Drug Resistance Monitoring in Cambodia

Sensitivity (S or S/RI) at 4 sentinel sites 1991 – 97 Western areas: Battambang, Pursat, Eastern areas:Ratanakiri, Kratie  Chloroquine (West): S or S/RI = 3-12% (East): S/RI = 76%-86%  Fansidar® (West): S or S/RI = 0-13% (East): S or S/RI = 57-80%  Quinine and Tetracycline (All areas):S/RI = 100 %  Mefloquine monotherapy: (West): S or S/RI = 80%-97% (East): S or S/RI = 100%

Drug Resistance Monitoring in Cambodia 1998  No study  Lack of budget  Lack of human resources due to Dengue due to Dengue epidemic outbreak

Mefloquine25mg Drug Resistance of Chloroquine & Mefloquine Monotherapy 1999 Sampov Loun Rovieng Mefloquine25mg Chloroquine Mefloquine25mg/kgw

Drug Resistance Artecom in Cambodia 1999 Sampov Loun snoul Artecom(Art.+piperaq.+trimetho prime) 2days,28days follow up

Drug Resistance of A+M in Cambodia 2000 Sampov Loun Oral,Kg Speu

Samlot Snoul Drug Resistance of A+M Monitoring2001

Drug Resistance of Artekine 2 & Coarterm 2001 Anlong Veng Artekine Artekine Coarterm 38 15

N=82 Drug Resistance Monitoring A+M in Cambodia 2002 N=36 N=75 Preah Vihear Pailin Veal Veng Ratanakiri Snoul

Drug Resistance of Artekine 2 & Coarterm in Cambodia 2002 Sampov Loun Snoul Coarterm N=55 N=65 Artekine 2.

Drug Resistance Monitoring A+M in Cambodia 2003 Name of sites No. of enrollment Drop outACPRLTF Oral97 (64.7%) 06 (6.2%) 88 (96.7%) 03 a (3.3%) Anlong Veng 92 (61%) 02 (2.2%) 88 (97.8%) 02 b (2.2%) Snoul66 (41.8%) 03 (4.5%) 63 (100%) 0 Sampov loun 55 (21%) 03 (5.5%) 48 (92.7%) 4 c (7.3%) a = PCR confirmed all cases are recrudescing b = Showed that both are re – infection c = PCR confirmed all cases are recrudescing PCR were done by Institute Pasteur of Cambodia

Drug Resistance Monitoring at sentinel sites, Cambodia 2002 & 2003 YearName of sitesNo. of enrollment ACPR (%)LTF (%) 2002Pailin Pursat Prah vihear Rattanakiri Battambang Kg. Speu Kratie O. M. Chey

Sentinel sites of drug resistance monitoring in Cambodia

Conclusion The result showed the sensitivity of A+M still high (ACPR = 92 – 100%) each sentinel site if we compared to the result of previous study. So The A+M can be continue as drug for our first line treatment of malaria.

Test system Days Othe r day Clinical examinationXXXXXXXXX Axillary TemperatureXXXXXXXXX Treatment A+M A=12mg/kg, for 3days M=25mg/kg on day0 X A+M XAXA XAXA ParasitemiaXXXXXXXXX Blood spot (PCR) Blood sampling ( For In Vitro test) XXXX XXX

Thank you for your attention