centers for Disease Control and Prevention (CDC)
    MMWR Morb. Mortal. Wkly. Rep., 1999 Jan 22;48(2):29-33.
    PMID: 9933126
    In 1988, the World Health Assembly resolved to eradicate poliomyelitis globally by 2000. A plan of action for polio eradication in the Western Pacific Region (WPR) by 1995 was adopted in 1990. The plan was based on routine and supplemental vaccination activities with oral poliovirus vaccine (OPV) and acute flaccid paralysis (AFP) surveillance in the eight countries where polio was endemic (Cambodia, China, Laos, Malaysia, Mongolia, Papua New Guinea, Philippines, and Vietnam). Regionwide, the number of reported polio cases decreased from approximately 6000 in 1990 to zero in 1998. This report describes the extensive efforts to eliminate the last chains of poliovirus transmission in the Mekong River area.
    Matched MeSH terms: Cambodia/epidemiology
  8. Dinh TC, Bac ND, Minh LB, Ngoc VTN, Pham VH, Vo HL, et al.
    Eur J Clin Microbiol Infect Dis, 2019 Sep;38(9):1585-1590.
    PMID: 31044332 DOI: 10.1007/s10096-019-03563-6
    Vietnam, Laos, and Cambodia have reported first cases of Zika virus (ZIKV) infection since 2010 (Cambodia) and 2016 (Vietnam and Laos). One case of ZIKV-related microcephaly was recognized among a hundred infected cases in these areas, raising a great concern about the health risk related to this virus infection. At least 5 cases of ZIKV infection among travelers to Vietnam, Laos, and Cambodia were recorded. It is noticeable that ZIKV in these areas can cause birth defects. This work aims to discuss the current epidemics of ZIKV in Vietnam, Laos, and Cambodia and update the infection risk of ZIKV for travelers to these areas.
    Matched MeSH terms: Cambodia/epidemiology
  9. Horn R, Heng C, Chea C, Sieng C, Louv C, Turton B, et al.
    Gerodontology, 2018 Mar;35(1):45-50.
    PMID: 29226455 DOI: 10.1111/ger.12315
    OBJECTIVE: Older adults (those above the age of 60) are an emerging demographic in Cambodia, and very little is understood about their oral health experiences, needs, perceptions and behaviours. The aim of this study was to explore the oral health experiences, practices and perceptions of a convenience sample of a small but diverse group of older adults in Cambodia.

    METHOD: A cross-sectional qualitative study in which focus group interviews were conducted by 5 trained senior Cambodian dental students. A convenience sample of 56 older adults and caregivers was recruited across urban, semi-urban and rural locations. Focus group conversations were recorded, transcribed and analysed thematically.

    RESULTS: The themes that emerged were around low expectations for both general health and oral health. A communal responsibility for health was expressed, and both money and transport were identified as key barriers to accessing care. Participants recognised that they had oral health problems, and acknowledged the impact of poor oral function on health and nutrition.

    CONCLUSION: This study is an important first step in better understanding the oral health experiences and perceptions of older people in Cambodia. Participants described the impacts of poor oral health as being important, even when compared with other general health conditions.

