MALARIA IN CAMBODIA

The Cambodian health authorities have reported an increase of 22.5% of malaria cases in 2003 representing more than 130000 cases for the last year.

Malaria remains a worrying problem of public health in this country with about 500000 Cambodians (more than 4% of the population), living in the forest areas (especially the Thai frontier, in the west) with a high level of transmission and a strong prevalence of malaria (15 to 40%).

In the rest of the country, especially in the plain and ricefield areas, malaria is present along the year but with a weak prevalence (below 3%). Only Phnom Penh, the capital, and the immediate surroundings of the Tonle Sap lake, Siem Reap, Sihanoukville are considered as unharmed. On the other hand, the touristic site of Angkor, the Islands off Sihanoukville and the region of Battambang are malaria-infected.

Our advises:

1. Anti-malarial prophylaxis with mefloquine (Lariam), in absence of contraindication, to be started 10 days before the departure and to be continued during the stay and 3 weeks after the return; alternatives (in absence of contraindication): atovaquone-proguanil combination (Malarone), or doxycycline (particularly in the border forest areas with Thailand).
2. Take the usual protections against mosquitos.
3. Important: in presence of an unexplained fever at your return, make mention to your doctor of your stay in Cambodia or in Asia.