WorldWideScience

Sample records for cambodia

  1. Cambodia.

    Science.gov (United States)

    1987-04-01

    The population of Cambodia stood at 6.25 million in 1986, with an average annual growth rate of 2.1%. Life expectancy is presently 42 years for men and 44.9 years for women. The government is currently disputed between resistance groups and Vietnamese-installed authorities in Phnom Penh. No single authority controls the entire country. The urban population increased sharply during the 1970-75 war, but after seizing power the Khmer Rouge forced most urban residents to return to rural areas as peasants. Massive numbers of people were executed for political reasons or died of starvation and disease during the Khmer Rouge period and after the dislocations caused by the Vietnamese invasion: an estimated 1.5-3 million people are estimated to have died out of a 1975 population of 7.3 million. The resistance forces have grown in size and effectiveness since 1985 and now challenge Vietnam's position in Cambodia. The Cambodian economy, badly damaged by the war and the Khmer Rouge regime, has only slowly begun to recover. Per capita gross national product (GNP) is estimated at less than US$100. The food situation remains precarious, with shortages of rice, meat, vegetables, sugar, flour, and dairy products. Extensive damage to the country's irrigation system, on which rice production depends, has only begun to be repaired. Basic services such as electricity and water are erratic. Although literacy and primary education campaigns have achieved success, health conditions remain poor.

  2. Cambodia's economy

    OpenAIRE

    Ear, Sophal

    2008-01-01

    "This presentation is adapted from a Harvard KSG workshop held earlier this year on the Political Economy of "Binding Constraints to Growth" Cambodia Pilot for which I served as an External Panelist/Resource Person."

  3. CDM Country Guide for Cambodia

    International Nuclear Information System (INIS)

    2005-01-01

    Under the Integrated Capacity Strengthening for the CDM (ICS-CDM) programme, IGES presents the CDM Country Guides, a series of manuals on CDM project development for Cambodia, China, India, Indonesia, the Philippines, and Thailand. These guidebooks aim at facilitating CDM project developments in Asia by providing essential information to both project developers and potential investors. This volume is on Cambodia

  4. Cambodia pits data against poverty

    International Development Research Centre (IDRC) Digital Library (Canada)

    to provide medicines and vaccines against the most common diseases — malaria and dengue, for instance, are widespread ... says, given that the cost of $50 000 to survey more .... used to prepare maps and monitor Cambodia's progress.

  5. Burden of stroke in Cambodia.

    Science.gov (United States)

    Loo, Keat Wei; Gan, Siew Hua

    2013-08-01

    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. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  6. Oncology in Cambodia.

    Science.gov (United States)

    Eav, S; Schraub, S; Dufour, P; Taisant, D; Ra, C; Bunda, P

    2012-01-01

    Cambodia, a country of 14 million inhabitants, was devastated during the Khmer Rouge period and thereafter. The resources of treatment are rare: only one radiotherapy department, renovated in 2003, with an old cobalt machine; few surgeons trained to operate on cancer patients; no hematology; no facilities to use intensive chemotherapy; no nuclear medicine department and no palliative care unit. Cervical cancer incidence is one of the highest in the world, while in men liver cancer ranks first (20% of all male cancers). Cancers are seen at stage 3 or 4 for 70% of patients. There is no prevention program - only a vaccination program against hepatitis B for newborns - and no screening program for cervical cancer or breast cancer. In 2010, oncology, recognized as a full specialty, was created to train the future oncologists on site at the University of Phnom Penh. A new National Cancer Center will be built in 2013 with modern facilities for radiotherapy, medical oncology, hematology and nuclear medicine. Cooperation with foreign countries, especially France, and international organizations has been established and is ongoing. Progress is occurring slowly due to the shortage of money for Cambodian institutions and the lay public. Copyright © 2012 S. Karger AG, Basel.

  7. Myths about AIDS in Cambodia.

    Science.gov (United States)

    Nariddh, M C

    1994-08-01

    HIV has been reported in the capital city of Cambodia, Phnom Penh, as well as in the northwestern provinces of Banteay Meanchey, Battambang, Pursat, and Kompong Chhnang. Unofficial reports indicate the presence of HIV in three northeastern provinces. According to World Health Organization data, 382 people were infected with HIV in Cambodia as of March 1994, but the national AIDS program estimates that 2000-4000 Cambodians may be HIV-seropositive. Small surveys in 1992 identified HIV infection rates to be 4.5% among patients of sexually transmitted disease (STD) clinics and 9.2% among prostitutes. A seroprevalence rate of 4.3% was found in 1993 among clients of STD clinics and others requesting HIV testing. These rather marked levels of infection exist in Cambodia even though HIV was first identified in the country as recently as 1991 among screened blood from volunteer donors. By December 1993, the rate of positive results from blood donors had increased to 1.97%.; the rate of infection among blood donors is expected to double to approximately 4% in 1994. People in Cambodia variously believe that AIDS is nonexistent, AIDS is a problem of other countries, can be transmitted by mosquitoes, healthy people do not have AIDS, a cure exists for AIDS, AIDS can be contracted only from prostitutes, AIDS is the most severe state of syphilis, and AIDS is only a propaganda ploy of condom producers to market their products. It is therefore proving extremely difficult to convince people that AIDS is a truly threatening disease against which they should protect themselves, especially when symptoms are rarely present during the early stage of infection. Health education campaigns, videos, posters, and accurate reporting in the media will, however, help change minds and hopefully induce HIV-preventive behaviors. Of interest, the article notes that virtually every prostitute in Cambodia has at least two-three STDs.

  8. Plasmodium vivax Malaria in Cambodia

    Science.gov (United States)

    Siv, Sovannaroth; Roca-Feltrer, Arantxa; Vinjamuri, Seshu Babu; Bouth, Denis Mey; Lek, Dysoley; Rashid, Mohammad Abdur; By, Ngau Peng; Popovici, Jean; Huy, Rekol; Menard, Didier

    2016-01-01

    The Cambodian National Strategic Plan for Elimination of Malaria aims to move step by step toward elimination of malaria across Cambodia with an initial focus on Plasmodium falciparum malaria before achieving elimination of all forms of malaria, including Plasmodium vivax in 2025. The emergence of artemisinin-resistant P. falciparum in western Cambodia over the last decade has drawn global attention to support the ultimate goal of P. falciparum elimination, whereas the control of P. vivax lags much behind, making the 2025 target gradually less achievable unless greater attention is given to P. vivax elimination in the country. The following review presents in detail the past and current situation regarding P. vivax malaria, activities of the National Malaria Control Program, and interventional measures applied. Constraints and obstacles that can jeopardize our efforts to eliminate this parasite species are discussed. PMID:27708187

  9. Critical Literacy in Elementary Education in Cambodia

    Science.gov (United States)

    In, Vichea

    2012-01-01

    This study focuses on a quest for insights into the introduction and negotiation of critical literacy in elementary education in Cambodia, whose recent past was scarred by devastating conflicts and wars. In this study, critical education is seen as a key to avoiding the reproduction of an unwanted past and minimizing social injustice in Cambodia.…

  10. Revisiting Primary School Dropout in Rural Cambodia

    Science.gov (United States)

    No, Fata; Sam, Chanphirun; Hirakawa, Yukiko

    2012-01-01

    Previous studies on school dropout in Cambodia often used data from subjects after they already dropped out or statistics from education-related institutions. Using data from children in two rural provinces before they dropped out, this study examines four main factors in order to identify their influence on primary school dropout in Cambodia.…

  11. Burkholderia pseudomallei Antibodies in Children, Cambodia

    Science.gov (United States)

    Pheaktra, Ngoun; Putchhat, Hor; Sin, Lina; Sen, Bun; Kumar, Varun; Langla, Sayan; Peacock, Sharon J.; Day, Nicholas P.

    2008-01-01

    Antibodies to Burkholderia pseudomallei were detected in 16% of children in Siem Reap, Cambodia. This organism was isolated from 30% of rice paddies in the surrounding vicinity. Despite the lack of reported indigenous cases, melioidosis is likely to occur in Cambodia. PMID:18258125

  12. Cambodia: Country Poverty Analysis 2014

    OpenAIRE

    Asian Development Bank (ADB); Asian Development Bank (ADB); Asian Development Bank (ADB); Asian Development Bank (ADB)

    2014-01-01

    Cambodia’s new national poverty lines show higher historical poverty rates and a dramatic decline in poverty during the 2007–2009 global financial crisis. With 18.9% of the population being poor in 2012, Cambodia now counts among the countries with the most rapid poverty reduction in the world. However, many people moved only slightly above the poverty line—remaining highly vulnerable—and poverty is increasing both in urban areas and according to the international poverty line of $2 per day. ...

  13. All projects related to Cambodia | Page 3 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Global Financial Crisis and Vulnerability in Cambodia ... crisis of 2008 has aggravated poverty and inequality through contractions in employment, consumption and investment. ... Region: Cambodia, Far East Asia, Central Asia, South Asia.

  14. The Third Indochina Conflict: Cambodia’s Total War

    Science.gov (United States)

    2014-12-12

    movement which sought to unify the efforts of the independence movements in Cambodia, Laos and Vietnam against the French.5 The Cambodian left-wing...of Cambodia, 2007). 32 Martin, Cambodia: A Shattered Society. 33 Nayan Chanda, Brother Enemy, 43. Nayan Chanda wrote that Mao Tse -tung understood...

  15. Swimming in uncharted waters. Reports from Cambodia

    NARCIS (Netherlands)

    Wijers, G.D.M.

    2011-01-01

    This is 2006 and my home is Phnom Penh. I’m on a placement for a volunteer organization that aims at the sharing of skills and knowledge for a local salary. My years in Cambodia have their highs and lows but hours of careless happiness are hard to come by. There is commiseration and compassion,

  16. Cambodia Rural Livelihoods and Natural Resources Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Cambodia is one of the least developed countries in Southeast Asia, with a large poor rural population dependent on natural resources for food and income. Over the past several years, the country has introduced extensive legislation related to the management of natural resources. On paper, the role of local communities ...

  17. English in Cambodia: Changes and Challenges

    Science.gov (United States)

    Moore, Stephen H.; Bounchan, Suksiri

    2010-01-01

    This paper reports research undertaken at a prestigious university in Phnom Penh in late 2007. The views of lecturers who teach the BEd (TEFL) degree and their students were canvassed in relation to the status of English in Cambodia. The students completed a questionnaire probing their views on the notion of a Cambodian English, as well as their…

  18. Cambodia Development Research Forum II | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Cambodia's research community is still rebuilding from decades of turmoil that included civil war and a period of ethnic and intellectual cleansing under the Khmer Rouge. Its development research community remains dispersed and unconnected, though there are pockets of strong capacity. IDRC was one of the first ...

  19. Pediatric Palliative Care Initiative in Cambodia

    Directory of Open Access Journals (Sweden)

    Mahmut Yaşar Çeliker

    2017-07-01

    Full Text Available Cancer care with curative intent remains difficult to manage in many resource-limited settings such as Cambodia. Cambodia has a small workforce with limited financial and health-care resources resulting in delayed diagnoses and availability of limited therapeutic tools. Thus, palliative care becomes the primary form of care in most cases. Although palliative care is becoming an integral part of medical care in developed countries, this concept remains poorly understood and utilized in developing countries. Angkor Hospital for Children serves a relatively large pediatric population in northern Cambodia. According to the modern definition of palliative care, approximately two-thirds of the patients admitted to the hospital were deemed candidates to receive palliative care. In an effort to develop a pediatric palliative care team utilizing existing resources and intensive training, our focus group recruited already existing teams with different health-care expertise and other motivated members of the hospital. During this process, we have also formed a palliative care training team of local experts to maintain ongoing palliative care education. Feedback from patients and health-care providers confirmed the effectiveness of these efforts. In conclusion, palliative and sustainable care was offered effectively in a resource-limited setting with adequately trained and motivated local providers. In this article, the steps and systems used to overcome challenges in Cambodia are summarized in the hope that our experience urges governmental and non-governmental agencies to support similar initiatives.

  20. Pediatric Palliative Care Initiative in Cambodia

    Science.gov (United States)

    Çeliker, Mahmut Yaşar; Pagnarith, Yos; Akao, Kazumi; Sophearin, Dim; Sorn, Sokchea

    2017-01-01

    Cancer care with curative intent remains difficult to manage in many resource-limited settings such as Cambodia. Cambodia has a small workforce with limited financial and health-care resources resulting in delayed diagnoses and availability of limited therapeutic tools. Thus, palliative care becomes the primary form of care in most cases. Although palliative care is becoming an integral part of medical care in developed countries, this concept remains poorly understood and utilized in developing countries. Angkor Hospital for Children serves a relatively large pediatric population in northern Cambodia. According to the modern definition of palliative care, approximately two-thirds of the patients admitted to the hospital were deemed candidates to receive palliative care. In an effort to develop a pediatric palliative care team utilizing existing resources and intensive training, our focus group recruited already existing teams with different health-care expertise and other motivated members of the hospital. During this process, we have also formed a palliative care training team of local experts to maintain ongoing palliative care education. Feedback from patients and health-care providers confirmed the effectiveness of these efforts. In conclusion, palliative and sustainable care was offered effectively in a resource-limited setting with adequately trained and motivated local providers. In this article, the steps and systems used to overcome challenges in Cambodia are summarized in the hope that our experience urges governmental and non-governmental agencies to support similar initiatives. PMID:28804708

  1. Cambodia : tous les projets | Page 3 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sujet: MIGRANT WORKERS, FOREIGN WORKERS, WORKING ... Région: Central Asia, Far East Asia, South Asia, Cambodia, Indonesia, Malaysia, Philippines, Thailand, ... Sujet: WOMEN'S RIGHTS, GENDER DISCRIMINATION, GENDER ...

  2. All projects related to Cambodia | Page 2 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Inclusive Development and Chinese Foreign Direct Investment in the Greater Mekong ... and think tanks in Cambodia, Laos, Thailand, and China's Yunnan province. ... OCCUPATIONAL SAFETY, INFORMATION TECHNOLOGY, Gender.

  3. Decomposition of childhood malnutrition in Cambodia.

    Science.gov (United States)

    Sunil, Thankam S; Sagna, Marguerite

    2015-10-01

    Childhood malnutrition is a major problem in developing countries, and in Cambodia, it is estimated that approximately 42% of the children are stunted, which is considered to be very high. In the present study, we examined the effects of proximate and socio-economic determinants on childhood malnutrition in Cambodia. In addition, we examined the effects of the changes in these proximate determinants on childhood malnutrition between 2000 and 2005. Our analytical approach included descriptive, logistic regression and decomposition analyses. Separate analyses are estimated for 2000 and 2005 survey. The primary component of the difference in stunting is attributable to the rates component, indicating that the decrease of stunting is due mainly to the decrease in stunting rates between 2000 and 2005. While majority of the differences in childhood malnutrition between 2000 and 2005 can be attributed to differences in the distribution of malnutrition determinants between 2000 and 2005, differences in their effects also showed some significance. © 2013 John Wiley & Sons Ltd.

  4. Diarrheal Diseases and Climate Change in Cambodia.

    Science.gov (United States)

    McIver, Lachlan J; Imai, Chisato; Buettner, Petra G; Gager, Paul; Chan, Vibol S; Hashizume, Masahiro; Iddings, Steven N; Kol, Hero; Raingsey, Piseth P; Lyne, K

    2016-10-01

    The DRIP-SWICCH (Developing Research and Innovative Policies Specific to the Water-related Impacts of Climate Change on Health) project aimed to increase the resilience of Cambodian communities to the health risks posed by climate change-related impacts on water. This article follows a review of climate change and water-related diseases in Cambodia and presents the results of a time series analysis of monthly weather and diarrheal disease data for 11 provinces. In addition, correlations of diarrheal disease incidence with selected demographic, socioeconomic, and water and sanitation indicators are described, with results suggesting education and literacy may be most protective against disease. The potential impact of climate change on the burden of diarrheal disease in Cambodia is considered, along with the implications of these findings for health systems adaptation.

  5. Promoting Women's Economic Empowerment in Cambodia

    OpenAIRE

    Asian Development Bank (ADB); Asian Development Bank (ADB); Asian Development Bank (ADB); Asian Development Bank (ADB)

    2015-01-01

    Women’s economic empowerment is essential for more inclusive growth in Cambodia. This study takes stock of major gender issues in the Cambodian economy seen through the lens of women’s participation, benefit, and agency—the three prerequisites for a fairer distribution of growth benefits. It examines labor market trends and obstacles to women’s economic empowerment—particularly in agriculture, business development, and wage employment. Labor migration and vulnerability to shocks are highlight...

  6. Low Circulation of Zika Virus, Cambodia, 2007-2016.

    Science.gov (United States)

    Duong, Veasna; Ong, Sivuth; Leang, Rithea; Huy, Rekol; Ly, Sowath; Mounier, Ugo; Ou, Teyputita; In, Saraden; Peng, Borin; Ken, Sreymom; Buchy, Philippe; Tarantola, Arnaud; Horwood, Paul F; Dussart, Philippe

    2017-02-01

    We describe a retrospective study on circulation of Zika virus in Cambodia during 2007-2016 among patients with dengue-like symptoms and Aedes aegypti mosquitoes. Our findings suggest that Zika virus in Cambodia belongs to the Asia genotype, is endemic, has low prevalence, and has had low-level impact on public health.

  7. Health Care Costs Attributable to Tobacco in Cambodia | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    There is strong evidence from other countries that smoking increases the TB infection rate and reduces tuberculosis survival rates. Cambodia has high TB and smoking rates, so the cost of tobacco use will also include the cost of excess tuberculosis-related deaths. Cambodia's health information systems are weak and ...

  8. 75 FR 11620 - Waiver of Restriction on Assistance to Cambodia

    Science.gov (United States)

    2010-03-11

    ... DEPARTMENT OF STATE [Public Notice 6918] Waiver of Restriction on Assistance to Cambodia Pursuant to section 7086(c)(2) of the Department of State, Foreign Operations, and Related Programs... Cambodia, and I hereby waive such restriction. This determination shall be reported to the Congress, and...

  9. A Multimedia Approach to ODL for Agricultural Training in Cambodia

    Science.gov (United States)

    Grunfeld, Helena; Ng, Maria Lee Hoon

    2013-01-01

    Open distance learning (ODL) has long been an important option for formal and non-formal education (NFE) in most developed and developing countries, but less so in post-conflict countries, including Cambodia. However, in Cambodia there is now greater awareness that ODL can complement traditional face-to-face educational approaches, particularly as…

  10. Introduction of ICT and Multimedia into Cambodia's Teacher Training Centres

    Science.gov (United States)

    Dionys, David

    2012-01-01

    This article describes the integration of ICT in the teacher training centres of Cambodia. It focuses on the collaboration between the Teacher Training Department of the Ministry of Education, Youth and Sports (MoEYS) of Cambodia and VVOB (Flemish Association for Development Cooperation and Technical Assistance), which is aimed at improving ICT…

  11. 31 CFR 500.565 - Family remittances to nationals of Vietnam and Cambodia.

    Science.gov (United States)

    2010-07-01

    ... Vietnam and Cambodia. 500.565 Section 500.565 Money and Finance: Treasury Regulations Relating to Money... remittances to nationals of Vietnam and Cambodia. (a) The remittances specified in this section are authorized... relative is a national of Vietnam or Cambodia, is a resident of Vietnam, Cambodia, or a country to which...

  12. Ground-water resources of Cambodia

    Science.gov (United States)

    Rasmussen, William Charles; Bradford, Gary M.