    Matched MeSH terms: Cambodia/epidemiology
  10. Chen MY, Lee CN
    Adv Pharmacol, 2000;49:417-36.
    PMID: 11013770
    Matched MeSH terms: Cambodia/epidemiology
  11. Phan K, Kim KW, Hashim JH
    Environ Res, 2014 Nov;135:37-41.
    PMID: 25262072 DOI: 10.1016/j.envres.2014.07.031
    We investigated relationship of arsenicosis symptoms with total blood arsenic (BAs) and serum albumin (SAlb) of residents in the Mekong River basin of Cambodia. We found that arsenicosis patients had significantly higher BAs and lower SAlb than asymptomatic villagers (Mann-Whitney U test, p<0.01). Arsenicosis symptoms were found to be 76.4% (1.764 times) more likely to develop among individuals having an SAlb≤44.3gL(-1) than among those who had an SAlb>44.3gL(-1) (OR=1.764, 95% CI=0.999-3.114) and 117.6% (2.176 times) as likely to occur among those with BAs>5.73µgL(-1) than for those having BAs≤5.73µgL(-1) (OR=2.176, 95% CI=1.223-3.872). Furthermore, a significant negative correlation was also found between BAs and SAlb (rs (199)=-0.354, p<0.0001). As such, this study suggests that people with low SAlb and/or high BAs are likely to rapidly develop arsenicosis symptoms.
    Matched MeSH terms: Cambodia/epidemiology
  12. Roehler DR, Ear C, Parker EM, Sem P, Ballesteros MF
    Int J Inj Contr Saf Promot, 2015;22(2):165-71.
    PMID: 24499413 DOI: 10.1080/17457300.2013.876050
    This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007-2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.
    Matched MeSH terms: Cambodia/epidemiology
  13. Chher T, Hak S, Kallarakkal TG, Durward C, Ramanathan A, Ghani WMN, et al.
    Ethn Health, 2018 Jan;23(1):1-15.
    PMID: 27781495 DOI: 10.1080/13557858.2016.1246431
    OBJECTIVES: To obtain data on the prevalence of oral mucosal lesions (OMLs) among Cambodians, and to assess the relationship between known risk habits of oral diseases with prevalence of oral potentially malignant disorders (OPMDs).

    DESIGN: This was a population-based, cross-sectional study whereby subjects were adults aged 18 years old and above. A workshop on the identification of OML was held to train and calibrate dental officers prior to data collection in the field. Sociodemographic and risk habits data were collected via face-to-face interview, whilst presence of OML and clinical details of lesions such as type and site were collected following clinical oral examination by the examiners. Data analysis was carried out using the Statistical Package for Social Science (SPSS) version 12.0. The association between risk habits and risk of OPMD was explored using logistic regression analysis.

    RESULTS: A total of 1634 subjects were recruited. Prevalence of OML for this population was 54.1%. Linea alba was the most common lesion seen (28.7%). This study showed an overall OPMD prevalence of 5.6%. The most common type of OPMD was leukoplakia (64.8%), followed by lichen planus (30.8%). Subjects who only smoked were found to have an increased risk for OPMD of almost four-fold (RR 3.74, 95%CI 1.89-7.41). The highest risk was found for betel quid chewers, where the increased risk observed was more than six times (RR 6.75, 95%CI 3.32-13.72). Alcohol consumption on its own did not seem to confer an increased risk for OPMD, however when practiced concurrently with smoking, a significant risk of more than five times was noted (RR 5.69 95%CI 3.14-10.29).

    CONCLUSION: The prevalence of OML was 54.1%, with linea alba being the most commonly occurring lesion. Smoking, alcohol consumption and betel quid chewing were found to be associated with the prevalence of OPMD, which was 5.6%.

    Matched MeSH terms: Cambodia/epidemiology
  14. Hong SA, Peltzer K
    Subst Use Misuse, 2019;54(2):288-296.
    PMID: 30463459 DOI: 10.1080/10826084.2018.1517797
    BACKGROUND: Though alcohol and tobacco are the most commonly used substances among adolescents, little is known about the patterning of early adolescent substance use in Association of South-East Asian Nations (ASEAN) member states.

    OBJECTIVES: This study examined past month patterns of substances use and its gender difference among adolescents.

    METHODS: Cross-sectional samples among adolescents aged 13-16 years who completed the Global School-based Student Health Survey (GSHS) from eight ASEAN countries were included in the analysis (n = 40,212).

    RESULTS: Prevalence of past month any tobacco use was relatively high in Brunei, Indonesia, Malaysia, Thailand, and the Philippines (11-15%), but prevalence of dual cigarette and other forms of tobacco use was about 2-5% in the five countries. Past month alcohol consumption prevalence was also high in Thailand, Viet Nam, and the Philippines (16-24%), compared to the rest countries (1.4-8.2%). Moreover, prevalence of the concurrent alcohol and tobacco use was higher in Thailand and the Philippines (7 and 10%, respectively), particularly in boys (13 and 15%, respectively). Conclusions/importance: Almost 30-40% of the boys and 10-20% of girls in Malaysia, Philippines, Thailand, and Viet Nam are engaged in at least one of the two risk behaviors, and the concurrent alcohol and tobacco use was also relatively high among boys in those countries (5-15%). This study may provide some valuable insights on alcohol and tobacco policy in the region and requires to begin prevention and treatment programs in ASEAN member states.