    1977-01-01

    Cambodia (now the Khmer Republic), in tropical, humid southeast Asia, has an area of 175,630 km and a population of about 5 million. The Mekong River, one of the world's largest rivers, flows through Cambodia. Also, the Tonle Sap (Grand Lac), a highly productive fresh-water lake, functions as a huge off-channel storage reservoir for flood flow of the Mekong River. Surfacewater discharge in streams and rivers of Cambodia is abundant during the wet season, mid-May through mid-November, when 85 percent of the precipitation falls, but is frequently deficient during the remainder of the year. Annual rainfall ranges from 1,370 mm in the central lowlands to more than 5,000 mm in the mountainous highlands. The mean annual temperature for the country is 27.5?C and the evaporation rate is high. During 1960-63, 1,103 holes were drilled in 16 of the 18 khets (provinces), of which 795 or approximately 72 percent, were productive wells at rates ranging from 1.1 to 2,967 l/min. The productive wells ranged in depth from 2 to 209.4 m and were 23.2 m deep on the average. Mr. Rasmussen ' studied the subsurface geology of Cambodia in considerable detail by examining drillers' logs and constructing nine geologic cross sections. The principal aquifer tapped by drilled wells in Cambodia is the Old Alluvium. In many places, however, dug wells and a few shallow drilled wells obtain water from the Young Alluvium. Sandstone of the Indosinias Formation yields moderate to small quantities of water to wells in a number of places. Also, wells tapping water-bearing basalt have a small to moderate yield. The quality of water is recorded in only a few analyses. The dissolved solids concentrations appear to be generally low so that the water is usable for most purposes without treatment. Some well waters, however, are high in iron and would have to be aerated and filtered before use. In this report, well records are tabulated, and the geology and hydrology is discussed by khets. The bulk of the

  13. Molecular Epidemiology of Hemoglobinopathies in Cambodia.

    Science.gov (United States)

    Munkongdee, Thongperm; Tanakulmas, Jatuporn; Butthep, Punnee; Winichagoon, Pranee; Main, Barbara; Yiannakis, Miriam; George, Joby; Devenish, Robyn; Fucharoen, Suthat; Svasti, Saovaros

    2016-06-01

    Determining the magnitude of the thalassemia problem in a country is important for implementing a national prevention and control program. In order to acquire accurate thalassemia prevalence data, the gene frequency of α- and β-thalassemia (α- and β-thal) in different regions of a country should be determined. The molecular basis of thalassemia in Cambodia was performed by polymerase chain reaction (PCR)-based techniques in a community-based cross-sectional survey of 1631 unrelated individuals from three regions, Battambang, Preah Vihear and Phnom Penh. Thalassemia mutations were detected in 62.7% of the three studied population of Cambodia. Hb E (HBB: c.79G > A) was the most common β-globin gene mutation with a frequency ranging from 0.139 to 0.331, while the most frequent α-globin gene mutation was the -α(3.7) (rightward) deletion (0.098-0.255). The other frequencies were 0.001-0.003 for β-thal, 0.008-0.011 for α-thal-1 (- -(SEA)), 0.003-0.008 for α-thal-2 [-α(4.2) (leftward deletion)], 0.021-0.044 for Hb Constant Spring (Hb CS, HBA2: c.427T > C) and 0.009-0.036 for Hb Paksé (HBA2: c.429A > T). A regional specific thalassemia gene frequency was observed. Preah Vihear had the highest prevalence of Hb E (55.9%), α-thal-2 (24.0%) and nondeletional α-thal (15.1%), whereas Phnom Penh had the lowest frequency of thalassemia genes. Interestingly, in Preah Vihear, the frequency of Hb Paksé was extremely high (0.036), almost equivalent to that of Hb CS (0.044). Our results indicate the importance of micromapping and epidemiology studies of thalassemia, which will assist in establishing the national prevention and control program in Cambodia.

  14. An Impact Evaluation of Feed the Future Cambodia HARVEST project

    Data.gov (United States)

    US Agency for International Development — Helping Address Rural Vulnerabilities and Ecosystem Stability (Cambodia-HARVEST) was a five-year program (2011-2016) supported under the Global Hunger and Food...

  15. Khmeriosicyos, a new monotypic genus of Cucurbitaceae from Cambodia

    NARCIS (Netherlands)

    Wilde, de W.J.J.O.; Duyfjes, B.E.E.; Ham, van der R.W.J.M.

    2004-01-01

    A new monotypic genus from Cambodia is described. The genus is defined by a unique combination of characters and has distinct pollen features. The only species is Khmeriosicyos harmandii W.J. de Wilde & Duyfjes.

  16. Interim Feed The Future Population Based Assessment of Cambodia

    Data.gov (United States)

    US Agency for International Development — This is the interim population based survey of Feed the Future in Cambodia for 2015. The data is split into survey modules. Modules A through C includes location...

  17. Food Security and Climate Change in Cambodia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Food Security and Climate Change in Cambodia ... Eleven world-class research teams set to improve livestock vaccine development and production to benefit farmers across the ... Building resilience through socially equitable climate action.

  18. cambodia : tous les projets | Page 3 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Région: Central Asia, Far East Asia, South Asia, Cambodia, Indonesia, Malaysia, Philippines, Thailand, Singapore ... ECONOMIC RESEARCH, SOCIAL RESEARCH, Social Policy, LABOUR LEGISLATION, LABOUR ECONOMICS, COMPETITION, COMPETITIVENESS, ENTREPRENEURSHIP, INCOME DISTRIBUTION.

  19. Global Financial Crisis and Vulnerability in Cambodia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The global financial crisis of 2008 has aggravated poverty and inequality through contractions in employment, consumption and investment. While there have been a number of ... Country(s). Cambodia, Far East Asia, Central Asia, South Asia ...

  20. Calming the mind: Healing after mass atrocity in Cambodia

    OpenAIRE

    Agger, Inger

    2015-01-01

    After catastrophic events in which people?s survival has been threatened, as happened during the Khmer Rouge regime in Cambodia 1975?1979, some continue to suffer from painful mental symptoms. Surveys carried out in Cambodia based on Western diagnostic categories have found a high prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the population. This study explored Cambodian approaches to healing trauma, examining the ways in which Cambodians appeal to el...

  1. Analysis of Radar Images of Angkor, Cambodia

    Science.gov (United States)

    Freeman, Anthony; Hensley, Scott; Moore, Elizabeth

    2000-01-01

    During the 1996 AIRSAR Pacific Rim Deployment, data were collected over Angkor in Cambodia. The temples of Angkor date the succession of cities to the 9th-13th century AD, but little is known of its prehistoric habitation. A related area of archaeological debate has been the origin, spiritual meaning and use of the hydraulic constructions in the urban zone. The high resolution, multi-channel capability of AIRSAR, together with the unprecedentedly accurate topography provided by TOPSAR, offer identification and delineation of these features. Examples include previously unrecorded circular earthworks around circular village sites, detection of unrecorded earthwork dykes, reservoirs and canal features, and of temple sites located some distance from the main temple complex at Angkor.

  2. Livelihood strategies and dynamics in rural Cambodia

    DEFF Research Database (Denmark)

    Jiao, Xi; Pouliot, Mariéve; Walelign, Solomon Zena

    2017-01-01

    This paper addresses one of the major challenges in rural livelihood analysis to quantitatively examine the dynamics of household livelihood strategies. It investigates the interactions between livelihood assets, activities, and outcomes, and captures the dynamics of long-term changes......, for latent class cluster analysis and regression estimation. In this paper, livelihood strategies are quantified based on allocation of available resources, which overcomes the limitations of income-based analysis. Our study identifies five household livelihood strategies pursued in the study areas...... and their underlying factors. The study aims to identify the classification of rural livelihood strategies, their transitions and factors influencing these processes and changes. We employ the dynamic livelihood strategy framework, and use panel data for 2008 and 2012 covering 464 households in 15 villages in Cambodia...

  3. Pulmonary melioidosis in Cambodia: A prospective study

    Directory of Open Access Journals (Sweden)

    Te Vantha

    2011-05-01

    Full Text Available Abstract Background Melioidosis is a disease caused by Burkholderia pseudomallei and considered endemic in South-East Asia but remains poorly documented in Cambodia. We report the first series of hospitalized pulmonary melioidosis cases identified in Cambodia describing clinical characteristics and outcomes. Methods We characterized cases of acute lower respiratory infections (ALRI that were identified through surveillance in two provincial hospitals. Severity was defined by systolic blood pressure, cardiac frequency, respiratory rate, oxygen saturation and body temperature. B. pseudomallei was detected in sputum or blood cultures and confirmed by API20NE gallery. We followed up these cases between 6 months and 2 years after hospital discharge to assess the cost-of-illness and long-term outcome. Results During April 2007 - January 2010, 39 ALRI cases had melioidosis, of which three aged ≤2 years; the median age was 46 years and 56.4% were males. A close contact with soil and water was identified in 30 patients (76.9%. Pneumonia was the main radiological feature (82.3%. Eleven patients were severe cases. Twenty-four (61.5% patients died including 13 who died within 61 days after discharge. Of the deceased, 23 did not receive any antibiotics effective against B. pseudomallei. Effective drugs that were available did not include ceftazidime. Mean total illness-related costs was of US$65 (range $25-$5000. Almost two-thirds (61.5% incurred debt and 28.2% sold land or other belongings to pay illness-related costs. Conclusions The observed high fatality rate is likely explained by the lack or limited access to efficient antibiotics and under-recognition of the disease among clinicians, which led to inappropriate therapy.

  4. Project CHECO Southeast Asia Report. Aerial Protection of Mekong River Convoys in Cambodia

    National Research Council Canada - National Science Library

    Mitchell, William A

    1971-01-01

    ...) shortages in the Khmer Republic (Cambodia) which had resulted from successful enemy attacks on commercial shipping vessels sailing the Mekong River inside Cambodia These attacks, combined with the closure of land Route 4 from the port city...

  5. The glycemic status of diabetes in an urban area of Cambodia.

    Science.gov (United States)

    Jung, Chang Hee; Kim, Kwang Joon; Lee, Yun-Kyu; Kwon, Jin-Hyun; Lee, Byung Wan; Kwon, Hyuk-Sang; Park, Joong-Yeol; Khun, Touch; Cha, Bong-Yun; Cho, Nam H

    2014-05-01

    Recently the Korea Diabetes Association participated in the 'Cambodia-Korea Twinning Project' to help Cambodia establish its own modernized diabetes center and to raise awareness of the seriousness of diabetes. Here we report the status of diabetes in an urban area of Cambodia as obtained through this project. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Collaborative Development of Anatomy Workshops for Medical and Dental Students in Cambodia

    Science.gov (United States)

    Hayes, Jennifer A.; Ivanusic, Jason J.; le Roux, Cara M.; Hatzopoulos, Kate; Gonsalvez, David; Hong, Someth; Durward, Callum

    2011-01-01

    After Phnom Penh was liberated from the Khmer Rouge in 1979, health science education in Cambodia had to be completely rebuilt. In this article, the authors report the results of a teaching collaboration between the University of Melbourne (Australia), the International University (Cambodia), and the University of Health Sciences (Cambodia). The…

  7. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

    Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

    2016-03-10

    This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

  8. Avian influenza: the political economy of disease control in Cambodia.

    Science.gov (United States)

    Ear, Sophal

    2011-01-01

    Abstract In the wake of avian flu outbreaks in 2004, Cambodia received $45 million in commitments from international donors to help combat the spread of animal and human influenza, particularly avian influenza (H5N1). How countries leverage foreign aid to address the specific needs of donors and the endemic needs of the nation is a complex and nuanced issue throughout the developing world. Cambodia is a particularly compelling study in pandemic preparedness and the management of avian influenza because of its multilayered network of competing local, national, and global needs, and because the level of aid in Cambodia represents approximately $2.65 million per human case-a disproportionately high number when compared with neighbors Vietnam and Indonesia. This paper examines how the Cambodian government has made use of animal and human influenza funds to protect (or fail to protect) its citizens and the global community. It asks how effective donor and government responses were to combating avian influenza in Cambodia, and what improvements could be made at the local and international level to help prepare for and respond to future outbreaks. Based on original interviews, a field survey of policy stakeholders, and detailed examination of Cambodia's health infrastructure and policies, the findings illustrate that while pandemic preparedness has shown improvements since 2004, new outbreaks and human fatalities accelerated in 2011, and more work needs to be done to align the specific goals of funders with the endemic needs of developing nations.

  9. "Research in Cambodia, Half a Century Ago: An Address to the Thailand, Laos, Cambodia Studies Group"

    Directory of Open Access Journals (Sweden)

    William E. Willmott

    2012-09-01

    Full Text Available Address to the Thailand, Laos, Cambodia Studies Association at the Association for Asian Studies Annual Conference in Toronto, March 16, 2012This event has given me the opportunity to return to almost the beginning of my academic career: my doctoral fieldwork in Cambodia fifty years ago. (It was preceded by fieldwork in an Inuit community in the Ungava, Northern Canada; not relevant here. Rereading my publications from that research has allowed me to relive the excitement of my Cambodian year, living with my wife and child in Phnom Penh apart from a month in Siem Reap, where I could hire a cyclo for ten riels and visit the various ruins of Angkor every afternoon. Research on overseas Chinese was informed by different paradigms in those days. Bill Skinner was a leading thinker in the field, and Maurice Freedman, my mentor and supervisor, was another. Our issues focused on community social structure and nationalism—many of us were supporters of the national liberation movements in Southeast Asian countries. For most of us, Chinese identity was simply a methodological issue...

  10. Cambodia: From Dependency to Sovereignty - Emerging National Leadership

    Directory of Open Access Journals (Sweden)

    Vincent Mcnamara

    2015-10-01

    Full Text Available In the millennium leading up to its days of glory and regional leadership under the iconic Angkor empire, and even in the centuries of dependence since, Cambodia has often benefited significantly from the influence of its patrons, starting with traders from India who sailed up the Mekong at the beginning of a magnificent water transport system including an inland sea. Most recently such benefits have been from global and multilateral sources. Equally, due to its pivotal strategic location at the centre of the South-East corner of Asia, Cambodia has also suffered, at times enormously, from the competing influences of a plethora of well-intentioned but radically different influences: religious, cultural, linguistic, imperial, political, ideological and educational. This article will review the educational system of Cambodia and the issues that come with achieving political and now psychological freedom from dependence on foreign dominance and tutelage.

  11. Influences on Academic Achievement of Primary School Pupils in Cambodia

    Directory of Open Access Journals (Sweden)

    Sopheak Song

    2012-12-01

    Full Text Available Employing education production function approach, this article investigates the influences of school and pupil background factors on academic achievement of primary school pupils in Cambodia. Based on achievement data of 1,080 Grade 6 pupils from one rural and one semi-urban area, the study reveals that school and teacher quality exerts a considerable effect on pupils’ performance. Teachers’ experience and teacher guides are positively correlated with academic achievement, while instructional time loss is significantly associated with poor performance. In light of these results, policies to boost academic achievement of primary school pupils in Cambodia are discussed.

  12. All projects related to cambodia | Page 2 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-01-18

    In most societies, sex work is highly stigmatized and sex workers are subject to blame, disapproval and discrimination. Start Date: January 18, 2010. End Date: June 30, 2012. Topic: PROSTITUTION, VIOLENCE AGAINST WOMEN, OCCUPATIONAL SAFETY, INFORMATION TECHNOLOGY. Region: India, Cambodia, Far ...

  13. Small-scale Aquaculture to Strengthen Food Security in Cambodia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Small-scale Aquaculture to Strengthen Food Security in Cambodia (CIFSRF) ... for their families' consumption in the same ponds as large fish, which can be sold for income. ... The project also studies opportunities to scale up the model for broader use ... Assessing improvements in nutrition outcomes following agricultural ...

  14. The Nature of the Genocide in Cambodia (Kampuchea).

    Science.gov (United States)

    Kiernan, Ben

    1991-01-01

    Gives an historical overview of Cambodia during the Pol Pot regime. Describes the genocide that attempted to eradicate Buddhist monks, Vietnamese, Chinese, and Muslim Chams between 1975 and 1979. Argues the regime should still be held accountable and that the case should be tried in the World Court. (NL)

  15. CASE STUDY: Cambodia pits data against poverty | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-12-20

    Dec 20, 2010 ... This plan is getting support from the Department of Water and Meteorology.” “We also found how many villages were far from the main road and so .... CBMS has grown rapidly in Cambodia, both in terms of enabling lower ...

  16. cambodia : tous les projets | Page 4 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sujet: TRANSPORT INFRASTRUCTURE, INTERNATIONAL TRANSPORT, REGIONAL INTEGRATION, TRADE FACILITATION. Région: Central Asia, Far East Asia, South Asia, Cambodia, China, Laos, Viet Nam, Thailand. Programme: Emploi et croissance. Financement total : CA$ 300,000.00. Programme de recherche sur ...

  17. Academic Achievement among Adolescents in Cambodia: Does Caregiver Trauma Matter?

    Science.gov (United States)

    Eng, Sothy; Mulsow, Miriam; Cleveland, Harrington; Hart, Sybil L.

    2009-01-01

    How will hostilities occurring around today's world influence future generations in affected areas? Cambodia may be one place where this question can be answered, and academic achievement is one way to measure these effects. Cambodian adolescent/caregiver dyads (n=288) were examined for links between caregiver trauma history and adolescent…

  18. Fatal motorcycle crashes: a growing public health problem in Cambodia.

    Science.gov (United States)

    Roehler, Douglas R; Ear, Chariya; Parker, Erin M; Sem, Panhavuth; Ballesteros, Michael F

    2015-01-01

    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.

  19. Seroepidemiology of Human Enterovirus 71 Infection among Children, Cambodia

    Science.gov (United States)

    Horwood, Paul F.; Andronico, Alessio; Tarantola, Arnaud; Salje, Henrik; Duong, Veasna; Mey, Channa; Ly, Sovann; Dussart, Philippe; Cauchemez, Simon

    2016-01-01

    Enterovirus 71 is reported to have emerged in Cambodia in 2012; at least 54 children with severe encephalitis died during that outbreak. We used serum samples collected during 2000–2011 to show that the virus had been widespread in the country for at least a decade before the 2012 outbreak. PMID:26690000

  20. Soils under conservation agriculture with vegetables in Siem Reap, Cambodia

    Science.gov (United States)

    Smallholder vegetable farmers in Siem Reap, Cambodia experienced declining crop productivity. It could be a result of a mixture of factors such as nutrient and pest problems and extreme weather events such as droughts and/or heavy rains. The no-till, continuous mulch and diverse species principles o...

  1. Funding mobilization strategies of nongovernmental organizations in Cambodia

    NARCIS (Netherlands)

    Khieng, S.

    2014-01-01

    The objectives of this paper are to map strategies for resource mobilization of nongovernmental organizations (NGOs) in different sectors in heavily aid-dependent Cambodia and analyse the past and future trends of each of the evolving strategies. The data used is the product of a national survey

  2. Cambodia Development Research Forum II | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Understanding SME policy environment in ASEAN. Téléchargez le PDF. Dossiers. Sustainable forest governance in the Asia-Pacific region : has REDD+ adequately addressed drivers of deforestation and forest degradation? Téléchargez le PDF. Rapports. Cambodia's preparedness for ASEAN economic community 2015 ...

  3. Improving women's lives in Cambodia through fish on farms

    International Development Research Centre (IDRC) Digital Library (Canada)

    Household food insecurity in Cambodia is high. The diet ... at 40% and anemia among women of reproductive age is over 50%. ... Over 70% of households ... Monthly monitoring has shown that the household ... agriculture and food production but earn 30% ... Figure 2: Percentage of women who have their own money and ...

  4. All projects related to cambodia | Page 3 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Enabling Sex Workers to Document Violence (India and Cambodia) ... Topic: PROSTITUTION, VIOLENCE AGAINST WOMEN, OCCUPATIONAL SAFETY, ... 2008 has aggravated poverty and inequality through contractions in employment, ... of the H5N1 subtype is a major disease of poultry that affects humans at a low rate.

  5. Cambodia: From Killing Fields to Field of Dreams

    Science.gov (United States)

    1997-04-01

    Richard Nixon assuring 6 evening television audiences that we were not really bombing Cambodia, the history of the country goes back over 4000 years. Early...through a gate topped by a huge ‘ Pepsi ’ sign, is the building where 14-year-old Mat Srey Mom, locally known as ‘Suzy,’ got her first economics lesson

  6. Rural household incomes and land grabbing in Cambodia

    DEFF Research Database (Denmark)

    Jiao, Xi; Smith-Hall, Carsten; Theilade, Ida

    2015-01-01

    This paper empirically quantifies environmentally augmented rural household incomes in Cambodia and analyzes how economic land concessions (ELCs) affect such incomes. Data is derived from a structured survey of 600 randomly selected households in 15 villages in three study sites in Cambodia, where...... local livelihoods are highly reliant on access to land and natural resources, supported by qualitative data from focus group discussions. Gini coefficient decomposition, multiple regression models, and propensity score matching (PSM) models were employed to analyze the composition of income portfolios......, determinants of major income sources, and the impacts of land grabbing on incomes. Results documented high reliance on environmental income (32–35% of total household income) and farm income (51–53%) across income quartiles; demonstrated the variation in product composition across quartiles...

  7. Low Urinary Iodine Concentration among Mothers and Children in Cambodia.

    Science.gov (United States)

    Laillou, Arnaud; Sophonneary, Prak; Kuong, Khov; Hong, Rathavuth; Un, Samoeurn; Chamnan, Chhoun; Poirot, Etienne; Berger, Jacques; Wieringa, Frank

    2016-04-05

    A 2014 national assessment of salt iodization coverage in Cambodia found that 62% of samples were non-iodized, suggesting a significant decline in daily iodine intakes. The Cambodian Micronutrient Survey conducted in 2014 (CMNS-2014) permitted obtaining national data on urinary iodine concentrations (UIC) to assess iodine status and whether iodized salt use had an impact. Urine samples were collected from mothers (n = 736) and children (n = 950). The median UIC was 63 µg/L and 72 µg/L in mothers and children respectively. More than 60% of mothers and their children had a UIC Cambodia. It is essential for the government to enhance enforcement of the iodized salt legislation, and implement short term strategies, such as iodine supplementation, to prevent an increase of severe complications due to iodine deficiency in the Cambodian population.