    Matched MeSH terms: Cambodia/epidemiology
  15. Choi KS, Kye SJ, Kim JY, Damasco VR, Sorn S, Lee YJ, et al.
    Virus Genes, 2013 Oct;47(2):244-9.
    PMID: 23764918 DOI: 10.1007/s11262-013-0930-2
    Three isolates of Newcastle disease virus (NDV) were isolated from tracheal samples of dead village chickens in two provinces (Phnom Penh and Kampong Cham) in Cambodia during 2011-2012. All of these Cambodian NDV isolates were categorized as velogenic pathotype, based on in vivo pathogenicity tests and F cleavage site motif sequence ((112)RRRKRF(117)). The phylogenetic analysis and the evolutionary distances based on the sequences of the F gene revealed that all the three field isolates of NDV from Cambodia form a distinct cluster (VIIh) together with three Indonesian strains and were assigned to the genotype VII within the class II. Further phylogenetic analysis based on the hyper-variable region of the F gene revealed that some of NDV strains from Malaysia since the mid-2000s were also classified into the VIIh virus. This indicates that the VIIh NDVs are spreading through Southeast Asia. The present investigation, therefore, emphasizes the importance of further surveillance of NDV in neighboring countries as well as throughout Southeast Asia to contain further spreading of these VIIh viruses.
    Matched MeSH terms: Cambodia/epidemiology
  16. Shrestha AD, Vedsted P, Kallestrup P, Neupane D
    Eur J Cancer Care (Engl), 2020 Mar;29(2):e13207.
    PMID: 31820851 DOI: 10.1111/ecc.13207
    INTRODUCTION: Oral cancer is common cancer in many low- and middle-income countries (LMICs) with a low five-year survival rate. It is among the four most common types of cancer in South East Asia region. In South-Central Asia, lip and oral cavity cancer is the second most common cancer according to the specific cancer types.

    METHODS: This scoping review intended to investigate published studies on the current prevalence and incidence of oral cancer in LMICs. The review was conducted applying the search words "Oral Cancer" and "Mouth neoplasm" as the Medical Subject Heading (MeSH) major topic and "Epidemiology" and ("prevalence" OR "incidence") as the MeSH subheading; the search was supplemented by cross-references. Included studies met the following criteria: original studies, reporting of prevalence or incidence rates, population-based studies, studies in English language and studies involving humans.

    RESULTS: The sample sizes ranged from 486 to 101,761 with 213,572 persons included. Buccal mucosa is one of the most common sites of oral cancer, associated with the widespread exposure to chewing tobacco. The incidence is likely to rise in the region where gutkha, pan masala, pan-tobacco and various other forms of chewing tobacco are popular.

    CONCLUSION: This review contributes to useful information on prevalence and incidence estimates of oral cancer in LMICs.

    Matched MeSH terms: Cambodia/epidemiology
  17. Tan YL, Mackay J, Kolandai MA, Dorotheo EU
    Asian Pac J Cancer Prev, 2020 Jul 01;21(S1):23-25.
    PMID: 32649167 DOI: 10.31557/APJCP.2020.21.S1.23
    OBJECTIVE: This case series describes tobacco industry tactics and strategies used to interfere, derail, delay, and weaken the development of effective health warning regulations in Malaysia, Cambodia, the Philippines, and Hong Kong.

    METHODS: A historical review of official reports, news articles, and gray literature was undertaken to identify tobacco industry tactics and strategies to hamper government efforts in implementing stronger pictorial health warning regulations in four Asian jurisdictions (Cambodia, Hong Kong, Malaysia, and the Philippines).