  8. Emergence of pediatric melioidosis in Siem Reap, Cambodia.

    Science.gov (United States)

    Pagnarith, Yos; Kumar, Varun; Thaipadungpanit, Janjira; Wuthiekanun, Vanaporn; Amornchai, Premjit; Sin, Lina; Day, Nicholas P; Peacock, Sharon J

    2010-06-01

    We describe the first cases of pediatric melioidosis in Cambodia. Thirty-nine cases were diagnosed at the Angkor Hospital for Children, Siem Reap, between October 2005 and December 2008 after the introduction of microbiology capabilities. Median age was 7.8 years (range = 1.6-16.2 years), 15 cases were male (38%), and 4 cases had pre-existing conditions that may have pre-disposed the patient to melioidosis. Infection was localized in 27 cases (69%) and disseminated in 12 cases (31%). Eleven cases (28%) were treated as outpatients, and 28 (72%) cases were admitted. Eight children (21%) died a median of 2 days after admission; seven deaths were attributable to melioidosis, all of which occurred in children receiving suboptimal antimicrobial therapy and before bacteriological culture results were available. Our findings indicate the need for heightened awareness of melioidosis in Cambodia, and they have led us to review microbiology procedures and antimicrobial prescribing of suspected and confirmed cases.

  9. Influence of Climate Factors on Rice Yields in Cambodia

    Directory of Open Access Journals (Sweden)

    Dek Vimean Pheakdey

    2017-12-01

    Full Text Available Temperature and precipitation have been known as the key determinant factors to affect rice production in climate change. In this study, the relationship between climate variables and rice yields during 1993–2012 in Cambodia was analyzed and evaluated. The Ordinary Least Squares analysis was applied to examine the relationship of three climate variables (TCV including maximum temperature, minimum temperature and rainfall against seasonal rice yields. By this period, a remarkable increasing trend of annual temperature was observed whilst rainfall was not significantly changed. The TCV explains approximately 63% and 56% of the variability of rice yields in wet and dry seasons, respectively. It is found that in Cambodia, non-climate factors such as fertilizers, water, cultivars, and soil fertility cause 40% variation to rice yields, whereas the remaining 60% can be influenced by climate variability. The levels of temperature difference (LTD between maximum and minimum temperatures of the wet season (WS and dry season (DS were 7.0 and 8.6 oC, respectively. The lower value of LTD may cause the reduction of rice in WS (2.2 tons/ha as compared to that of DS (3.0 tons/ha. Rice yield has increased 50.5% and 33.8% in DS and WS, respectively, may due to the improvement of rice cultivation practices in Cambodia such as the better use of fertilizers, pest and weed control, and irrigation, and more effective rice cultivated protocol, as the increased trend of temperature may detrimentally affect rice yield. The breeding of heat and drought tolerance rice varieties and development of irrigation system are effective to reduce the negative influence from climate change to rice production in Cambodia.

  10. Working Conditions and Factory Survival: Evidence from Better Factories Cambodia

    OpenAIRE

    Robertson, Raymond; Brown, Drusilla; Dehejia, Rajeev

    2016-01-01

    A large and growing literature has identified several conditions, including exporting, that contribute to plant survival. A prevailing sentiment suggests that anti-sweatshop activity against plants in developing countries adds the risk of making survival more difficult by imposing external constraints that may interfere with optimizing behavior. Using a relatively new plant-level panel dataset from Cambodia, this paper applies survival analysis to estimate the relationship between changes in ...

  11. Influenza activity in Cambodia during 2006-2008

    Directory of Open Access Journals (Sweden)

    Zhou Weigong

    2009-10-01

    Full Text Available Abstract Background There is little information about influenza disease among the Cambodian population. To better understand the dynamics of influenza in Cambodia, the Cambodian National Influenza Center (NIC was established in August 2006. To continuously monitor influenza activity, a hospital based sentinel surveillance system for ILI (influenza like illness with a weekly reporting and sampling scheme was established in five sites in 2006. In addition, hospital based surveillance of acute lower respiratory infection (ALRI cases was established in 2 sites. Methods The sentinel sites collect weekly epidemiological data on ILI patients fulfilling the case definition, and take naso-pharyngeal specimens from a defined number of cases per week. The samples are tested in the Virology Unit at the Institut Pasteur in Phnom Penh. From each sample viral RNA was extracted and amplified by a multiplex RT-PCR detecting simultaneously influenza A and influenza B virus. Influenza A viruses were then subtyped and analyzed by hemagglutination inhibition assay. Samples collected by the ALRI system were tested with the same approach. Results From 2006 to 2008, influenza circulation was observed mainly from June to December, with a clear seasonal peak in October shown in the data from 2008. Conclusion Influenza activity in Cambodia occurred during the rainy season, from June to December, and ended before the cool season (extending usually from December to February. Although Cambodia is a tropical country geographically located in the northern hemisphere, influenza activity has a southern hemisphere transmission pattern. Together with the antigenic analysis of the circulating strains, it is now possible to give better influenza vaccination recommendation for Cambodia.

  12. Typhoid fever among hospitalized febrile children in Siem Reap, Cambodia.

    Science.gov (United States)

    Wijedoru, Lalith P M; Kumar, Varun; Chanpheaktra, Ngoun; Chheng, Kheng; Smits, Henk L; Pastoor, Rob; Nga, Tran Vu Thieu; Baker, Stephen; Wuthiekanun, Vanaporn; Peacock, Sharon J; Putchhat, Hor; Parry, Christopher M

    2012-02-01

    Typhoid fever was confirmed by positive blood culture in 5 (3.7%) of 134 febrile children hospitalized in Cambodia. Typhoid was suspected in an additional 25 (18.7 %) blood culture-negative children based on: a positive immunoglobulin M lateral flow assay (IgMFA) (16); a positive polymerase chain reaction (PCR) for Salmonella typhi (2); or clinical assessment (7). The specificity of the IgMFA and PCR assays requires further study.

  13. Indicators for sustainable tourism: The case of Cambodia

    Directory of Open Access Journals (Sweden)

    Nhep Tinat

    2015-03-01

    Full Text Available Most research on tourism in Cambodia so far has focused on growth. There is very limited research on indicators for sustainability. A failure to create indicators for sustainable tourism may lead to short-term growth but the country will suffer in the long run. Sustainability really matters in tourism especially in a new destination like Cambodia. Cambodia has no clear indicators determining tourism sustainability. Cambodia’s tourism is remarkably flourishing, but behind this growth some challenges exist: Cultural and environmental impacts, economic leakage, sex tourism, drug trafficking and disease transmission. These concern tourism sustainability. This research intends to fill a significant gap regarding challenges hampering sustainable tourism, particularly creating indicators, by studying the activities of Cambodia’s tourism. The aim is to contribute to developing more comprehensive policies and measures that address problems by drawing on the activities and perspectives of the country’s tourism stakeholders: These include public and private actors, NGOs, local people and tourists.

  14. A Multimedia Approach to ODL for Agricultural Training in Cambodia

    Directory of Open Access Journals (Sweden)

    Helena Grunfeld

    2013-03-01

    Full Text Available Open distance learning (ODL has long been an important option for formal and non-formal education (NFE in most developed and developing countries, but less so in post-conflict countries, including Cambodia. However, in Cambodia there is now greater awareness that ODL can complement traditional face-to-face educational approaches, particularly as there is a shortage of teachers in the country. Thus, understanding how ODL can achieve learning and other objectives has important implications for both formal education and NFE. If it can be found to be effective, ODL has the potential of reaching a large number of people at comparatively lower average costs. This paper reports on a project where the same content was taught to farmers in Cambodia via traditional face-to-face and via ODL and compares outcomes between the different training methods. Exploring the extent to which farmers had adopted new farm practices taught in the course, our results indicate that the outcomes did not vary considerably between those trained using the different approaches.

  15. The commercialization of traditional medicine in modern Cambodia.

    Science.gov (United States)

    Ros, Bandeth; Lê, Gillian; McPake, Barbara; Fustukian, Suzanne

    2018-01-01

    Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60 years in Cambodia, a country with high out-of-pocket expenditures for health. The life histories suggest that traditional medicine in Cambodia has been undergoing a process of commercialization, with significant impacts on poor households. In the earlier lives of respondents, payments for traditional medicine were reported to have been flexible, voluntary or appropriate to patients' financial means. In contrast, contemporary practitioners appear to seek immediate cash payments that have frequently led to considerable debt and asset sales by traditional medicine users. Given traditional medicine's popularity as a source of treatment in Cambodia and its potential to contribute to household impoverishment, we suggest that it needs to be included in a national conversation about achieving Universal Health Coverage in the country. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  16. Examination of core competencies of agricultural development professionals in Cambodia.

    Science.gov (United States)

    Suvedi, Murari; Ghimire, Ramjee; Channa, Ty

    2018-04-01

    This cross-sectional study examined perceived level of importance, perceived level of competency in extension core competencies, and whether and how perceptions of competency vary by respondents' demographics; ascertained gaps in competency, if any; and identified ways for agricultural development professionals in Cambodia to acquire core competencies. Data were collected using a group-administered survey among 39 agricultural development professionals participating in a national workshop in December 2015. The survey consisted of 48 competencies representing eight core competencies, and each competency had level of importance and level of competency parts. The findings show that extension workers in Cambodia deemed all competencies highly or very highly important to their extension work; however, their perceived level of competency in those competencies appeared not to meet the expectations. The level of competency in all but communication skills and diversity significantly differed by gender but not by age and experience. Respondents indicated all four methods-preservice, in-service, basic induction training, and participation in seminars, workshops, and webinars-equally appropriate to acquire core competencies. The findings imply that the agricultural development authority in Cambodia should review, update, or design extension education curricula incorporating the competencies highlighted in this study and train its extension cadres on those competencies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Becoming and Being Academic Women in Cambodia: Cultural and Other Understandings

    Science.gov (United States)

    Maxwell, T. W.; Nget, Sokhany; Am, Kunthy; Peou, Leakhna; You, Songly

    2015-01-01

    Cambodia's higher education is under development. This is the first study of the role of women teaching in a university in Cambodia. There has been many studies of academic women in western countries and these guided the 16 interviews in Khmer that were carried out by young female researchers, translated by them and then analysed with the…

  18. 76 FR 33019 - Waiver of Restriction on Assistance to the Royal Government of Cambodia

    Science.gov (United States)

    2011-06-07

    ... DEPARTMENT OF STATE [Public Notice: 7491] Waiver of Restriction on Assistance to the Royal Government of Cambodia Pursuant to Section 7086(c)(2) of the Department of State, Foreign Operations, and... waive the requirements of Section 7086(c)(1) of the Act with respect to the Royal Government of Cambodia...

  19. "A Frog in a Well": The Exclusion of Disabled People from Work in Cambodia

    Science.gov (United States)

    Gartrell, Alexandra

    2010-01-01

    Based on ethnographic research conducted in north-west Cambodia in 2000-2001, this paper examines why disabled people experience systematic marginalisation in the labour market. Although there are no official data on the relationship between disability and employment status in Cambodia, this research suggests that disabled people are more likely…

  20. Educational Policy Trajectories in an Era of Globalization: Singapore and Cambodia

    Science.gov (United States)

    Tan, Charlene

    2010-01-01

    This paper critically discusses the educational policy trajectories of Singapore and Cambodia in an era of globalization. Drawing upon David Johnson's five metaphors to describe the historical and political forces that shape educational policy trajectories, the paper argues that Cambodia's current educational policy trajectory is characterized by…

  1. 78 FR 17745 - Waiver of Restriction on Assistance to the Central Government of Cambodia

    Science.gov (United States)

    2013-03-22

    ... DEPARTMENT OF STATE [Public Notice 8245] Waiver of Restriction on Assistance to the Central Government of Cambodia Pursuant to Section 7031(b)(3) of the Department of State, Foreign Operations, and... United States to waive the requirements of Section 7031(b)(1) of the Act with respect to Cambodia and I...

  2. Enhancing Aid Effectiveness in Education through a Sector-Wide Approach in Cambodia

    Science.gov (United States)

    Hattori, Hiroyuki

    2009-01-01

    Since 2001 the government of Cambodia has striven to advance policy-led education reform based on a sector-wide approach. This paper critically reviews the status and progress of Cambodia's education reform from the perspective of the aid's effectiveness. The paper looks at the performance of the sector reform in the three priority areas…

  3. Is Something Better than Nothing? An Evaluation of Early Childhood Programs in Cambodia

    Science.gov (United States)

    Rao, Nirmala; Sun, Jin; Pearson, Veronica; Pearson, Emma; Liu, Hongyun; Constas, Mark A.; Engle, Patrice L.

    2012-01-01

    This study evaluated the relative effectiveness of home-based, community-based, and state-run early childhood programs across Cambodia. A total of 880 five-year-olds (55% girls) from 6 rural provinces in Cambodia attending State Preschools, Community Preschools, Home-Based Programs, or no programs were assessed twice using the Cambodian…

  4. Educational Cooperation between Thailand and Cambodia: Outcomes on Human Development, International Understanding and Future Prospect

    Science.gov (United States)

    Kijtorntham, Wichuda; Ruangdej, Phumjit; Saisuwan, Chatchanog

    2015-01-01

    Thailand and Cambodia set up educational cooperation since 1996, before signed a Memorandum of Understanding on Cooperation in the Promotion of Education in 2003. This research aimed to investigate outcomes of educational cooperation projects on Cambodia human development and international understanding, process of participatory learning and…

  5. Unsystematic Technology Adoption in Cambodia: Students' Perceptions of Computer and Internet Use

    Science.gov (United States)

    Richardson, Jayson W.; Nash, John B.; Flora, Kevin L.

    2014-01-01

    This study was designed to understand how upper secondary school students in Cambodia perceive the use of computers and the Internet. Data were collected from students in three urban upper secondary schools (n = 1,137) in Cambodia using questionnaires. The data indicate that the more exposure a Cambodian student had to computers and the Internet…

  6. The unfinished health agenda: Neonatal mortality in Cambodia.

    Directory of Open Access Journals (Sweden)

    Rathmony Hong

    Full Text Available Reduction of neonatal and under-five mortality rates remains a primary target in the achievement of universal health goals, as evident in renewed investments of Sustainable Development Goals. Various studies attribute declines in mortality to the combined effects of improvements in health care practices and changes in socio-economic factors. Since the early nineties, Cambodia has managed to evolve from a country devastated by war to a nation soon to enter the group of middle income countries. Cambodia's development efforts are reflected in some remarkable health outcomes such as a significant decline in child mortality rates and the early achievement of related Millennium Development Goals. An achievement acknowledged through the inclusion of Cambodia as one of the ten fast-track countries in the Partnership for Maternal, Newborn and Child Health. This study aims to highlight findings from the field so to provide evidence for future programming and policy efforts. It will be argued that to foster further advances in health, Cambodia will need to keep neonatal survival and health high on the agenda and tackle exacerbating inequities that arise from a pluralistic health system with considerable regional differences and socio-economic disparities.Data was drawn from Demographic Health Surveys (2000, 2005, 2010, 2014. Information on a series of demographic and socio-economic household characteristics and on child anthropometry, feeding practices and child health were collected from nationally representative samples. To reach the required sample size, live-births that occurred over the past 10 years before the date of the interview were included. Demographic variables included: gender of the child, living area (urban or rural; four ecological regions (constructed by merging provinces and the capital, mother's age at birth (<20, 20-35, 35+, birth interval (long, short and birth order (1st, 2-3, 4-6, 7+. Socio-economic variables included: mother

  7. The unfinished health agenda: Neonatal mortality in Cambodia.

    Science.gov (United States)

    Hong, Rathmony; Ahn, Pauline Yongeun; Wieringa, Frank; Rathavy, Tung; Gauthier, Ludovic; Hong, Rathavuth; Laillou, Arnaud; Van Geystelen, Judit; Berger, Jacques; Poirot, Etienne

    2017-01-01

    Reduction of neonatal and under-five mortality rates remains a primary target in the achievement of universal health goals, as evident in renewed investments of Sustainable Development Goals. Various studies attribute declines in mortality to the combined effects of improvements in health care practices and changes in socio-economic factors. Since the early nineties, Cambodia has managed to evolve from a country devastated by war to a nation soon to enter the group of middle income countries. Cambodia's development efforts are reflected in some remarkable health outcomes such as a significant decline in child mortality rates and the early achievement of related Millennium Development Goals. An achievement acknowledged through the inclusion of Cambodia as one of the ten fast-track countries in the Partnership for Maternal, Newborn and Child Health. This study aims to highlight findings from the field so to provide evidence for future programming and policy efforts. It will be argued that to foster further advances in health, Cambodia will need to keep neonatal survival and health high on the agenda and tackle exacerbating inequities that arise from a pluralistic health system with considerable regional differences and socio-economic disparities. Data was drawn from Demographic Health Surveys (2000, 2005, 2010, 2014). Information on a series of demographic and socio-economic household characteristics and on child anthropometry, feeding practices and child health were collected from nationally representative samples. To reach the required sample size, live-births that occurred over the past 10 years before the date of the interview were included. Demographic variables included: gender of the child, living area (urban or rural; four ecological regions (constructed by merging provinces and the capital), mother's age at birth (birth interval (long, short) and birth order (1st, 2-3, 4-6, 7+). Socio-economic variables included: mother education level (none, primary

  8. Imaging in the Khmer’s Land: Cambodia Country Report

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    Samantha\tG. Harrington

    2015-11-01

    Full Text Available Cambodia is located in Southeast Asia on the Indochina Peninsula and borders Vietnam, Laos, Thailand and the Gulf of Thailand (Figure 1. With a total area of 69,898 square miles and population of 15,458,332, Cambodia’s population density has steadily increased since 1980. The country’s annual rate of urbanization is 2.65 %. As of 2014, 20.5% of the population lives in an urban setting. The estimated population growth rate is 1.63% (1. The capital of Cambodia is Phnom Penh, which is located in the southern part of the country. Other major cities include Battambang and Siem Reap, both of which have populations over 150,000. There are officially 24 provinces and one municipality (Phnom Penh. However, many consider Phnom Penh to be its own province. As a result, some research puts the number of Cambodian provinces at 25. The climate is tropical with two seasons: monsoon season (May to November and dry season (December to April. Temperatures range from approximately 70 to 95°F. Cambodia’s economy largely depends on the garment industry, tourism, construction, real estate and agriculture. Cambodia gained independence from France in 1953 and was first ruled by a constitutional monarchy under King Norodom Sihanouk. After a five-year struggle starting in 1970, the Khmer Rouge captured Phnom Penh in 1975. Pol Pot, the leader of the Khmer Rouge, oversaw a brutal regime that, through executions and forced labor, was responsible for the deaths of at least 1.5 million Cambodians. The Vietnamese drove out the Khmer Rouge in 1979. After years of Vietnamese occupation, the 1991 Paris Peace Accords established a ceasefire and a democratic framework for the country. By 1993 elections established a new coalition government; yet, political instability and violence persisted throughout the 1990s. Cambodia most recently held elections in 2013, as a multiparty democracy under a constitutional monarchy.The devastation caused by the Khmer Rouge has had long

  9. Effectiveness of community forestry in Prey Long forest, Cambodia.

    Science.gov (United States)

    Lambrick, Frances H; Brown, Nick D; Lawrence, Anna; Bebber, Daniel P

    2014-04-01

    Cambodia has 57% forest cover, the second highest in the Greater Mekong region, and a high deforestation rate (1.2%/year, 2005-2010). Community forestry (CF) has been proposed as a way to reduce deforestation and support livelihoods through local management of forests. CF is expanding rapidly in Cambodia. The National Forests Program aims to designate one million hectares of forest to CF by 2030. However, the effectiveness of CF in conservation is not clear due to a global lack of controlled comparisons, multiple meanings of CF, and the context-specific nature of CF implementation. We assessed the effectiveness of CF by comparing 9 CF sites with paired controls in state production forest in the area of Prey Long forest, Cambodia. We assessed forest condition in 18-20 randomly placed variable-radius plots and fixed-area regeneration plots. We surveyed 10% of households in each of the 9 CF villages to determine the proportion that used forest products, as a measure of household dependence on the forest. CF sites had fewer signs of anthropogenic damage (cut stems, stumps, and burned trees), higher aboveground biomass, more regenerating stems, and reduced canopy openness than control areas. Abundance of economically valuable species, however, was higher in control sites. We used survey results and geographic parameters to model factors affecting CF outcomes. Interaction between management type, CF or control, and forest dependence indicated that CF was more effective in cases where the community relied on forest products for subsistence use and income. © 2014 Society for Conservation Biology.