    RESULTS: Nineteen countries/jurisdictions in the WHO Western Pacific region currently require pictorial health warnings on cigarette packs, including some of the world's largest, in line with the WHO Framework Convention on Tobacco Control Article 11 Guidelines. In the four jurisdictions examined, tobacco industry interference consisted of lobbying and misinformation of high-level government officers and policy-makers, distributing industry-friendly legislative drafts, taking government to court, challenging government timelines for law implementation, and mobilizing third parties. Strong political leadership and strategic advocacy enabled governments to successfully overcome this industry interference.

    CONCLUSION: The tobacco industry uses similar tactics in different jurisdictions to derail, delay, and weaken the implementation of effective health warning policies. Identifying and learning from international experiences can help anticipate and defeat such challenges.

    Matched MeSH terms: Cambodia/epidemiology
  18. Zhang L, Tao Y, Woodring J, Rattana K, Sovannarith S, Rathavy T, et al.
    Int J Epidemiol, 2019 08 01;48(4):1327-1339.
    PMID: 30879066 DOI: 10.1093/ije/dyz037
    BACKGROUND: The Regional Framework for Triple Elimination of Mother-to-Child Transmission (EMTCT) of HIV, Hepatitis B (HBV) and Syphilis in Asia and the Pacific 2018-30 was endorsed by the Regional Committee of WHO Western Pacific in October 2017, proposing an integrated and coordinated approach to achieve elimination in an efficient, coordinated and sustainable manner. This study aims to assess the population impacts and cost-effectiveness of this integrated approach in the Cambodian context.

    METHODS: Based on existing frameworks for the EMTCT for each individual infection, an integrated framework that combines infection prevention procedures with routine antenatal care was constructed. Using decision tree analyses, population impacts, cost-effectiveness and the potential reduction in required resources of the integrated approach as a result of resource pooling and improvements in service coverage and coordination, were evaluated. The tool was assessed using simulated epidemiological data from Cambodia.

    RESULTS: The current prevention programme for 370,000 Cambodian pregnant women was estimated at USD$2.3 ($2.0-$2.5) million per year, including the duration of pregnancy and up to 18 months after delivery. A model estimate of current MTCT rates in Cambodia was 6.6% (6.2-7.1%) for HIV, 14.1% (13.1-15.2%) for HBV and 9.4% (9.0-9.8%) for syphilis. Integrating HIV and syphilis prevention into the existing antenatal care framework will reduce the total time required to provide this integrated care by 19% for health care workers and by 32% for pregnant women, resulting in a net saving of $380,000 per year for the EMTCT programme. This integrated approach reduces HIV and HBV MTCT to 6.1% (5.7-6.5%) and 13.0% (12.1-14.0%), respectively, and substantially reduces syphilis MCTC to 4.6% (4.3-5.0%). Further introduction of either antiviral treatment for pregnant women with high viral load of HBV, or hepatitis B immunoglobulin (HBIG) to exposed newborns, will increase the total cost of EMTCT to $4.4 ($3.6-$5.2) million and $3.3 ($2.7-$4.0) million per year, respectively, but substantially reduce HBV MTCT to 3.5% (3.2-3.8%) and 5.0% (4.6-5.5%), respectively. Combining both antiviral and HBIG treatments will further reduce HBV MTCT to 3.4% (3.1-3.7%) at an increased total cost of EMTCT of $4.5 ($3.7-$5.4) million per year. All these HBV intervention scenarios are highly cost-effective ($64-$114 per disability-adjusted life years averted) when the life benefits of these prevention measures are considered.

    CONCLUSIONS: The integrated approach, using antenatal, perinatal and postnatal care as a platform in Cambodia for triple EMTCT of HIV, HBV and syphilis, is highly cost-effective and efficient.

    Matched MeSH terms: Cambodia/epidemiology
  19. Shearer FM, Huang Z, Weiss DJ, Wiebe A, Gibson HS, Battle KE, et al.
    PLoS Negl Trop Dis, 2016 Aug;10(8):e0004915.
    PMID: 27494405 DOI: 10.1371/journal.pntd.0004915
    BACKGROUND: Infection by the simian malaria parasite, Plasmodium knowlesi, can lead to severe and fatal disease in humans, and is the most common cause of malaria in parts of Malaysia. Despite being a serious public health concern, the geographical distribution of P. knowlesi malaria risk is poorly understood because the parasite is often misidentified as one of the human malarias. Human cases have been confirmed in at least nine Southeast Asian countries, many of which are making progress towards eliminating the human malarias. Understanding the geographical distribution of P. knowlesi is important for identifying areas where malaria transmission will continue after the human malarias have been eliminated.

    METHODOLOGY/PRINCIPAL FINDINGS: A total of 439 records of P. knowlesi infections in humans, macaque reservoir and vector species were collated. To predict spatial variation in disease risk, a model was fitted using records from countries where the infection data coverage is high. Predictions were then made throughout Southeast Asia, including regions where infection data are sparse. The resulting map predicts areas of high risk for P. knowlesi infection in a number of countries that are forecast to be malaria-free by 2025 (Malaysia, Cambodia, Thailand and Vietnam) as well as countries projected to be eliminating malaria (Myanmar, Laos, Indonesia and the Philippines).

    CONCLUSIONS/SIGNIFICANCE: We have produced the first map of P. knowlesi malaria risk, at a fine-scale resolution, to identify priority areas for surveillance based on regions with sparse data and high estimated risk. Our map provides an initial evidence base to better understand the spatial distribution of this disease and its potential wider contribution to malaria incidence. Considering malaria elimination goals, areas for prioritised surveillance are identified.

    Matched MeSH terms: Cambodia/epidemiology
  20. Horm SV, Mardy S, Rith S, Ly S, Heng S, Vong S, et al.
    PLoS One, 2014;9(10):e110713.
    PMID: 25340711 DOI: 10.1371/journal.pone.0110713
    BACKGROUND: The Cambodian National Influenza Center (NIC) monitored and characterized circulating influenza strains from 2009 to 2011.

    METHODOLOGY/PRINCIPAL FINDINGS: Sentinel and study sites collected nasopharyngeal specimens for diagnostic detection, virus isolation, antigenic characterization, sequencing and antiviral susceptibility analysis from patients who fulfilled case definitions for influenza-like illness, acute lower respiratory infections and event-based surveillance. Each year in Cambodia, influenza viruses were detected mainly from June to November, during the rainy season. Antigenic analysis show that A/H1N1pdm09 isolates belonged to the A/California/7/2009-like group. Circulating A/H3N2 strains were A/Brisbane/10/2007-like in 2009 before drifting to A/Perth/16/2009-like in 2010 and 2011. The Cambodian influenza B isolates from 2009 to 2011 all belonged to the B/Victoria lineage represented by the vaccine strains B/Brisbane/60/2008 and B/Malaysia/2506/2004. Sequences of the M2 gene obtained from representative 2009-2011 A/H3N2 and A/H1N1pdm09 strains all contained the S31N mutation associated with adamantanes resistance except for one A/H1N1pdm09 strain isolated in 2011 that lacked this mutation. No reduction in the susceptibility to neuraminidase inhibitors was observed among the influenza viruses circulating from 2009 to 2011. Phylogenetic analysis revealed that A/H3N2 strains clustered each year to a distinct group while most A/H1N1pdm09 isolates belonged to the S203T clade.

    CONCLUSIONS/SIGNIFICANCE: In Cambodia, from 2009 to 2011, influenza activity occurred throughout the year with peak seasonality during the rainy season from June to November. Seasonal influenza epidemics were due to multiple genetically distinct viruses, even though all of the isolates were antigenically similar to the reference vaccine strains. The drug susceptibility profile of Cambodian influenza strains revealed that neuraminidase inhibitors would be the drug of choice for influenza treatment and chemoprophylaxis in Cambodia, as adamantanes are no longer expected to be effective.

    Matched MeSH terms: Cambodia/epidemiology
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