  10. Iodized salt in Cambodia: trends from 2008 to 2014.

    Science.gov (United States)

    Laillou, Arnaud; Mam, Borath; Oeurn, Sam; Chea, Chantum

    2015-05-29

    Though the consequences of nutritional iodine deficiency have been known for a long time, in Cambodia its elimination has only become a priority in the last 18 years. The Royal Government of Cambodia initiated the National Sub-Committee for Control of Iodine Deficiency Disorders in 1996 to fight this problem. Using three different surveys providing information across all provinces, we examined the compliance of salt iodization in Cambodia over the last 6 years. Salt samples from the 24 provinces were collect at the household level in 2008 (n = 566) and 2011 (n = 1275) and at the market level in 2014 (n = 1862) and analysed through a wavelength spectrophotometer for iodine content. According to the samples collected, the median iodine content significantly dropped from 22 mg/kg (25th/75th percentile: 2/37 mg/kg) in 2011 to 0 mg/kg in 2014 (25th/75th percentile: 0/8.9 mg/kg) (p < 0.001). The proportion of non-iodized salt within our collected salt drastically increased from 22% in 2011 to 62% in 2014 (p < 0.001). Since the international organizations ceased to support the procurement of iodine, the prevalence of salt compliant with the Cambodian declined within our samples. To date, the current levels of iodine added to tested salt are unsatisfactory as 92% of those salts do not meet the government requirements (99.6% of the coarse salt and 82.4% of the fine salt). This inappropriate iodization could illustrate the lack of periodic monitoring and enforcement from government entities. Therefore, government quality inspection should be reinforced to reduce the quantity of salt not meeting the national requirement.

  11. Water cycle observations in forest watersheds of Cambodia

    Science.gov (United States)

    Shimizu, A.; Tamai, K.; Kabeya, N.; Shimizu, T.; Iida, S. I.

    2015-12-01

    The Lower Mekong River flows through Cambodia, where forests cover ~60% of the country and are believed to have a marked effect on the water cycle. These tropical seasonal forests in the Cambodian flat lands are very precious in the Indochinese Peninsula as few forests of this type remain. However, few hydrological observations have been conducted in these areas. In Cambodia, deciduous and evergreen forests make up 42% and 33% of the total forest area, respectively. We established experimental watersheds both in deciduous and evergreen forests containing meteorological observation towers in Cambodia and collected various observational data since 2003 (O'Krieng, deciduous forest watershed including a 30-m-high observation tower, 2,245 km2; Stung Chinit, evergreen forest watershed including a 60-m-high observation tower, 3,700 km2 including three small watersheds). The basic data from these sites included various kinds of information related to the composition of vegetation, soil characteristics, etc. Hydrologic data was collected and linked to the above data; the main hydrologic research results follow. The water budget for each watershed was determined using an observational rainfall and runoff dataset. The evapotranspiration rate in an evergreen forest was obtained using various observational methods including the Bowen energy-balance ratio and the bandpass eddy covariance method. The annual evapotranspiration of evergreen forests, estimated using the Bowen energy-balance ratio method and water balance, was about 1100-1200 mm, corresponding to 70-80% of annual rainfall. While considering the importance of the presence of evergreen forest, we conducted sap flow measurements to analyze the transpiration process that maintains water uptake through root systems that reach to depths exceeding 8 m. Characteristics of the evaporation from the forest floor that form an important element of the evaporation system were estimated in both evergreen and deciduous forests.

  12. Leptospira and rodents in Cambodia : environmental determinants of infection

    OpenAIRE

    Ivanova, S.; Herbreteau, Vincent; Blasdell, K.; Chaval, Y.; Buchy, P.; Guillard, B.; Morand, S.

    2012-01-01

    We investigated infection of rodents and shrews by Leptospira spp. in two localities of Cambodia (Veal Renh, Kaev Seima) and in four types of habitat (forests, non-flooded lands, lowland rain-fed paddy fields, houses) during the wet and the dry seasons. Habitat preference was common, and rodent and shrew species were found only in houses or in rain-fed paddy fields or in forests. Among 649 small mammals trapped belonging to 12 rodent species and 1 shrew species, 71 of 642 animals tested were ...

  13. Diabetes and associated disorders in Cambodia: two epidemiological surveys.

    Science.gov (United States)

    King, Hilary; Keuky, Lim; Seng, Serey; Khun, Touch; Roglic, Gojka; Pinget, Michel

    2005-11-05

    The Asia-Pacific region is thought to be severely affected by diabetes. However, reliable, standardised data on prevalence and characteristics of glucose intolerance in Asian populations remain sparse. We describe the results of two field surveys undertaken in Cambodia in 2004. 2246 randomly selected adults aged 25 years and older were examined in two communities, one rural (Siemreap) and one semi-urban (Kampong Cham). The diagnosis of diabetes and impaired glucose tolerance was based on 2-h blood glucose estimation using criteria recommended by the latest report of a WHO Expert Group. Blood pressure, anthropometry, habitual diet, and other relevant characteristics were also recorded. Prevalence of diabetes was 5% in Siemreap and 11% in Kampong Cham. Prevalence of impaired glucose tolerance was 10% in Siemreap and 15% in Kampong Cham. About two-thirds of all cases of diabetes were undiagnosed before the survey. Prevalence of hypertension was 12% at Siemreap and 25% at Kampong Cham. People in Kampong Cham had higher estimates of central obesity than those in Siemreap. Diabetes and hypertension are not uncommon in Cambodia. A quarter of all adults in the chosen suburban community had some degree of glucose intolerance. Since Cambodian society is relatively poor, and lifestyle is fairly traditional by international standards, these findings are unexpected.

  14. Calming the mind: Healing after mass atrocity in Cambodia.

    Science.gov (United States)

    Agger, Inger

    2015-08-01

    After catastrophic events in which people's survival has been threatened, as happened during the Khmer Rouge regime in Cambodia 1975-1979, some continue to suffer from painful mental symptoms. Surveys carried out in Cambodia based on Western diagnostic categories have found a high prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the population. This study explored Cambodian approaches to healing trauma, examining the ways in which Cambodians appeal to elements of Buddhism in their efforts to calm their minds, situating this mode of coping in the context of broader Khmer Buddhist practice and understandings. Western psychology may have much to learn from local, contextualised methods of dealing with the aftermath of trauma, including Khmer understandings of distress and approaches to relief. Methods of assessment and treatment of distress cannot be transposed wholesale from one cultural setting to another but require considerable cultural adaptation. This kind of cultural interchange may give rise to innovative, hybrid discourses and methods that may have much to offer in the support of victims of organised violence. © The Author(s) 2015.

  15. Sustainable Construction Industry in Cambodia: Awareness, Drivers and Barriers

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    Serdar Durdyev

    2018-02-01

    Full Text Available Although sustainability is of utmost importance, anecdotal evidence suggests that the concept is not adequately implemented in many developing countries. This paper investigates industry stakeholders’ awareness of the current state of, factors driving, and barriers hindering the adoption of sustainable construction (SC in Cambodia. Using an empirical questionnaire survey targeting local construction professionals, respondents were invited to rate their level of awareness, knowledge and understanding of SC, as well as to rate the level of importance of 31 drivers and 10 barriers identified from the seminal literature. The data set was subjected to the relative importance index method. The results suggest that the industry-wide adoption of SC practices is poor, which is believed to be due to a lack of awareness and knowledge, and reluctance to adopt new sustainable technologies. Furthermore, more efforts must be put into the selection of more durable materials for the extension of buildings’ lives and to minimize material consumption, as well as to develop energy-efficient buildings with minimal environmental impact and a healthy indoor environment, so that the ability of future generations to meet their own needs will not be compromised. The outcomes of this study have enriched knowledge about the current state of, drivers of, and barriers to sustainable construction in a typical developing economy. Although the outcomes of this study were a short scoping exercise, it has formed a significant base for future SC work within Cambodia.

  16. Cost and disease burden of Dengue in Cambodia

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    Beauté Julien

    2010-08-01

    Full Text Available Abstract Background Dengue is endemic in Cambodia (pop. estimates 14.4 million, a country with poor health and economic indicators. Disease burden estimates help decision makers in setting priorities. Using recent estimates of dengue incidence in Cambodia, we estimated the cost of dengue and its burden using disability adjusted life years (DALYs. Methods Recent population-based cohort data were used to calculate direct and productive costs, and DALYs. Health seeking behaviors were taken into account in cost estimates. Specific age group incidence estimates were used in DALYs calculation. Results The mean cost per dengue case varied from US$36 - $75 over 2006-2008 respectively, resulting in an overall annual cost from US$3,327,284 in 2008 to US$14,429,513 during a large epidemic in 2007. Patients sustain the highest share of costs by paying an average of 78% of total costs and 63% of direct medical costs. DALY rates per 100,000 individuals ranged from 24.3 to 100.6 in 2007-2008 with 80% on average due to premature mortality. Conclusion Our analysis confirmed the high societal and individual family burden of dengue. Total costs represented between 0.03 and 0.17% of Gross Domestic Product. Health seeking behavior has a major impact on costs. The more accurate estimate used in this study will better allow decision makers to account for dengue costs particularly among the poor when balancing the benefits of introducing a potentially effective dengue vaccine.

  17. First report of human intestinal sarcocystosis in Cambodia.

    Science.gov (United States)

    Khieu, Virak; Marti, Hanspeter; Chhay, Saomony; Char, Meng Chuor; Muth, Sinuon; Odermatt, Peter

    2017-10-01

    Human intestinal sarcocystosis (HIS), caused by Sarcocystis species, is acquired by eating undercooked meat from sarcocyst-containing cattle (S. hominis, S. heydorni) and pigs (S. suihominis). We report on the detection of human intestinal Sarcocystis infections in a cross-sectional survey of Strongyloides stercoralis in early 2014, in Rovieng District, Preah Vihear Province, northern Cambodia. Among 1081 participants, 108 (10.0%) were diagnosed with Sarcocystis spp. oocysts in stool samples. Males had a significantly higher risk of infection than females (OR: 1.9, 95% CI: 1.3-2.9, p=0.001). None of the reported symptoms (abdominal discomfort, diarrhea, muscle pain and itching skin) occurring in the two weeks preceding the examinations were associated with a Sarcocystis infection. Many Sarcocystis cases were found among those who had participated in a wedding celebration and Chinese New Year festivities, where they had consumed raw or insufficiently cooked beef (83.3%) and pork (38.9%) based dishes. This report documents the first HIS cases in Cambodia. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Nontuberculous Mycobacteria Infections at a Provincial Reference Hospital, Cambodia.

    Science.gov (United States)

    Bonnet, Maryline; San, Kim Chamroeun; Pho, Yati; Sok, Chandara; Dousset, Jean-Philippe; Brant, William; Hurtado, Northan; Eam, Khun Kim; Ardizzoni, Elisa; Heng, Seiha; Godreuil, Sylvain; Yew, Wing-Wai; Hewison, Cathy

    2017-07-01

    Prevalence of nontuberculous mycobacteria (NTM) disease is poorly documented in countries with high prevalence of tuberculosis (TB). We describe prevalence, risk factors, and TB program implications for NTM isolates and disease in Cambodia. A prospective cohort of 1,183 patients with presumptive TB underwent epidemiologic, clinical, radiologic, and microbiologic evaluation, including >12-months of follow-up for patients with NTM isolates. Prevalence of NTM isolates was 10.8% and of disease was 0.9%; 217 (18.3%) patients had TB. Of 197 smear-positive patients, 171 (86.8%) had TB confirmed (167 by culture and 4 by Xpert MTB/RIF assay only) and 11 (5.6%) had NTM isolates. HIV infection and past TB were independently associated with having NTM isolates. Improved detection of NTM isolates in Cambodia might require more systematic use of mycobacterial culture and the use of Xpert MTB/RIF to confirm smear-positive TB cases, especially in patients with HIV infection or a history of TB.

  19. Mental health survey among landmine survivors in Siem Reap province, Cambodia.

    Science.gov (United States)

    Lopes Cardozo, Barbara; Blanton, Curtis; Zalewski, Tami; Tor, Svang; McDonald, Laura; Lavelle, James; Brooks, Robert; Anderson, Mark; Mollica, Richard

    2012-01-01

    Many survivors of the Khmer Rouge period in Cambodia and the subsequent war with Vietnam have now returned to Cambodia. In this two-stage household cluster survey in Siem Reap Province in Cambodia, we explored the mental health consequences on 166 landmine injury survivors selected from 1000 household in 50 clusters and an oversample of all landmine survivors. We found a prevalence of anxiety of 62% for all respondents, 74% for depression, and 34% for post-traumatic stress disorder (PTSD). These prevalences were statistically significantly higher than among the adult population who had not been injured by landmines. These data underscore the importance of providing mental health care services for the people in Siem Reap Province in Cambodia who have been injured by landmines.

  20. Snake prices and crocodile appetites: Aquatic wildlife supply and demand on Tonle Sap Lake, Cambodia

    OpenAIRE

    Brooks, SE; Allison, EH; Gill, JA; Reynolds, JD

    2010-01-01

    Commercial trade is a major driver of over-exploitation of wild species, but the pattern of demand and how it responds to changes in supply is poorly understood. Here we explore the markets for snakes from Tonle Sap Lake in Cambodia to evaluate future exploitation scenarios, identify entry points for conservation and, more generally, to illustrate the value of multi-scale analysis of markets to traded wildlife conservation. In Cambodia, the largest driver of snake exploitation is the domestic...

  1. NEW AND RARE ORCHIDS (ORCHIDACEAE IN THE FLORA OF CAMBODIA AND LAOS

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    L. V. Averyanov

    2015-04-01

    Full Text Available Herbarium material collected in 2009–2013 in Cambodia and Laos provides 240 new localities for 156 orchid species (from 73 genera. Among them, 13 and 45 species respectively are new for the flora of each country. One species (Bulbophyllum konstantinovii discovered in Cambodia is described as new for science. Eight genera (Acanthephippium, Didymoplexiopsis, Eclecticus, Herpysma, Hetaeria, Lecanorchis, Neuwiedia, and Trichosma were found in Laos at first.

  2. ‘Orphanage Tourism’ in Cambodia: When Residential Care Centres Become Tourist Attractions

    OpenAIRE

    Tess Guiney

    2012-01-01

    Cambodia’s recent history of instability has garnered it international notoriety as a place of genocide, corruption and insecurity. Currently, this perception of Cambodia has resulted in an influx of tourists seeking to volunteer at and visit orphanages throughout the country hoping to combat the perceived poverty and suffering. With only 21 state-run orphanages in Cambodia the remaining 248 (although it is potentially even more) rely significantly on over-seas donations with many advertising...

  3. Nonfatal Injuries and Psychosocial Correlates among Middle School Students in Cambodia and Vietnam

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    Karl Peltzer

    2017-03-01

    Full Text Available The aim of the study was to estimate the prevalence and psychosocial correlates of nonfatal injury among middle school students in Cambodia and Vietnam. Cross-sectional data from 7137 school children (mean age 15.5 years, SD = 1.4 who were randomly sampled for participation in nationally representative Global School-based Health Surveys (GSHS in Cambodia and Vietnam were analyzed. The proportion of school children reporting one or more serious injuries in the past year was 22.6% among boys and 17.5% among girls in Cambodia and 34.3% among boys and 25.1% among girls in Vietnam. The most prevalent cause of the most serious injury in Cambodia was traffic injuries (4.7% among boys and 4.3% among girls and in Vietnam it was falls (10.0% among boys and 7.0% among girls. In multinomial logistic regression analyses, experiencing hunger (as an indicator for low socioeconomic status and drug use were associated with having sustained one injury and two or more injuries in the past 12 months in Cambodia. In addition, poor mental health was associated with two or more injuries. In Vietnam, being male, experiencing hunger, current alcohol use, poor mental health and ever having had sex were associated with having sustained one injury and two or more injuries in the past 12 months. Several psychosocial variables were identified which could help in designing injury prevention strategies among middle school children in Cambodia and Vietnam.

  4. Multiple populations of artemisinin-resistant Plasmodium falciparum in Cambodia

    Science.gov (United States)

    Miotto, Olivo; Almagro-Garcia, Jacob; Manske, Magnus; MacInnis, Bronwyn; Campino, Susana; Rockett, Kirk A; Amaratunga, Chanaki; Lim, Pharath; Suon, Seila; Sreng, Sokunthea; Anderson, Jennifer M; Duong, Socheat; Nguon, Chea; Chuor, Char Meng; Saunders, David; Se, Youry; Lon, Chantap; Fukuda, Mark M; Amenga-Etego, Lucas; Hodgson, Abraham VO; Asoala, Victor; Imwong, Mallika; Takala-Harrison, Shannon; Nosten, Francois; Su, Xin-zhuan; Ringwald, Pascal; Ariey, Frédéric; Dolecek, Christiane; Hien, Tran Tinh; Boni, Maciej F; Thai, Cao Quang; Amambua-Ngwa, Alfred; Conway, David J; Djimdé, Abdoulaye A; Doumbo, Ogobara K; Zongo, Issaka; Ouedraogo, Jean-Bosco; Alcock, Daniel; Drury, Eleanor; Auburn, Sarah; Koch, Oliver; Sanders, Mandy; Hubbart, Christina; Maslen, Gareth; Ruano-Rubio, Valentin; Jyothi, Dushyanth; Miles, Alistair; O’Brien, John; Gamble, Chris; Oyola, Samuel O; Rayner, Julian C; Newbold, Chris I; Berriman, Matthew; Spencer, Chris CA; McVean, Gilean; Day, Nicholas P; White, Nicholas J; Bethell, Delia; Dondorp, Arjen M; Plowe, Christopher V; Fairhurst, Rick M; Kwiatkowski, Dominic P

    2013-01-01

    We describe an analysis of genome variation in 825 Plasmodium falciparum samples from Asia and Africa that reveals an unusual pattern of parasite population structure at the epicentre of artemisinin resistance in western Cambodia. Within this relatively small geographical area we have discovered several distinct but apparently sympatric parasite subpopulations with extremely high levels of genetic differentiation. Of particular interest are three subpopulations, all associated with clinical resistance to artemisinin, which have skewed allele frequency spectra and remarkably high levels of haplotype homozygosity, indicative of founder effects and recent population expansion. We provide a catalogue of SNPs that show high levels of differentiation in the artemisinin-resistant subpopulations, including codon variants in various transporter proteins and DNA mismatch repair proteins. These data provide a population genetic framework for investigating the biological origins of artemisinin resistance and for defining molecular markers to assist its elimination. PMID:23624527

  5. Epilepsy: some controversies, some knowledge and some experience from Cambodia.

    Science.gov (United States)

    Hun, Chamroeun; Hok, Tola; Ros, Sina; Chan, Samleng; Bhalla, Devender

    2014-01-01

    Epilepsy-related health outcomes remain unacceptably low in much of the developing world. According to us, it is because of the failure since long to see, and address, epilepsy beyond its preset conventional image. The objective of this paper was to highlight the presence, and influence, of these conventional practices and also to demonstrate what happened when a bold unconventional approach to address epilepsy was taken in Cambodia. Data are taken from existing published literature on epilepsy as well as our field experience during several population-based surveys conducted in Cambodia. We complimented this with our knowledge gained over this long period. It is demonstrated that epilepsy is far more important in Asia that it is currently considered to be, and also vis-à-vis other geographic regions. Pregnancy and birth-related factors carry far higher odds for epilepsy than several "highly vocal" infections. A refocus in epilepsy is required to help move from its traditional negative image to an image where epilepsy is considered a "positive-looking" disorder that is full of "opportunities;" such as availability of safe effective inexpensive treatment, etc. Stigma is a two-side entity (i.e., it is present, and it is influential), and diligence should be therefore practiced before using the stigma label. Nevertheless, psychosocial aspects shouldn't be limited to stigma or Jacoby stigma scale alone. Quality of life is a subjective phenomenon, and patients should determine directly what affects them. It is highly desirable that if we want to find newer answers to old problems in epilepsy, we need to shed our conventional approach and preset conclusions. We should choose to move toward "opportunities" visibly present in epilepsy. Our Cambodian experience demonstrates more intimately that opportunities do get identified when preset conclusions are questioned, and an approach that goes beyond expected and by default is taken.

  6. Pediatric bloodstream infections in Cambodia, 2007 to 2011.

    Science.gov (United States)

    Stoesser, Nicole; Moore, Catrin E; Pocock, Joanna M; An, Khun Peng; Emary, Kate; Carter, Michael; Sona, Soeng; Poda, Sar; Day, Nicholas; Kumar, Varun; Parry, Christopher M

    2013-07-01

    Pediatric bacterial bloodstream infections (BSIs) are a major cause of morbidity and mortality worldwide. Epidemiological data from resource-limited settings in southeast Asia, such as Cambodia, are sparse but have important implications for treatment and public health strategies. We retrospectively investigated BSI in children at a pediatric hospital and its satellite clinic in Siem Reap, Cambodia, from January 1, 2007, to July 31, 2011. The range of bacterial pathogens and their antimicrobial susceptibility patterns were analyzed in conjunction with demographic, clinical and outcome data. Of 7682 blood cultures with results (99.9% of cultures taken), 606 (7.9%) episodes of BSI were identified in 588 children. The incidence of BSI increased from 14 to 50/1000 admissions (P < 0.001); this was associated with an increased sampling rate. Most BSI were community acquired (89.1%). Common pathogens included Salmonella Typhi (22.8% of all isolates), Staphylococcus aureus (12.2%), Streptococcus pneumoniae (10.0%), Klebsiella pneumoniae (6.4%) and Escherichia coli (6.3%). 21.5% of BSI were caused by a diverse group of uncommon organisms, the majority of which were environmental Gram-negative species. No Listeria monocytogenes or Group B streptococcal BSI were identified. Antimicrobial resistance, particularly among the Enterobacteriaceae, was common. Overall mortality was substantial (19.0%), higher in neonates (36.9%) and independently associated with meningitis/meningoencephalitis and K. pneumoniae infection. BSI is a common problem in Cambodian children attending hospital and associated with significant mortality. Further studies are needed to clarify the epidemiology of neonatal sepsis, the contribution of atypical organisms and the epidemiology of pneumococcal disease before the introduction of vaccine.

  7. 3 CFR - Presidential Determination for the Kingdom of Cambodia Under Section 2(b)(2) of the Export-Import...

    Science.gov (United States)

    2010-01-01

    ... Cambodia Under Section 2(b)(2) of the Export-Import Bank Act of 1945, as amended Presidential Documents... Determination for the Kingdom of Cambodia Under Section 2(b)(2) of the Export-Import Bank Act of 1945, as... the Export-Import Bank Act of 1945, as amended (12 U.S.C. 635(b)(2)(C)), I hereby determine that the...

  8. Hydropower and local community : A case study of the Kamchay dam, a China-funded hydropower project in Cambodia

    NARCIS (Netherlands)

    Pheakdey, Heng

    2017-01-01

    To solve its chronic power shortage, the Government of Cambodia has placed the development of hydropower as one of the national priorities. With a total of US$2.4bn in investment, China is the most prominent player in hydropower development in Cambodia. The increase of hydropower projects and

  9. Time to unsuccessful tuberculosis treatment outcome, Cambodia, China, and Viet Nam.

    Science.gov (United States)

    Hoa, N B; Sokun, C; Wei, C; Lauritsen, J M; Rieder, H L

    2012-03-21

    To determine the frequency and characteristics of patients with unsuccessful tuberculosis (TB) treatment. Random selection of TB case registers among all treatment units in Cambodia, two provinces in China, and Viet Nam. The data of two calendar years were analyzed to assess unsuccessful outcomes and their time of occurrence. Among the 33 309 TB patients, treatment was unsuccessful in respectively 10.1%, 3.0% and 9.1% of patients in Cambodia, China and Viet Nam. The risk of death was highest in Cambodia, higher among males than females, increased with age, and was more common among retreatment cases than new cases, and among patients with a high than a low sputum smear microscopy grade. Half of all deaths occurred in the first 2 months in Cambodia and within 11 weeks in China and Viet Nam. Median time to default was 3 months in Cambodia and Viet Nam, and about 2 months in China. Treatment was highly successful in the three study countries, with a low proportion of death and default. As the majority of defaulting occurs at the beginning of treatment, all countries should critically review their current policy of treatment support in this period.

  10. Perceived stigma by children on antiretroviral treatment in Cambodia.

    Science.gov (United States)

    Barennes, Hubert; Tat, Sovann; Reinharz, Daniel; Vibol, Ung

    2014-12-10

    HIV-related stigma diminishes the quality of life of affected patients. Little is known about perceived and enacted stigma of HIV-infected children in resources-limited settings. We documented the prevalence of perceived stigma and associated factors associated among children on antiretroviral therapy (ART) at a referral hospital in Cambodia. After informed consent, a standardized pre-tested 47-item questionnaire was confidentially administered to consecutive children (7 to 15 years) or their guardians if the child was 18 months to 6 years, during their routine ART visits. The questionnaire explored the sociodemographics of the child and the parents, HIV history, adherence to ART, tolerance of ART and perceived stigma. Associations between perceived stigma and the children's characteristics were measured by bivariate and multivariate analyses. Of 183 children, 101 (55.2%) had lost at least one and 45 (24.6%) both parents; 166 (90.7%) went to school. Of 183 children (female: 84, 45.9%, median age 7.0 years, interquartile range: 2.0-9.6), 79 (43.2%) experienced perceived stigma, including rejection by others (26.8%), no invitations to social activities (18.6%) and exclusion from games (14.2%). A total of 43 (23.5%) children were fearful of their disease and 61 (53.9%) of 113 older than 6 years reported knowledge of their HIV status. Of 136 children over five years and eligible for education, 7 (3.8%) could not go to school due to perceived stigma. Incomplete adherence to ART was reported for 17 (9.2%) children. In multivariate analysis, school attendance (odds ratio [OR]: 3.9; 95% confidence interval [CI]: 2.0-7.9) and income of less than one dollar per person per day (OR: 2.2, 95% CI: 1.1-4.5) were associated with perceived stigma. Conversely, receipt of social support (OR: 0.4, 95% CI 0.2-0.9) was associated with lower risk of perceived stigma. Perceived stigma in pediatric ART patients remains a significant issue in Cambodia. Psychological support and

  11. Rapid assessment of injection practices in Cambodia, 2002

    Directory of Open Access Journals (Sweden)

    Goldstein Susan

    2005-06-01

    Full Text Available Abstract Background Injection overuse and unsafe injection practices facilitate transmission of bloodborne pathogens such as hepatitis B virus (HBV, hepatitis C virus (HCV, and human immunodeficiency virus (HIV. Anecdotal reports of unsafe and unnecessary therapeutic injections and the high prevalence of HBV (8.0%, HCV (6.5%, and HIV (2.6% infection in Cambodia have raised concern over injection safety. To estimate the magnitude and patterns of such practices, a rapid assessment of injection practices was conducted. Methods We surveyed a random sample of the general population in Takeo Province and convenience samples of prescribers and injection providers in Takeo Province and Phnom Penh city regarding injection-related knowledge, attitudes, and practices. Injection providers were observed administering injections. Data were collected using standardized methods adapted from the World Health Organization safe injection assessment guidelines. Results Among the general population sample (n = 500, the overall injection rate was 5.9 injections per person-year, with 40% of participants reporting receipt of ≥ 1 injection during the previous 6 months. Therapeutic injections, intravenous infusions, and immunizations accounted for 74%, 16% and 10% of injections, respectively. The majority (>85% of injections were received in the private sector. All participants who recalled their last injection reported the injection was administered with a newly opened disposable syringe and needle. Prescribers (n = 60 reported that 47% of the total prescriptions they wrote included a therapeutic injection or infusion. Among injection providers (n = 60, 58% recapped the syringe after use and 13% did not dispose of the used needle and syringe appropriately. Over half (53% of the providers reported a needlestick injury during the previous 12 months. Ninety percent of prescribers and injection providers were aware HBV, HCV, and HIV were transmitted through unsafe

  12. Low specificity of 2 tetanus rapid tests in Cambodia.

    Science.gov (United States)

    Schlumberger, M; Yvonnet, B; Lesage, G; Tep, B

    2015-01-01

    Rapid testing for tetanus on serum or blood allows for an immediate evaluation of individual protection against tetanus in developed countries, using a "single step" immunochromatographic technique using tetanus toxoid. The specificity of these tests, compared to the reference method for tetanus, mouse serum neutralization testing, has however never been assessed in these countries, due to the difficulty to perform serum neutralization titration in mice, because of animal testing bioethical regulations. A collection of sera from adult volunteers in Cambodia, living in rural environment, was tested for tetanus antibodies by ELISA in France, and by mouse serum neutralization in Vietnam. This allowed estimating the sensitivity and specificity of 2 rapid tetanus tests, available on the market: TQS™ and Tetanotop™. The sensitivity of these tests was adequate, compared to mice serum neutralization test, for a test threshold of 0.01 IU/mL, (100% for TQS™, 91% for Tetanotop™), but their specificity was very low (1% for TQS™ and 13% for Tetanotop™). The results prove that these rapid tests for the assessment of individual protection against tetanus should not be used in the adult rural Cambodian population. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Screening of selected indigenous plants of Cambodia for antiplasmodial activity.

    Science.gov (United States)

    Hout, Sotheara; Chea, Aun; Bun, Sok-Siya; Elias, Riad; Gasquet, Monique; Timon-David, Pierre; Balansard, Guy; Azas, Nadine

    2006-08-11

    The in vitro antiplasmodial activity of 117 aqueous, methanol and dichloromethane extracts derived from different parts of 28 indigenous wild plant species was studied. These plants are commonly used in Cambodian traditional medicine. The plant extracts were tested for in vitro activity against a chloroquine resistant Plasmodium falciparum strain (W2). Nine extracts were moderately active with IC(50) values ranging between 5 and 10 microg/ml, 17 extracts were active with IC(50) values ranging between 1 and 5 microg/ml. These 26 extracts derived from eight plants belong to six families. The most active extracts were dichloromethane and came from Stephania rotunda and Brucea javanica with IC(50) values of 1 microg/ml and a selectivity index > or = 25. It is interesting to note that some aqueous extracts were as active as dichloromethane extracts especially aqueous extracts of Stephania rotunda, Brucea javanica, Phyllanthus urinaria and Eurycoma longifolia with IC(50) values of uses of these plants for the treatment of malaria and/or fever. In this study, we report the antiplasmodial potential activity of eight plant species from Cambodia. Among them four are tested for the first time.

  14. Microbiological effectiveness of mineral pot filters in Cambodia.

    Science.gov (United States)

    Brown, Joe; Chai, Ratana; Wang, Alice; Sobsey, Mark D

    2012-11-06

    Mineral pot filters (MPFs) are household water treatment (HWT) devices that are manufactured and distributed by the private sector, with millions of users in Southeast Asia. Their effectiveness in reducing waterborne microbes has not been previously investigated. We purchased three types of MPFs available on the Cambodian market for systematic evaluation of bacteria, virus, and protozoan surrogate microbial reduction in laboratory challenge experiments following WHO recommended performance testing protocols. Results over the total 1500 L testing period per filter indicate that the devices tested were highly effective in reducing Esherichia coli (99.99%+), moderately effective in reducing bacteriophage MS2 (99%+), and somewhat effective against Bacillus atrophaeus, a spore-forming bacterium we used as a surrogate for protozoa (88%+). Treatment mechanisms for all filters included porous ceramic and activated carbon filtration. Our results suggest that these commercially available filters may be at least as effective against waterborne pathogens as other, locally available treatment options such as ceramic pot filters or boiling. More research is needed on the role these devices may play as interim solutions to the problem of unsafe drinking water in Cambodia and globally.

  15. Financial sustainability planning for immunization services in Cambodia.

    Science.gov (United States)

    Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann

    2006-07-01

    The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.

  16. Prevalence of counterfeit anthelminthic medicines: a cross-sectional survey in Cambodia.

    Science.gov (United States)

    Khan, Mohiuddin Hussain; Okumura, Junko; Sovannarith, Tey; Nivanna, Nam; Akazawa, Manabu; Kimura, Kazuko

    2010-05-01

    To assess the prevalence of counterfeit anthelminthic medicines in Cambodia, and to determine influential factors. Commonly used anthelminthic medicines were collected from private drug outlets. Medicines were carefully observed including their registration labelling, and their authenticity was investigated with the manufacturers and the Medicines Regulatory Authorities. Samples were analysed by High-Performance Liquid Chromatography at the National Health Product Quality Control Centre, Cambodia. Two hundred and three samples of anthelminthics were collected from 137 drug stores. Domestic products constituted 36.9%. Of 196 samples which were verified for registration, 15.8% were not registered. Of 165 samples successfully investigated for their authenticity, 7 (4.2%) were identified as counterfeit. All of these medicines were purchased in open packs or containers, and most of them were foreign manufactured and/or without registration. The results of our survey urge strict implementation of drug registration and vigilance on the availability of unregistered medicines to combat counterfeit medicines in Cambodia.

  17. Assessment of Trachoma in Cambodia: Trachoma Is Not a Public Health Problem.

    Science.gov (United States)

    Meng, Ngy; Seiha, Do; Thorn, Pok; Willis, Rebecca; Flueckiger, Rebecca M; Dejene, Michael; Lewallen, Susan; Courtright, Paul; Solomon, Anthony W

    2016-01-01

    To determine whether trachoma is a public health problem requiring intervention in Cambodia. Based on historical evidence and reports, 14 evaluation units (EUs) in Cambodia, judged to be most likely to harbor trachoma, were selected. The Global Trachoma Mapping Project methodology was used to carry out rigorous surveys to determine the prevalence of trachomatous inflammation-follicular (TF) and trichiasis in each EU. The EU-level prevalence of TF among 25,801 1-9-year-old children examined ranged from 0% to 0.2%. Among the 24,502 adults aged 15+ years examined, trichiasis was found in 59 people. Age- and sex-adjusted prevalences of trichiasis in all ages in the EUs studied ranged from 0% to 0.14%; five EUs had a prevalence of trichiasis ≥0.1%. There appears to be no need nor justification at this time for implementing public health measures to control trachoma in Cambodia.

  18. HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

    Science.gov (United States)

    Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

    2014-01-01

    This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

  19. Dynamic of H5N1 virus in Cambodia and emergence of a novel endemic sub-clade.

    Science.gov (United States)

    Sorn, San; Sok, Touch; Ly, Sovann; Rith, Sareth; Tung, Nguyen; Viari, Alain; Gavotte, Laurent; Holl, Davun; Seng, Heng; Asgari, Nima; Richner, Beat; Laurent, Denis; Chea, Nora; Duong, Veasna; Toyoda, Tetsuya; Yasuda, Chadwick Y; Kitsutani, Paul; Zhou, Paul; Bing, Sun; Deubel, Vincent; Donis, Ruben; Frutos, Roger; Buchy, Philippe

    2013-04-01

    In Cambodia, the first detection of HPAI H5N1 virus in birds occurred in January 2004 and since then there have been 33 outbreaks in poultry while 21 human cases were reported. The origin and dynamics of these epizootics in Cambodia remain unclear. In this work we used a range of bioinformatics methods to analyze the Cambodian virus sequences together with those from neighboring countries. Six HA lineages belonging to clades 1 and 1.1 were identified since 2004. Lineage 1 shares an ancestor with viruses from Thailand and disappeared after 2005, to be replaced by lineage 2 originating from Vietnam and then by lineage 3. The highly adapted lineage 4 was seen only in Cambodia. Lineage 5 is circulating both in Vietnam and Cambodia since 2008 and was probably introduced in Cambodia through unregistered transboundary poultry trade. Lineage 6 is endemic to Cambodia since 2010 and could be classified as a new clade according to WHO/OIE/FAO criteria for H5N1 virus nomenclature. We propose to name it clade 1.1A. There is a direct filiation of lineages 2 to 6 with a temporal evolution and geographic differentiation for lineages 4 and 6. By the end of 2011, two lineages, i.e. lineages 5 and 6, with different transmission paths cocirculate in Cambodia. The presence of lineage 6 only in Cambodia suggests the existence of a transmission specific to this country whereas the presence of lineage 5 in both Cambodia and Vietnam indicates a distinct way of circulation of infected poultry. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Perinatal consumption of thiamin-fortified fish sauce in rural Cambodia: a randomized controlled efficacy trial

    Science.gov (United States)

    Importance: Infantile beriberi, a potentially fatal disease caused by thiamin deficiency, remains a public health concern in Cambodia and regions where B-vitamin poor, polished white rice is a staple food. Low maternal thiamin intake reduces breast milk thiamin concentrations, placing breastfed infa...

  1. Fish sauce, soy sauce, and vegetable oil fortification in Cambodia: where do we stand to date?

    Science.gov (United States)

    Theary, Chan; Panagides, Dora; Laillou, Arnaud; Vonthanak, Saphoon; Kanarath, Chheng; Chhorvann, Chhea; Sambath, Pol; Sowath, Sol; Moench-Pfanner, Regina

    2013-06-01

    The prevalence of micronutrient deficiencies in Cambodia is among the highest in Southeast Asia. Fortification of staple foods and condiments is considered to be one of the most cost-effective strategies for addressing micronutrient deficiencies at the population level. The Government of Cambodia has recognized the importance of food fortification as one strategy for improving the nutrition security of its population. This paper describes efforts under way in Cambodia for the fortification of fish sauce, soy sauce, and vegetable oil. Data were compiled from a stability test of Cambodian fish sauces fortified with sodium iron ethylenediaminetetraacetate (NaFeEDTA); analysis of fortified vegetable oils in the Cambodian market; a Knowledge, Attitudes, and Practices (KAP) study of fortified products; and food fortification program monitoring documents. At different levels of fortification of fish sauce with NaFeEDTA, sedimentation and precipitation were observed. This was taken into consideration in the government-issued standards for the fortification of fish sauce. All major brands of vegetable oil found in markets at the village and provincial levels are imported, and most are nonfortified. Fish sauce, soy sauce, and vegetable oil are widely consumed throughout Cambodia and are readily available in provincial and village markets. Together with an effective regulatory monitoring system, the government can guarantee that these commodities, whether locally produced or imported, are adequately fortified. A communications campaign would be worthwhile, once fortified commodities are available, as the KAP study found that Cambodians had a positive perception of fortified sauces.

  2. Perinatal consumption of thiamine-fortified fish sauce in rural Cambodia. A randomized clinical trial

    Science.gov (United States)

    Infantile beriberi, a potentially fatal disease caused by thiamine deficiency, is a public health concern in Cambodia and regions where thiamine-poor white rice is a staple food. Low maternal thiamine intake reduces breast milk thiamine placing breastfed infants at risk of beriberi. The objective wa...

  3. Double inequity? The social dimensions of deforestation and forest protection in local communities in Northern Cambodia

    DEFF Research Database (Denmark)

    Pasgaard, Maya; Chea, Lily

    2013-01-01

    governance, contested tenure arrangements, high agricultural dependency, and power discrepancies, this paper analyzes and critically discusses this ‘double inequity’ of deforestation and forest protection in Cambodia, and recommendations on how to ensure more equitable distribution of costs and benefits...

  4. The right to appeal a judgment of the Extraordinary Chambers in the courts of Cambodia

    NARCIS (Netherlands)

    O'Neill, L.; Sluiter, G.

    2009-01-01

    In early 2007, we submitted a report to the Extraordinary Chambers in the Courts of Cambodia commenting on several aspects of its then-draft Internal Rules, including whether the ECCC’s envisaged appeal system adhered to international standards. The Internal Rules were adopted in June 2007, and then

  5. Farmers’ Perspectives on Risk and Adaptation Strategies in the Mekong, Cambodia

    NARCIS (Netherlands)

    Ly, Kesa; Fraiture, de C.M.S.

    2016-01-01

    Aims: In Cambodia the frequency and impacts of natural disasters has been increasing. The impacts of droughts and floods are most severe within the agricultural sector which accounts for around 29% of Cambodia’s GDP and 59% of the work force. In this paper we assess the farmers’ perspectives on risk

  6. The economic consequences of malnutrition in Cambodia, more than 400 million US dollar lost annually.

    Science.gov (United States)

    Bagriansky, Jack; Champa, Ngy; Pak, Kimchoeun; Whitney, Sophie; Laillou, Arnaud

    2014-01-01

    Cambodia is among the 28 worst countries globally with the highest rates of childhood malnutrition. The aim of the assessment was to apply published evidence associating malnutrition and a variety of functional consequences to project economic implications of this high rate of childhood malnutrition. Such information is vital to advocate for appropriate programs and action plan to reduce malnutrition (from severe stunting to micronutrient deficiencies). This exercise used a "consequence model" to apply these "coefficients of loss" established in the global scientific literature to Cambodia health, demographic and economic data to develop a national estimation of the economic losses link to malnutrition. The impact of the indicators of malnutrition analysed represent a burden to the national economy of Cambodia estimated at more than $400 million annually -2.5% of GDP. Micronutrient deficiencies suggest deficits in the quality of the diet - representing a national burden of more than $200 million annually while breastfeeding behaviours account for 6% of the burden. 57% of the losses emerge from indicators measured in children, while 43% of losses are from indicators independent of childhood measurements - indicators of maternal behaviour along with maternal and adult nutrition. Given the low cost of interventions and the high baseline losses, investment in nutrition programs in Cambodia is likely to offer high returns and attractive benefit cost ratios. Since nearly half the losses are determined prior to the birth of the child, this has implications for targeting and timing of programs.

  7. Learning to Read in Ratanakiri: A Case Study from Northeastern Cambodia

    Science.gov (United States)

    Gregerson, Marilyn J.

    2009-01-01

    In Ratanakiri province, northeastern Cambodia, the majority of the local people are native speakers of ethnic minority languages. Primarily subsistence farmers, they use their own language to communicate with others in their villages, and as they work in their rice fields. A baseline survey taken between 1996 and 1998 in five such villages showed…

  8. Disability and Democracy in Cambodia: An Integrative Approach to Community Building and Civic Engagement

    Science.gov (United States)

    Zook, Darren C.

    2010-01-01

    The political framework through which the various communities of disabled persons in Cambodia advocate for and claim their rights is complex and confusing. Both governmental and non-governmental actors engage this political framework through the mobilization of persons from the various disabled communities, competing in the civic sphere through…

  9. Challenges of Adopting the Use of Technology in Less Developed Countries: The Case of Cambodia

    Science.gov (United States)

    Richardson, Jayson W.

    2011-01-01

    Drawing on Everett Rogers's theory of the diffusion of innovations, this article identifies the barriers, challenges, and successes in the adoption of technology training by teacher trainers in Cambodia. The analysis was based on data collected from an open-ended survey, face-to-face interviews, and document analysis. Findings reveal that the…

  10. Reviewing the Role of Teachers in Achieving Education for All in Cambodia

    Science.gov (United States)

    Kim, Chae-Young; Rouse, Martyn

    2011-01-01

    Over the last 20 years education policies in Cambodia have been driven by the global Education for All (EFA) campaign and have resulted in a rapid increase in the rates of primary education enrolment. However, the increasing number of children enrolling in schools has not always translated into high rates of primary education completion. Against…

  11. Conservation agriculture improves yield and reduces weeding activity in sandy soils of Cambodia

    Science.gov (United States)

    Intensive tillage in many less-developed countries, including Cambodia have caused significant decline in agriculture’s natural resources and sustainability. With limited available data, long-term conventional tillage system (CT) and conservation agriculture system (CA) can affect changes in soil pr...

  12. Impact of School Readiness Program Interventions on Children's Learning in Cambodia

    Science.gov (United States)

    Nonoyama-Tarumi, Yuko; Bredenberg, Kurt

    2009-01-01

    To reduce the high repetition rates in early years of primary school, the government of Cambodia piloted a school readiness program (SRP) in the first two months of Grade 1 of primary school. This study examines whether such intervention has effects on students' immediate acquisition of school readiness skills as well as students' longer term…

  13. Student Achievement and Education Policy in a Period of Rapid Expansion: Assessment Data Evidence from Cambodia

    Science.gov (United States)

    Marshall, Jeffery H.; Chinna, Ung; Nessay, Puth; Hok, Ung Ngo; Savoeun, Va; Tinon, Soeur; Veasna, Meung

    2009-01-01

    This article analyses student achievement and school quality in large samples of schools in Cambodia. Descriptive summaries of student proficiency levels in language and mathematics reveal large gaps between average performance in grades three and six. Given the near universal completion rates for grade three--and lower access to grade six--these…

  14. Completeness and consistency in recording information in the tuberculosis case register, Cambodia, China and Viet Nam.

    Science.gov (United States)

    Hoa, N B; Wei, C; Sokun, C; Lauritsen, J M; Rieder, H L

    2010-10-01

    Tuberculosis (TB) case registers in Cambodia, two provinces in China and in Viet Nam. To determine completeness and consistency of information for quarterly reports on case finding and treatment outcome. A representative sample of TB case registers was selected in Cambodia, in two provinces in China and in Viet Nam. Quarterly reports were reproduced from double-entered, validated data to determine completeness and consistency. The dataset comprised 37,635 patient records in 2 calendar years. Only 0.2%, 3.6% and 1.1% of cases, respectively, in Cambodia, the two China provinces, and Viet Nam did not allow classification for the quarterly report on case finding. If the treatment outcome was reported as cured, it was correct in 99.9%, 85.7%, and 98.5% of the respective three jurisdictions: errors were mostly due to misclassification of completion as cure. Under-reporting of failures was more frequent than over-reporting in Cambodia and Viet Nam, while in the two provinces in China 84% of reported failures did not actually meet the bacteriological criterion. This evaluation demonstrates that recording essential information is exemplary in all three countries. It will be essential to carefully supervise the ability of staff to correctly define TB treatment outcome results in all three countries.

  15. Distance Education Policy and Public Awareness in Cambodia, Laos, and Viet Nam

    Science.gov (United States)

    Vuth, Doung; Than, Chhuon Chan; Phanousith, Somphone; Phissamay, Phonpasit; Tai, Tran Thi

    2007-01-01

    The current project brings together academic and governmental specialists from Cambodia, Laos, and Viet Nam (CLV), in a collaborative study of the prospects for distance education (DE) in those countries. The study's overall objectives are to: (1) survey and take stock of existing educational scenarios and problems in CLV; (2) document the…

  16. Situation Reports--Brasil, Cambodia, Fiji, Malaysia (West), Thailand, and Uganda.

    Science.gov (United States)

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in six foreign countries are presented in these situation reports. Countries included are Brazil, Cambodia, Fiji, Malaysia (West), Thailand, and Uganda. Information is provided, where appropriate and available, under two topics, general background and family planning situation. General background…

  17. The Ethics of Survival: Teaching the Traditional Arts to Disadvantaged Children in Post-Conflict Cambodia

    Science.gov (United States)

    Kallio, Alexis A.; Westerlund, Heidi

    2016-01-01

    Cambodia's recent history of conflict and political instability has resulted in a recognized need to recover, regenerate, preserve and protect the nation's cultural heritage. Many education programmes catering for disadvantaged youth have implemented traditional Khmer music and dance lessons, suggesting that these programmes share the…

  18. ‘Orphanage Tourism’ in Cambodia: When Residential Care Centres Become Tourist Attractions

    Directory of Open Access Journals (Sweden)

    Tess Guiney

    2012-09-01

    Full Text Available Cambodia’s recent history of instability has garnered it international notoriety as a place of genocide, corruption and insecurity. Currently, this perception of Cambodia has resulted in an influx of tourists seeking to volunteer at and visit orphanages throughout the country hoping to combat the perceived poverty and suffering. With only 21 state-run orphanages in Cambodia the remaining 248 (although it is potentially even more rely significantly on over-seas donations with many advertising and heavily encouraging ‘orphanage tourism’. Although touted as an altruistic, beneficial experience, awareness of the darker side of ‘orphanage tourism’ has recently grown and the negative impacts that such practices can have on a vulnerable section of society have become evident. Orphan numbers in Cambodia are at their lowest point in decades, whilst orphanage numbers have undergone a 76 per cent increase in the last five years, coinciding with a 76 per cent increase in tourist numbers. This research investigates the forms that ‘orphanage tourism’ takes in Cambodia and the impacts of this popular phenomenon on those who are purported to benefit: orphanages and orphans.

  19. International Uranium Resources Evaluation Project (IUREP) national favourability studies: Democratic Kampuchea (Cambodia)

    International Nuclear Information System (INIS)

    1977-10-01

    The potential for uranium deposits appears to be poor in Cambodia. It is largely alluvium. Uranium may occur in discordant deposits in metamorphics and intrusives in the Cardamon and Elephant Hills in the south, and in placers of U/TH minerals in the delta or banks of the Mekong River. The potential is in category 1 (less than 1000 tonnes U ). (author)

  20. Height, zinc and soil-transmitted helminth infections in schoolchildren: a study in Cuba and Cambodia.

    Science.gov (United States)

    de Gier, Brechje; Mpabanzi, Liliane; Vereecken, Kim; van der Werff, Suzanne D; D'Haese, Patrick C; Fiorentino, Marion; Khov, Kuong; Perignon, Marlene; Chamnan, Chhoun; Berger, Jacques; Parker, Megan E; Díaz, Raquel Junco; Núñez, Fidel Angel; Rivero, Lázara Rojas; Gorbea, Mariano Bonet; Doak, Colleen M; Ponce, Maiza Campos; Wieringa, Frank T; Polman, Katja

    2015-04-20

    Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms.

  1. Japanese encephalitis in a Danish short-term traveler to Cambodia

    DEFF Research Database (Denmark)

    Werlinrud, Anne M; Christiansen, Claus B; Koch, Anders

    2011-01-01

    We present a recent case of Japanese encephalitis in a Danish male traveler to Cambodia, who we believe is the second Danish case within the last 15 years. Although both this and a number of other travel-related cases occurred in short-term travelers, change in vaccination recommendations...

  2. The Importance of Understanding Culture When Improving Education: Learning from Cambodia

    Science.gov (United States)

    Berkvens, Jan B. Y.

    2017-01-01

    Following Education for All, initiatives like child-friendly schools initiative, are rolled out in many countries, including Cambodia. The child-friendly schools initiative is addressing general and local needs of children in schools, like a safe environment, well-trained teachers and the provision of teaching and materials. But there is also a…

  3. Time to unsuccessful tuberculosis treatment outcome, Cambodia, China, and Viet Nam

    DEFF Research Database (Denmark)

    Hoa, N B; Sokun, C; Wei, C

    2012-01-01

    OBJECTIVE: To determine the frequency and characteristics of patients with unsuccessful tuberculosis (TB) treatment. METHODS: Random selection of TB case registers among all treatment units in Cambodia, two provinces in China, and Viet Nam. The data of two calendar years were analyzed to assess u...

  4. Human Sentinel Surveillance of Influenza and Other Respiratory Viral Pathogens in Border Areas of Western Cambodia.

    Directory of Open Access Journals (Sweden)

    Ans Timmermans

    Full Text Available Little is known about circulation of influenza and other respiratory viruses in remote populations along the Thai-Cambodia border in western Cambodia. We screened 586 outpatients (median age 5, range 1-77 presenting with influenza-like-illness (ILI at 4 sentinel sites in western Cambodia between May 2010 and December 2012. Real-time reverse transcriptase (rRT PCR for influenza was performed on combined nasal and throat specimens followed by viral culture, antigenic analysis, antiviral susceptibility testing and full genome sequencing for phylogenetic analysis. ILI-specimens negative for influenza were cultured, followed by rRT-PCR for enterovirus and rhinovirus (EV/RV and EV71. Influenza was found in 168 cases (29% and occurred almost exclusively in the rainy season from June to November. Isolated influenza strains had close antigenic and phylogenetic relationships, matching vaccine and circulating strains found elsewhere in Cambodia. Influenza vaccination coverage was low (<20%. Western Cambodian H1N1(2009 isolate genomes were more closely related to 10 earlier Cambodia isolates (94.4% genome conservation than to 13 Thai isolates (75.9% genome conservation, despite sharing the majority of the amino acid changes with the Thai references. Most genes showed signatures of purifying selection. Viral culture detected only adenovirus (5.7% and parainfluenza virus (3.8%, while non-polio enteroviruses (10.3% were detected among 164 culture-negative samples including coxsackievirus A4, A6, A8, A9, A12, B3, B4 and echovirus E6 and E9 using nested RT-PCR methods. A single specimen of EV71 was found. Despite proximity to Thailand, influenza epidemiology of these western Cambodian isolates followed patterns observed elsewhere in Cambodia, continuing to support current vaccine and treatment recommendations from the Cambodian National Influenza Center. Amino acid mutations at non-epitope sites, particularly hemagglutinin genes, require further investigation in

  5. Human Sentinel Surveillance of Influenza and Other Respiratory Viral Pathogens in Border Areas of Western Cambodia.

    Science.gov (United States)

    Timmermans, Ans; Melendrez, Melanie C; Se, Youry; Chuang, Ilin; Samon, Nou; Uthaimongkol, Nichapat; Klungthong, Chonticha; Manasatienkij, Wudtichai; Thaisomboonsuk, Butsaya; Tyner, Stuart D; Rith, Sareth; Horm, Viseth Srey; Jarman, Richard G; Bethell, Delia; Chanarat, Nitima; Pavlin, Julie; Wongstitwilairoong, Tippa; Saingam, Piyaporn; El, But Sam; Fukuda, Mark M; Touch, Sok; Sovann, Ly; Fernandez, Stefan; Buchy, Philippe; Chanthap, Lon; Saunders, David

    2016-01-01

    Little is known about circulation of influenza and other respiratory viruses in remote populations along the Thai-Cambodia border in western Cambodia. We screened 586 outpatients (median age 5, range 1-77) presenting with influenza-like-illness (ILI) at 4 sentinel sites in western Cambodia between May 2010 and December 2012. Real-time reverse transcriptase (rRT) PCR for influenza was performed on combined nasal and throat specimens followed by viral culture, antigenic analysis, antiviral susceptibility testing and full genome sequencing for phylogenetic analysis. ILI-specimens negative for influenza were cultured, followed by rRT-PCR for enterovirus and rhinovirus (EV/RV) and EV71. Influenza was found in 168 cases (29%) and occurred almost exclusively in the rainy season from June to November. Isolated influenza strains had close antigenic and phylogenetic relationships, matching vaccine and circulating strains found elsewhere in Cambodia. Influenza vaccination coverage was low (Cambodia isolates (94.4% genome conservation) than to 13 Thai isolates (75.9% genome conservation), despite sharing the majority of the amino acid changes with the Thai references. Most genes showed signatures of purifying selection. Viral culture detected only adenovirus (5.7%) and parainfluenza virus (3.8%), while non-polio enteroviruses (10.3%) were detected among 164 culture-negative samples including coxsackievirus A4, A6, A8, A9, A12, B3, B4 and echovirus E6 and E9 using nested RT-PCR methods. A single specimen of EV71 was found. Despite proximity to Thailand, influenza epidemiology of these western Cambodian isolates followed patterns observed elsewhere in Cambodia, continuing to support current vaccine and treatment recommendations from the Cambodian National Influenza Center. Amino acid mutations at non-epitope sites, particularly hemagglutinin genes, require further investigation in light of an increasingly important role of permissive mutations in influenza virus evolution

  6. Rabies Vaccine and Rabies Immunoglobulin in Cambodia: Use and Obstacles to Use.

    Science.gov (United States)

    Tarantola, Arnaud; Ly, Sowath; In, Sotheary; Ong, Sivuth; Peng, Yiksing; Heng, Nayyim; Buchy, Philippe

    2015-01-01

    Authorities have pledged to eliminate canine rabies by 2020 in Cambodia, a country with a very high rabies burden. Logistic and financial access to timely and adequate postexposure prophylaxis (PEP) is essential for preventing rabies in humans. We undertook a survey of the few identified sites where PEP rabies vaccination and rabies immunoglobulin (RIG) are available in Cambodia. We examined the Rabies Prevention Center at Institut Pasteur du Cambodge (rpc@ipc) database and rpc@ipc order forms for 2012 to assess vaccine and RIG use. We conducted a rapid internet survey of centers that provide rabies vaccine and RIG in Cambodia, other than rpc@ipc. The cost of a full course of intramuscular or intradermal PEP in Cambodia, with and without RIG, was also estimated. Rabies vaccination is free of charge in one foundation hospital and is accessible for a fee at Institut Pasteur du Cambodge (IPC), some institutions, and some Cambodian private clinics. In 2012, 27,500 rabies vaccine doses (0.5 mL) and 591 equine RIG doses were used to provide intradermal PEP to 20,610 persons at rpc@ipc following animal bites. Outside of rpc@ipc, an estimated total of 53,400 vaccine doses and 200 RIG doses were used in Cambodia in 2012. The wholesale cost of full rabies PEP was estimated at 50% to 100% of a Cambodian farmer's monthly wage. Local populations and travelers cannot be sure to locally access adequate and timely PEP due to high costs and low access to RIG. Travelers to high-endemic areas such as Cambodia are strongly encouraged to undergo pre-exposure vaccination or seek expert advice, as per World Health Organization (WHO) recommendations. State-subsidized, pre-positioned stocks of human vaccine and RIG in bite management centers would extend the rabies prevention centers network. Support from Institut Pasteur du Cambodge for staff training, cold chain, and quality control would contribute to reducing the risk of rabies deaths in Cambodia. © 2015 International Society of

  7. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam

    Directory of Open Access Journals (Sweden)

    Lauritsen Jens M

    2011-05-01

    Full Text Available Abstract Background The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Objectives Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. Methods A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007 were obtained for comparison. Results A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively. The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Conclusions Characteristics of patients

  8. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam.

    Science.gov (United States)

    Hoa, Nguyen B; Wei, Chen; Sokun, Chay; Lauritsen, Jens M; Rieder, Hans L

    2011-05-23

    The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007) were obtained for comparison. A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively.The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Characteristics of patients greatly differed between countries and between patient categories. In Cambodia

  9. Health system strengthening in Cambodia-a case study of health policy response to social transition.

    Science.gov (United States)

    Grundy, John; Khut, Qiu Yi; Oum, Sophal; Annear, Peter; Ky, Veng

    2009-10-01

    Cambodia, following decades of civil conflict and social and economic transition, has in the last 10 years developed health policy innovations in the areas of health contracting, health financing and health planning. This paper aims to outline recent social, epidemiological and demographic health trends in Cambodia, and on the basis of this outline, to analyse and discuss these policy responses to social transition. Sources of information included a literature review, participant observation in health planning development in Cambodia between 1993 and 2008, and comparative analysis of demographic health surveys between 2000 and 2005. In Cambodia there have been sharp but unequal improvements in child mortality, and persisting high maternal mortality rates. Data analysis demonstrates associations between location, education level and access to facility based care, suggesting the dominant role of socio-economic factors in determining access to facility based health care. These events are taking place against a background of rapid social transition in Cambodian history, including processes of decentralization, privatization and the development of open market economic systems. Primary policy responses of the Ministry of Health to social transition and associated health inequities include the establishment of health contracting, hospital health equity funds and public-private collaborations. Despite the internationally recognized health policy flexibility and innovation demonstrated in Cambodia, policy response still lags well behind the reality of social transition. In order to minimize the delay between transition and response, new policy making tactics are required in order to provide more flexible and timely responses to the ongoing social transition and its impacts on population health needs in the lowest socio-economic quintiles.

  10. Radar Image with Color as Height, Sman Teng, Temple, Cambodia

    Science.gov (United States)

    2002-01-01

    This image of Cambodia's Angkor region, taken by NASA's Airborne Synthetic Aperture Radar (AIRSAR), reveals a temple (upper-right) not depicted on early 19th Century French archeological survey maps and American topographic maps. The temple, known as 'Sman Teng,' was known to the local Khmer people, but had remained unknown to historians due to the remoteness of its location. The temple is thought to date to the 11th Century: the heyday of Angkor. It is an important indicator of the strategic and natural resource contributions of the area northwest of the capitol, to the urban center of Angkor. Sman Teng, the name designating one of the many types of rice enjoyed by the Khmer, was 'discovered' by a scientist at NASA's Jet Propulsion Laboratory, Pasadena, Calif., working in collaboration with an archaeological expert on the Angkor region. Analysis of this remote area was a true collaboration of archaeology and technology. Locating the temple of Sman Teng required the skills of scientists trained to spot the types of topographic anomalies that only radar can reveal.This image, with a pixel spacing of 5 meters (16.4 feet), depicts an area of approximately 5 by 4.7 kilometers (3.1 by 2.9 miles). North is at top. Image brightness is from the P-band (68 centimeters, or 26.8 inches) wavelength radar backscatter, a measure of how much energy the surface reflects back toward the radar. Color is used to represent elevation contours. One cycle of color represents 25 meters (82 feet) of elevation change, so going from blue to red to yellow to green and back to blue again corresponds to 25 meters (82 feet) of elevation change.AIRSAR flies aboard a NASA DC-8 based at NASA's Dryden Flight Research Center, Edwards, Calif. In the TOPSAR mode, AIRSAR collects radar interferometry data from two spatially separated antennas (2.6 meters, or 8.5 feet). Information from the two antennas is used to form radar backscatter imagery and to generate highly accurate elevation data. Built

  11. The Political Ecology of Chinese Large Dams in Cambodia: Implications, Challenges and Lessons Learnt from the Kamchay Dam

    Directory of Open Access Journals (Sweden)

    Giuseppina Siciliano

    2016-09-01

    Full Text Available Given the opportunities offered by foreign investment in energy infrastructure mostly by Chinese firms, the Government of Cambodia is giving high priority to developing hydropower resources for reducing energy poverty and powering economic growth. Using a “Political ecology of the Asian drivers” framework, this paper assesses China’s involvement in the development of large dams’ in Cambodia and its impacts on the access of natural resources such as water and energy by dam builders, local communities and the government. This analysis is based on 61 interviews and 10 focus group discussions with affected communities, institutional actors, Chinese dam builders and financiers in relation to the first large Chinese dam built in Cambodia: the Kamchay dam. Based on the results of the analysis this paper makes recommendations on how to improve the planning, implementation and governance of future large dams in Cambodia.

  12. Inequality in access to health care in Cambodia: socioeconomically disadvantaged women giving birth at home assisted by unskilled birth attendants.

    Science.gov (United States)

    Hong, Rathavuth; Them, Rathnita

    2015-03-01

    Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia. © 2011 APJPH.

  13. Effects of logging and recruitment on community phylogenetic structure in 32 permanent forest plots of Kampong Thom, Cambodia

    OpenAIRE

    Toyama, Hironori; Kajisa, Tsuyoshi; Tagane, Shuichiro; Mase, Keiko; Chhang, Phourin; Samreth, Vanna; Ma, Vuthy; Sokh, Heng; Ichihashi, Ryuji; Onoda, Yusuke; Mizoue, Nobuya; Yahara, Tetsukazu

    2015-01-01

    Ecological communities including tropical rainforest are rapidly changing under various disturbances caused by increasing human activities. Recently in Cambodia, illegal logging and clear-felling for agriculture have been increasing. Here, we study the effects of logging, mortality and recruitment of plot trees on phylogenetic community structure in 32 plots in Kampong Thom, Cambodia. Each plot was 0.25 ha; 28 plots were established in primary evergreen forests and four were established in se...

  14. Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change

    Directory of Open Access Journals (Sweden)

    Grace I. Davies

    2014-12-01

    Full Text Available Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

  15. Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.

    Science.gov (United States)

    Davies, Grace I; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

    2014-12-23

    Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

  16. Spatial and temporal epidemiology of clinical malaria in Cambodia 2004-2013.

    Science.gov (United States)

    Maude, Richard J; Nguon, Chea; Ly, Po; Bunkea, Tol; Ngor, Pengby; Canavati de la Torre, Sara E; White, Nicholas J; Dondorp, Arjen M; Day, Nicholas P J; White, Lisa J; Chuor, Char Meng

    2014-09-30

    Artemisinin-resistant Plasmodium falciparum malaria has recently been identified on the Thailand-Cambodia border and more recently in parts of Thailand, Myanmar and Vietnam. There is concern that if this resistance were to spread, it would severely hamper malaria control and elimination efforts worldwide. Efforts are currently underway to intensify malaria control activities and ultimately eliminate malaria from Cambodia. To support these efforts, it is crucial to have a detailed picture of disease burden and its major determinants over time. An analysis of spatial and temporal data on clinical malaria in Cambodia collected by the National Centre for Parasitology, Entomology and Malaria Control (CNM) and the Department of Planning and Health Information, Ministry of Health Cambodia from 2004 to 2013 is presented. There has been a marked decrease of 81% in annual cases due to P. falciparum since 2009 coinciding with a rapid scale-up in village malaria workers (VMWs) and insecticide-treated bed nets (ITNs). Concurrently, the number of cases with Plasmodium vivax has greatly increased. It is estimated that there were around 112,000 total cases in 2012, 2.8 times greater than the WHO estimate for that year, and 68,000 in 2013 (an annual parasite incidence (API) of 4.6/1000). With the scale-up of VMWs, numbers of patients presenting to government facilities did not fall and it appears likely that those who saw VMWs had previously accessed healthcare in the private sector. Malaria mortality has decreased, particularly in areas with VMWs. There has been a marked decrease in cases in parts of western Cambodia, especially in Pailin and Battambang Provinces. In the northeast, the fall in malaria burden has been more modest, this area having the highest API in 2013. The clinical burden of falciparum malaria in most areas of Cambodia has greatly decreased from 2009 to 2013, associated with roll-out of ITNs and VMWs. Numbers of cases with P. vivax have increased. Possible

  17. Community and school-based health education for dengue control in rural Cambodia: a process evaluation.

    Science.gov (United States)

    Khun, Sokrin; Manderson, Lenore

    2007-12-05

    Dengue fever continues to be a major public health problem in Cambodia, with significant impact on children. Health education is a major means for prevention and control of the National Dengue Control Program (NDCP), and is delivered to communities and in schools. Drawing on data collected in 2003-2004 as part of an ethnographic study conducted in eastern Cambodia, we explore the approaches used in health education and their effectiveness to control dengue. Community health education is provided through health centre outreach activities and campaigns of the NDCP, but is not systematically evaluated, is under-funded and delivered irregularly; school-based education is restricted in terms of time and lacks follow-up in terms of practical activities for prevention and control. As a result, adherence is partial. We suggest the need for sustained routine education for dengue prevention and control, and the need for approaches to ensure the translation of knowledge into practice.

  18. Community and school-based health education for dengue control in rural Cambodia: a process evaluation.

    Directory of Open Access Journals (Sweden)

    Sokrin Khun

    Full Text Available Dengue fever continues to be a major public health problem in Cambodia, with significant impact on children. Health education is a major means for prevention and control of the National Dengue Control Program (NDCP, and is delivered to communities and in schools. Drawing on data collected in 2003-2004 as part of an ethnographic study conducted in eastern Cambodia, we explore the approaches used in health education and their effectiveness to control dengue. Community health education is provided through health centre outreach activities and campaigns of the NDCP, but is not systematically evaluated, is under-funded and delivered irregularly; school-based education is restricted in terms of time and lacks follow-up in terms of practical activities for prevention and control. As a result, adherence is partial. We suggest the need for sustained routine education for dengue prevention and control, and the need for approaches to ensure the translation of knowledge into practice.

  19. Climate Change Risks – Methodological Framework and Case Study of Damages from Extreme Events in Cambodia

    DEFF Research Database (Denmark)

    Halsnæs, Kirsten; Kaspersen, Per Skougaard; Trærup, Sara Lærke Meltofte

    2016-01-01

    Climate change imposes some special risks on Least Developed Countries, and the chapter presents a methodological framework, which can be used to assess the impacts of key assumptions related to damage costs, risks and equity implications on current and future generations. The methodological...... framework is applied to a case study of severe storms in Cambodia based on statistical information on past storm events including information about buildings damaged and victims. Despite there is limited data available on the probability of severe storm events under climate change as well on the actual...... damage costs associated with the events in the case of Cambodia, we are using the past storm events as proxy data in a sensitivity analysis. It is here demonstrated how key assumptions on future climate change, income levels of victims, and income distribution over time, reflected in discount rates...

  20. Cross-sectional studies of tuberculosis prevalence in Cambodia between 2002 and 2011.

    Science.gov (United States)

    Mao, Tan Eang; Okada, Kosuke; Yamada, Norio; Peou, Satha; Ota, Masaki; Saint, Saly; Kouet, Pichenda; Chea, Manith; Keo, Sokonth; Pheng, Sok Heng; Tieng, Sivanna; Khun, Kim Eam; Sugamoto, Tetsuhiro; Matsumoto, Hiroko; Yoshiyama, Takashi; Ito, Kunihiko; Onozaki, Ikushi

    2014-08-01

    To measure trends in the pulmonary tuberculosis burden between 2002 and 2011 and to assess the impact of the DOTS (directly observed treatment, short-course) strategy in Cambodia. Cambodia's first population-based nationwide tuberculosis survey, based on multistage cluster sampling, was conducted in 2002. The second tuberculosis survey, encompassing 62 clusters, followed in 2011. Participants aged 15 years or older were screened for active pulmonary tuberculosis with chest radiography and/or for tuberculosis symptoms. For diagnostic confirmation, sputum smear and culture were conducted on those whose screening results were positive. Of the 40,423 eligible subjects, 37,417 (92.6%) participated in the survey; 103 smear-positive cases and 211 smear-negative, culture-positive cases were identified. The weighted prevalences of smear-positive tuberculosis and bacteriologically-positive tuberculosis were 271 (95% confidence interval, CI: 212-348) and 831 (95% CI: 707-977) per 100,000 population, respectively. Tuberculosis prevalence was higher in men than women and increased with age. A 38% decline in smear-positive tuberculosis (P = 0.0085) was observed with respect to the 2002 survey, after participants were matched by demographic and geographical characteristics. The prevalence of symptomatic, smear-positive tuberculosis decreased by 56% (P = 0.001), whereas the prevalence of asymptomatic, smear-positive tuberculosis decreased by only 7% (P = 0.7249). The tuberculosis burden in Cambodia has declined significantly, most probably because of the decentralization of DOTS to health centres. To further reduce the tuberculosis burden in Cambodia, tuberculosis control should be strengthened and should focus on identifying cases without symptoms and in the middle-aged and elderly population.

  1. Parental styles in second generation effects of genocide stemming from the Khmer Rouge regime in Cambodia.

    Science.gov (United States)

    Field, Nigel P; Om, Chariya; Kim, Thida; Vorn, Sin

    2011-11-01

    This study examined the impact of parental styles on second generation effects of trauma among adolescent offspring of survivors of the Khmer Rouge (KR) genocide in Cambodia. Two hundred high school students completed measures addressing their parents' trauma stemming from the KR regime, parental styles (role reversing, overprotective), depression and anxiety. Parents' role reversing parental style and mothers' overprotective parenting were shown to mediate the impact of their trauma symptoms on the child's depression and anxiety. The implications of the findings are discussed.

  2. Impact of helmet use on traumatic brain injury from road traffic accidents in Cambodia.

    Science.gov (United States)

    Gupta, Saksham; Klaric, Katherine; Sam, Nang; Din, Vuthy; Juschkewitz, Tina; Iv, Vycheth; Shrime, Mark G; Park, Kee B

    2018-01-02

    Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia. The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression. The most common injuries at presentation were contusions (47.0%), epidural hematomas (30.1%), subdural hematomas (27.9%), subarachnoid hemorrhages (12.4%), skull fractures (21.4%), and facial fractures (18.5%). Moderate-to-severe loss of consciousness was present in 36.3% of patients. Not wearing a helmet was associated with an odds ratio of 2.20 (95% confidence interval [CI], 1.15-4.22) for presenting with moderate to severe loss of consciousness compared to helmeted patients. Craniotomy or craniectomy was indicated for evacuation of hematoma in 20.0% of cases, and nonhelmeted patients had 3.21-fold higher odds of requiring neurosurgical intervention (95% CI, 1.25-8.27). Furthermore, lack of helmet usage was associated with 2.72-fold higher odds of discharge with functional deficits (95% CI, 1.14-6.49). In total, 30.1% of patients were discharged with severe functional deficits. Helmets demonstrate a protective effect and may be an effective public health intervention to significantly reduce the burden of traumatic brain injury in Cambodia and other developing countries with increasing rates of motorization across the world.

  3. Dietary exposure and human risk assessment of phthalate esters based on total diet study in Cambodia

    International Nuclear Information System (INIS)

    Cheng, Zhang; Li, Han-Han; Wang, Hong-sheng; Zhu, Xue-Mei; Sthiannopkao, Suthipong; Kim, Kyoung-Woong; Yasin, Mohamed Salleh Mohamed; Hashim, Jamal Hisham; Wong, Ming-Hung

    2016-01-01

    Phthalate esters are used in a wide variety of consumer products, and human exposure to this class of compounds is widespread. Nevertheless, studies on dietary exposure of human to phthalates are limited. In this study, to assess the daily intakes of phthalate esters and the possible adverse health impacts, different food samples were collected from three areas of Cambodia, one of the poorest countries in the world. The ∑phthalate ester concentrations in Kampong Cham, Kratie and Kandal provinces ranged from 0.05 to 2.34 (median 0.88) μg g −1 , 0.19–1.65 (median 0.86) μg g −1 and 0.24–3.05 (median 0.59) μg g −1 wet weight (ww), respectively. Di-2-Ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP) were the predominant compounds among all foodstuffs. The estimated daily intake (EDI) of phthalate esters for the general population in Kampong Cham, Kratie and Kandal was 34.3, 35.6 and 35.8 μg kg −1 bw d −1 , respectively. The dietary daily intake of DEHP, benzylbutyl phthalate (BBP) and di-n-butyl phthalate (DBP) in Kampong Cham, Kratie and Kandal were below the tolerable daily intakes (TDI) imposed by the European Food Safety Authority (EFSA) and reference doses (RfD) imposed by The United States Environmental Protection Agency (USEPA). Rice contributed the greatest quantity of DEHP to the daily intake in Cambodia so may deserve further exploration. To our knowledge, this is the first study to investigate the occurrence and the daily intakes of phthalate esters in Cambodia. - Highlights: • Phthalate esters concentration in daily foodstuffs collected from Cambodia. • Investigate the bioaccessbility of phthalate esters via the foodstuffs consumption. • Health risk evaluation of dietary exposure to phthalate esters.

  4. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia

    OpenAIRE

    Weissman, Amy; Ngak, Song; Srean, Chhim; Sansothy, Neth; Mills, Stephen; Ferradini, Laurent

    2016-01-01

    Introduction Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia. Methods Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ?18 years, identi...

  5. The impact of a livelihood program on depressive symptoms among people living with HIV in Cambodia.

    Science.gov (United States)

    Shimizu, Mayumi; Yi, Siyan; Tuot, Sovannary; Suong, Samedy; Sron, Samrithea; Shibanuma, Akira; Jimba, Masamine

    2016-01-01

    Psychological and social problems are major concerns in this era of successful antiretroviral therapy. Although livelihood programs have been implemented extensively to improve the daily living conditions of people living with HIV in Cambodia, no studies have yet investigated the impacts of these programs on the mental health of this vulnerable population. Therefore, we examined the impact of a livelihood program on depressive symptoms and associated factors among people living with HIV in Cambodia. A quasi-experimental, nonequivalent comparison group study was conducted in six provinces of Cambodia in 2014. Data were collected from an intervention group comprising 357 people living with HIV who had participated in the livelihood program and a comparison group comprising 328 people living with HIV who had not participated in this program. Multiple logistic regression analysis was carried out to examine the association between livelihood-program participation and depressive symptoms as measured by the depressive symptoms subscale of the 25-item Cambodian version of the Hopkins Symptom Checklist. A propensity score matching was used to examine the effect of the livelihood program on depressive symptoms while controlling for selection bias. Overall, 56.0% and 62.7% of the participants in the intervention and comparison groups, respectively, met the Hopkins Symptom Checklist threshold for depressive symptoms. The multiple logistic regression analysis showed that the participants in the intervention group had significantly lower odds of having depressive symptoms (adjusted odds ratio 0.68, 95% confidence interval 0.52-0.88). The analysis from propensity score matching indicated that the livelihood program helped mitigate depressive symptoms among the participants in the intervention group (T=-1.99). The livelihood program appeared to help mitigate the burden of depressive symptoms among people living with HIV in Cambodia. Thus, this program should be scaled up and

  6. Are Village Animal Health Workers Able to Assist in Strengthening Transboundary Animal Disease Control in Cambodia?

    Science.gov (United States)

    Stratton, J; Toribio, J-A L M L; Suon, S; Young, J R; Cowled, B; Windsor, P A

    2017-04-01

    A cross-sectional survey of 445 Village Animal Health Workers (VAHWs) from 19 provinces in Cambodia was undertaken. The aim was to establish their levels of training, farm visit frequency, reasons for visits and disease reporting practices, enabling the strengths and weaknesses of the VAHW system in Cambodia to be determined, in providing both a fee-based smallholder livestock clinical service and a government partnership in transboundary animal disease (TAD) surveillance and control. The study used 'guided group interviews' and identified that VAHWs had good contact with farmers with 61.5% making more than one farm visit daily. However, incomes from services remained low, with 45% VAHWs obtaining between 20 and 40% of their household income from VAHW activities. VAHWs recorded relatively high rates of disease reporting, with 72% claiming they report diseases immediately and 74% undertaking monthly reporting to veterinary authorities. Logistic regression analysis revealed VAHW contact frequency with district and/or provincial officers was associated with more VAHW farm visits, and frequency of VAHW visits to smallholder farms was positively associated with average monthly expenditure on animal medication and equipment. This suggests that increased veterinary extension to VAHWs and access to veterinary equipment, vaccines and drugs may further increase VAHW-farmer engagement. VAHWs provide an accessible, market-based, animal health 'treatment and reporting' service linked to livestock smallholders across Cambodia. However, for improved TAD prevention and more efficient control of outbreaks, research that assesses provision of an animal health 'preventive-based' business model is urgently needed to reduce both the costs to farmers and the risks to the economy due to foot-and-mouth disease and other TADs in Cambodia. © 2015 Blackwell Verlag GmbH.

  7. Field survey focused on Opisthorchis viverrini infection in five provinces of Cambodia.

    Science.gov (United States)

    Miyamoto, Kazuko; Kirinoki, Masashi; Matsuda, Hajime; Hayashi, Naoko; Chigusa, Yuichi; Sinuon, Muth; Chuor, Char Meng; Kitikoon, Viroj

    2014-04-01

    Opisthorchiasis is endemic in Thailand and Lao People's Democratic Republic and constitutes a major public health problem throughout the Mekong Basin. Although Cambodia is located in the Mekong Basin, the status of O. viverrini infection in that country was not previously clarified. This research was conducted to document the extent and distribution of O. viverrini infection in Cambodia. Surveillance was conducted in 55 villages in five Cambodian provinces. Research tools included stool examination using the Kato-Katz thick-smear technique, identification of intermediate hosts, and interviews covering factors related to O. viverrini infection. Some larvae and egg-positive stool samples were examined using PCR to detect O. viverrini DNA. A total of 16,082 stool samples from the 55 villages were examined, of which 1232 were egg positive. In 15 villages with egg-positive rates of greater than 10%, eggs were found in 998 of 3585 stool samples, for an egg-positive rate of 27.8%. PCR analysis showed that 30 of 33 samples were positive for O. viverrini DNA from five villages in Kampong Cham and Kampong Thom provinces. The first intermediate host Bithynia siamensis siamensis was identified in the target areas of Takaev, Kandal, and Kampong Cham provinces. Cercariae were identified morphologically as O. viverrini and some were confirmed using PCR. Metacercariae of O. viverrini were identified by morphologic observations, animal experiments, or PCR in six species of fish in the target areas. Four Cambodian provinces were identified as endemic areas of O. viverrini infection. Careful planning is necessary for effective field surveys, because complex environmental factors might be involved in the distribution of O. viverrini infection-endemic areas in Cambodia. Many problems remain to be resolved regarding the status of O. viverrini infection in Cambodia, and a nationwide baseline survey is necessary. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia.

    Science.gov (United States)

    Morishita, Fukushi; Yadav, Rajendra-Prasad; Eang, Mao Tan; Saint, Saly; Nishikiori, Nobuyuki

    2016-01-01

    Despite free TB services available in public health facilities, TB patients often face severe financial burden due to TB. WHO set a new global target that no TB-affected families experience catastrophic costs due to TB. To monitor the progress and strategize the optimal approach to achieve the target, there is a great need to assess baseline cost data, explore potential proxy indicators for catastrophic costs, and understand what intervention mitigates financial burden. In Cambodia, nationwide active case finding (ACF) targeting household and neighbourhood contacts was implemented alongside routine passive case finding (PCF). We analyzed household cost data from ACF and PCF to determine the financial benefit of ACF, update the baseline cost data, and explore whether any dissaving patterns can be a proxy for catastrophic costs in Cambodia. In this cross-sectional comparative study, structured interviews were carried out with 108 ACF patients and 100 PCF patients. Direct and indirect costs, costs before and during treatment, costs as percentage of annual household income and dissaving patterns were compared between the two groups. The median total costs were lower by 17% in ACF than in PCF ($240.7 [IQR 65.5-594.6] vs $290.5 [IQR 113.6-813.4], p = 0.104). The median costs before treatment were significantly lower in ACF than in PCF ($5.1 [IQR 1.5-25.8] vs $22.4 [IQR 4.4-70.8], pCambodia. ACF has the great potential to mitigate the costs incurred particularly before treatment. Social protection schemes that can replace lost income are critically needed to compensate for the most devastating costs in TB. An occurrence of selling household property can be a useful proxy for catastrophic cost in Cambodia.

  9. A qualitative and quantitative design of low-carbon development in Cambodia: Energy policy

    International Nuclear Information System (INIS)

    Hak, Mao; Matsuoka, Yuzuru; Gomi, Kei

    2017-01-01

    The formulation of a policy for a low-carbon development plan is one of the most important steps to help Cambodia achieve sustainable development objectives, promote a greener development path, and contribute to the global effort to reducing CO 2 emissions. This study is designed to propose some low-carbon energy strategies and quantitatively to assess CO 2 emissions and reductions. The Extended Snapshot (ExSS) tool is used to quantify socioeconomic assumptions and to estimate CO 2 emissions and reduction potentials. The results show that CO 2 emissions are projected to increase to about 23,277 (by about 5.5 times) and 91,325 ktCO 2 /year (by about 21.6 times) in 2030BaU and 2050BaU, respectively, from 4,221 ktCO 2 /year in 2010. This study proposes five strategies for low-carbon development plan towards 2050 which are expected to reduce CO 2 emissions by about 12,826 (about 55%) and 52,153 ktCO 2 /year (about 57%) in 2030CM and 2050CM, respectively. The present results should help researchers and experts gain a better understanding of CO 2 emissions and reduction potentials by applying a number of low-carbon measures in Cambodia. While the results should be counted as a preliminary study because of limited available country information, they are expected to provide useful insights for the government in formulating a concrete climate change mitigation policy for the country. - Highlights: • Low-carbon development is a win-win approach for socioeconomic development. • Cambodia has significant opportunities to reduce CO 2 emissions in the energy sector. • Five low-carbon energy strategies can limit CO 2 emissions by around 50% in Cambodia. • Green transport strategy contributes the highest CO 2 emissions reduction.

  10. Evidence of two distinct phylogenetic lineages of dog rabies virus circulating in Cambodia.

    Science.gov (United States)

    Mey, Channa; Metlin, Artem; Duong, Veasna; Ong, Sivuth; In, Sotheary; Horwood, Paul F; Reynes, Jean-Marc; Bourhy, Hervé; Tarantola, Arnaud; Buchy, Philippe

    2016-03-01

    This first extensive retrospective study of the molecular epidemiology of dog rabies in Cambodia included 149 rabies virus (RABV) entire nucleoprotein sequences obtained from 1998-2011. The sequences were analyzed in conjunction with RABVs from other Asian countries. Phylogenetic reconstruction confirmed the South-East Asian phylogenetic clade comprising viruses from Cambodia, Vietnam, Thailand, Laos and Myanmar. The present study represents the first attempt to classify the phylogenetic lineages inside this clade, resulting in the confirmation that all the Cambodian viruses belonged to the South-East Asian (SEA) clade. Three distinct phylogenetic lineages in the region were established with the majority of viruses from Cambodia closely related to viruses from Thailand, Laos and Vietnam, forming the geographically widespread phylogenetic lineage SEA1. A South-East Asian lineage SEA2 comprised two viruses from Cambodia was identified, which shared a common ancestor with RABVs originating from Laos. Viruses from Myanmar formed separate phylogenetic lineages within the major SEA clade. Bayesian molecular clock analysis suggested that the time to most recent common ancestor (TMRCA) of all Cambodian RABVs dated to around 1950. The TMRCA of the Cambodian SEA1 lineage was around 1964 and that of the SEA2 lineage was around 1953. The results identified three phylogenetically distinct and geographically separated lineages inside the earlier identified major SEA clade, covering at least five countries in the region. A greater understanding of the molecular epidemiology of rabies in South-East Asia is an important step to monitor progress on the efforts to control canine rabies in the region. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Key Factors Affecting Construction Safety Performance in Developing Countries: Evidence from Cambodia

    OpenAIRE

    Durdyev, Serdar; Mohamed, Sherif; Lay, Meng Leang; Ismail, Syuhaida

    2017-01-01

    Although proper safety management in construction is of utmost importance; anecdotal evidence suggests that safety is not adequately considered in many developing countries. This paper considers the key variables affecting construction safety performance in Cambodia. Using an empirical questionnaire survey targeting local construction professionals, respondents were invited to rate the level of importance of 30 variables identified from the seminal literature. The data set was subjected to f...

  12. Towards understanding household-level forest reliance in Cambodia - study sites, methods, and preliminary findings

    DEFF Research Database (Denmark)

    Ra, Koy; Pichdara, Lonn; Dararath, Yem

    There is growing international interest in the role of forests in poverty prevention and reduction. In consequence, this broad area of investigation has been subject to increased research; one major international research project is that facilitated by the Poverty Environment Network (PEN). This ......). This project covers a large number of sites in 26 countries throughout the tropics. The present report contains contextual details, methodological information and preliminary findings for the PEN sites in Cambodia....

  13. Dietary exposure and human risk assessment of phthalate esters based on total diet study in Cambodia

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Zhang; Li, Han-Han [College of Environment, Sichuan Agricultural University, Chengdu 611130 (China); Wang, Hong-sheng [Department of Microbial and Biochemical Pharmacy, School of Pharmaceutical Sciences, Sun Yat-sen University, No.132 Waihuandong Road, University Town, Guangzhou 510006 (China); Zhu, Xue-Mei [College of Environment, Sichuan Agricultural University, Chengdu 611130 (China); Sthiannopkao, Suthipong [Department of Environmental and Occupational Health, National Cheng Kung University, Tainan City, Taiwan (China); Kim, Kyoung-Woong [School of Environmental Science and Engineering, Gwangju Institute of Science and Technology, Gwangju (Korea, Republic of); Yasin, Mohamed Salleh Mohamed; Hashim, Jamal Hisham [United Nations University-International Institute for Global Health, Kuala Lumpur (Malaysia); Wong, Ming-Hung, E-mail: minghwong@ied.edu.hk [Consortium on Health, Environment, Education and Research (CHEER), and Department of Science and Environmental Studies, Hong Kong Institute of Education, Tai Po, Hong Kong (China); School of Environment, Jinan University, Guangzhou (China)

    2016-10-15

    Phthalate esters are used in a wide variety of consumer products, and human exposure to this class of compounds is widespread. Nevertheless, studies on dietary exposure of human to phthalates are limited. In this study, to assess the daily intakes of phthalate esters and the possible adverse health impacts, different food samples were collected from three areas of Cambodia, one of the poorest countries in the world. The ∑phthalate ester concentrations in Kampong Cham, Kratie and Kandal provinces ranged from 0.05 to 2.34 (median 0.88) μg g{sup −1}, 0.19–1.65 (median 0.86) μg g{sup −1} and 0.24–3.05 (median 0.59) μg g{sup −1} wet weight (ww), respectively. Di-2-Ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP) were the predominant compounds among all foodstuffs. The estimated daily intake (EDI) of phthalate esters for the general population in Kampong Cham, Kratie and Kandal was 34.3, 35.6 and 35.8 μg kg{sup −1} bw d{sup −1}, respectively. The dietary daily intake of DEHP, benzylbutyl phthalate (BBP) and di-n-butyl phthalate (DBP) in Kampong Cham, Kratie and Kandal were below the tolerable daily intakes (TDI) imposed by the European Food Safety Authority (EFSA) and reference doses (RfD) imposed by The United States Environmental Protection Agency (USEPA). Rice contributed the greatest quantity of DEHP to the daily intake in Cambodia so may deserve further exploration. To our knowledge, this is the first study to investigate the occurrence and the daily intakes of phthalate esters in Cambodia. - Highlights: • Phthalate esters concentration in daily foodstuffs collected from Cambodia. • Investigate the bioaccessbility of phthalate esters via the foodstuffs consumption. • Health risk evaluation of dietary exposure to phthalate esters.

  14. Seroprevalence and awareness of porcine cysticercosis across different pig production systems in south-central Cambodia

    Directory of Open Access Journals (Sweden)

    Aderosoye Adenuga

    2018-02-01

    Conclusions: Despite most pigs being kept confined in pens rather than raised in free-roaming systems, porcine cysticercosis appears to be endemic in south-central Cambodia and is associated with smallholder production. Further investigation is needed to identify which Taenia species are causing infections among pigs, and how seroprevalence and zoonotic risk may vary across the country, to understand the risks to public health and assess where interventions might be needed.

  15. The Molecular and Spatial Epidemiology of Typhoid Fever in Rural Cambodia.

    Science.gov (United States)

    Pham Thanh, Duy; Thompson, Corinne N; Rabaa, Maia A; Sona, Soeng; Sopheary, Sun; Kumar, Varun; Moore, Catrin; Tran Vu Thieu, Nga; Wijedoru, Lalith; Holt, Kathryn E; Wong, Vanessa; Pickard, Derek; Thwaites, Guy E; Day, Nicholas; Dougan, Gordon; Turner, Paul; Parry, Christopher M; Baker, Stephen

    2016-06-01

    Typhoid fever, caused by the bacterium Salmonella Typhi, is an endemic cause of febrile disease in Cambodia. The aim of this study was to better understand the epidemiology of pediatric typhoid fever in Cambodia. We accessed routine blood culture data from Angkor Hospital for Children (AHC) in Siem Reap province between 2007 and 2014, and performed whole genome sequencing (WGS) on the isolated bacteria to characterize the S. Typhi population. The resulting phylogenetic information was combined with conventional epidemiological approaches to investigate the spatiotemporal distribution of S. Typhi and population-level risk factors for reported disease. During the study period, there were 262 cases of typhoid within a 100 km radius of AHC, with a median patient age of 8.2 years (IQR: 5.1-11.5 years). The majority of infections occurred during the rainy season, and commune incidences as high as 11.36/1,000 in children aged typhoid fever in rural communes in Cambodia. Our data provide a platform for additional population-based typhoid fever studies in this location, and suggest that this would be a suitable setting in which to introduce a school-based vaccination programme with Vi conjugate vaccines.

  16. Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

    Science.gov (United States)

    Naganuma, Toshihide; Takemoto, Yoshiaki

    2017-01-01

    We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

  17. First archaeointensity results from the historical period of Cambodia, Southeast Asia

    Science.gov (United States)

    Higa, J. T.; Cai, S.; Tauxe, L.; Hendrickson, M.

    2017-12-01

    Understanding variations of the geomagnetic field has applications regarding the behavior of the Earth's outer core, dating of archeological artifacts, and the phenomenon that shields life from solar radiation. However, archaeointensity studies of the Holocene have been mostly limited to localities in Europe and the Middle East; archaeomagnetic surveys from Southeast Asia are almost non-existent. This investigation aims to establish a secular variation curve of geomagnetic field intensity for Cambodia. We sampled ancient iron smelting mounds from the Khmer Empire, located in present day Cambodia, and are analyzing them for paleointensity. The specimens are thought to be from the historical period, likely between 1000-1500 CE. Our samples, which include furnace fragments, iron slag, and ceramic tuyères, contain magnetic minerals that record the paleointensity of Earth's magnetic field at the time it was fired. Using the IZZI paleointensity method (Yu et al., 2004), which gradually replaces the sample's natural remanent magnetization with a thermal remanent magnetization obtained in a known lab field, we can determine the geomagnetic intensities preserved in these specimens. Based on our preliminary experiments, the tuyères, and perhaps also the fresh slag, will in all likelihood yield the most ideal results. Following additional measurements from these best-fit samples, we will determine the paleointensities of Cambodia for the time period from which the artifacts originated. This will commence the establishment of regional geomagnetic reference curves in Southeast Asia and also improve the global model.

  18. Experiences From Developing and Upgrading a Web-Based Surveillance System for Malaria Elimination in Cambodia.

    Science.gov (United States)

    Fu, Clementine; Lopes, Sérgio; Mellor, Steve; Aryal, Siddhi; Sovannaroth, Siv; Roca-Feltrer, Arantxa

    2017-06-14

    Strengthening the surveillance component is key toward achieving country-wide malaria elimination in Cambodia. A Web-based upgraded malaria information system (MIS) was deemed to essentially act as the central component for surveillance strengthening. New functionality (eg, data visualization) and operational (eg, data quality) attributes of the system received particular attention. However, building from the lessons learned in previous systems' developments, other aspects unique to Cambodia were considered to be equally important; for instance, feasibility issues, particularly at the field level (eg, user acceptability at various health levels), and sustainability needs (eg, long-term system flexibility). The Cambodian process of identifying the essential changes and critical attributes for this new information system can provide a model for other countries at various stages of the disease control and elimination continuum. Sharing these experiences not only facilitates the establishment of "best practices" but also accelerates global and regional malaria elimination efforts. In this article, Cambodia's experience in developing and upgrading its MIS to remain responsive to country-specific needs demonstrates the necessity for considering functionality, operationalization, feasibility, and sustainability of an information system in the context of malaria elimination. ©Clementine Fu, Sérgio Lopes, Steve Mellor, Siddhi Aryal, Siv Sovannaroth, Arantxa Roca-Feltrer. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 14.06.2017.

  19. The design and installation of Solar Home Systems in rural Cambodia

    Directory of Open Access Journals (Sweden)

    Rebecca Alice Watts

    2016-09-01

    Full Text Available This study contends that solar home systems (SHS are an appropriate solution to provide affordable, reliable and clean electricity in rural Cambodia. SHS provide decentralised electricity suitable for the electricity needs of rural households and with the decreasing cost of solar energy technologies, SHS are becoming an increasingly competitive source of energy. This study details the design and installation of two SHS in a rural community in Cambodia. The SHS have replaced the use of kerosene lamps and supplemented car battery usage, which has generated a cost saving of USD$2.50-3.20 per month. The SHS have increased the hours of quality lighting making it possible for users to improve educational outcomes by studying at night and participating in private education classes as well as potentially extending their working hours that provides an opportunity to increase their income. Community involvement in the installation of SHS and participation in an education program has ensured transfer of knowledge about system operation and maintenance at a local level that has ensured economic, social and environmental were benefits. This study builds a case in support of solar energy at the household level in rural Cambodia and makes recommendations for the deployment of SHS in rural communities throughout the developing world.

  20. Nuclear security policy in the context of counter-terrorism in Cambodia

    International Nuclear Information System (INIS)

    Khun, Vuthy; Wongsawaeng, Doonyapong

    2016-01-01

    The risk of nuclear or dirty bomb attack by terrorists is one of the most urgent and threatening danger. The Cambodian national strategy to combat weapons of mass destruction (WMD) depicts a layered system of preventive measures ranging from securing materials at foreign sources to interdicting weapons or nuclear or other radioactive materials at ports, border crossings, and within the Cambodian institutions dealing with the nuclear security to manage the preventive programs. The aim of this study is to formulate guidance, to identify scenario of threat and risk, and to pinpoint necessary legal frameworks on nuclear security in the context of counterterrorism based on the International Atomic Energy Agency nuclear security series. The analysis of this study is guided by theoretical review, the review of international laws and politics, by identifying and interpreting applicable rules and norms establishing the nuclear security regime and how well enforcement of the regime is carried out and, what is the likelihood of the future reform might be. This study will examine the existing national legal frameworks of Cambodia in the context of counterterrorism to prevent acts of nuclear terrorism and the threat of a terrorist nuclear attack within the Cambodia territory. It will shed light on departmental lanes of national nuclear security responsibility, and provide a holistic perspective on the needs of additional resources and emphasis regarding nuclear security policy in the context of counterterrorism in Cambodia

  1. Nuclear security policy in the context of counter-terrorism in Cambodia

    Science.gov (United States)

    Khun, Vuthy; Wongsawaeng, Doonyapong

    2016-01-01

    The risk of nuclear or dirty bomb attack by terrorists is one of the most urgent and threatening danger. The Cambodian national strategy to combat weapons of mass destruction (WMD) depicts a layered system of preventive measures ranging from securing materials at foreign sources to interdicting weapons or nuclear or other radioactive materials at ports, border crossings, and within the Cambodian institutions dealing with the nuclear security to manage the preventive programs. The aim of this study is to formulate guidance, to identify scenario of threat and risk, and to pinpoint necessary legal frameworks on nuclear security in the context of counterterrorism based on the International Atomic Energy Agency nuclear security series. The analysis of this study is guided by theoretical review, the review of international laws and politics, by identifying and interpreting applicable rules and norms establishing the nuclear security regime and how well enforcement of the regime is carried out and, what is the likelihood of the future reform might be. This study will examine the existing national legal frameworks of Cambodia in the context of counterterrorism to prevent acts of nuclear terrorism and the threat of a terrorist nuclear attack within the Cambodia territory. It will shed light on departmental lanes of national nuclear security responsibility, and provide a holistic perspective on the needs of additional resources and emphasis regarding nuclear security policy in the context of counterterrorism in Cambodia.

  2. Prevalence of Intestinal Helminths among Inhabitants of Cambodia (2006-2011)

    Science.gov (United States)

    Yong, Tai-Soon; Sohn, Woon-Mok; Eom, Keeseon S.; Jeoung, Hoo-Gn; Hoang, Eui-Hyug; Yoon, Cheong-Ha; Jung, Bong-Kwang; Lee, Soon-Hyung; Sinuon, Muth; Socheat, Duong

    2014-01-01

    In order to investigate the status of intestinal helminthic infections in Cambodia, epidemiological surveys were carried out on a national scale, including 19 provinces. A total of 32,201 fecal samples were collected from schoolchildren and adults between 2006 and 2011 and examined once by the Kato-Katz thick smear technique. The overall egg positive rate of intestinal helminths was 26.2%. The prevalence of hookworms was the highest (9.6%), followed by that of Opisthorchis viverrini/minute intestinal flukes (Ov/MIF) (5.7%), Ascaris lumbricoides (4.6%), and Trichuris trichiura (4.1%). Other types of parasites detected were Enterobius vermicularis (1.1%), Taenia spp. (0.4%), and Hymenolepis spp. (0.2%). The northwestern regions such as the Siem Reap, Oddar Meanchey, and Banteay Meanchey Provinces showed higher prevalences (17.4-22.3%) of hookworms than the other localities. The southwestern areas, including Koh Kong and Preah Sihanouk Provinces showed higher prevalences of A. lumbricoides (17.5-19.2%) and T. trichiura (6.1-21.0%). Meanwhile, the central and southern areas, in particular, Takeo and Kampong Cham Provinces, showed high prevalences of Ov/MIF (23.8-24.0%). The results indicate that a considerably high prevalence of intestinal helminths has been revealed in Cambodia, and thus sustained national parasite control projects are necessary to reduce morbidity due to parasitic infections in Cambodia. PMID:25548418

  3. Estimating the size of the homeless adolescent population across seven cities in Cambodia

    Directory of Open Access Journals (Sweden)

    Lindsay Stark

    2017-01-01

    Full Text Available Abstract Background The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to illuminate the scope of the issue, mobilize resources and direct the response. Methods Administrative zones across seven cities were purposively selected to cover the main urban areas known to have homeless populations in Cambodia. A complete enumeration of homeless individuals between the ages of 13 and 17 was attempted in the selected areas. In addition, a second independent count was conducted to enable a statistical estimation of completeness based on overlap across counts. This technique is known as capture-recapture. Adolescents were also interviewed about their schooling, health and other circumstances. Results After adjustment by the capture-recapture corrective multipliers (range: 3.53 -27.08, the study yielded an estimate of 2,697 13–17 year old homeless adolescents across all seven cities. The total number of homeless boys counted was significantly greater than homeless girls, especially in older ages. Conclusions To the authors’ knowledge, this is the first time capture-recapture methods have been applied to a homeless estimation of this scale in a resource-limited setting. Findings suggest the number of homeless adolescents in Cambodia is much greater than one would expect if relying on single count data alone and that this population faces many hardships.

  4. Assessing arsenic intake from groundwater and rice by residents in Prey Veng province, Cambodia

    International Nuclear Information System (INIS)

    Phan, Kongkea; Phan, Samrach; Heng, Savoeun; Huoy, Laingshun; Kim, Kyoung-Woong

    2014-01-01

    We investigated total daily intake of As by residents in Prey Veng province in the Mekong River basin of Cambodia. Groundwater (n = 11), rice (n = 11) and fingernail (n = 23) samples were randomly collected from the households and analyzed for total As by inductively coupled plasma mass spectrometry. Calculation indicated that daily dose of inorganic As was greater than the lower limits on the benchmark dose for a 0.5% increased incidence of lung cancer (BMDL 0.5 equals to 3.0 μg d −1 kg −1 body wt. ). Moreover, positive correlation between As in fingernail and daily dose of As from groundwater and rice and total daily dose of As were found. These results suggest that the Prey Veng residents are exposed to As in groundwater. As in rice is an additional source which is attributable to high As accumulation in human bodies in the Mekong River basin of Cambodia. -- Highlights: • We investigated total daily intake of As in Prey Veng province of Cambodia. • Residents in Prey Veng study area are at risk of As in groundwater. • As in rice is an additional source for high As accumulation in human bodies. -- Calculation of total daily intake indicated that Prey Veng residents are at risk of As in groundwater while As in rice is an additional source for high As accumulation in human bodies

  5. Towards safe abortion access: an exploratory study of medical abortion in Cambodia.

    Science.gov (United States)

    Petitet, Pascale Hancart; Ith, Leakhena; Cockroft, Melissa; Delvaux, Thérèse

    2015-02-01

    In 2010, following its approval by the Ministry of Health, the medical abortion combination pack Medabon (containing mifepristone and misoprostol) was made available at pharmacies and in a restricted number of health facilities in Cambodia. The qualitative study presented in this paper was conducted in 2012 as a follow-up to longer-term ethnographical research related to reproductive health and fertility regulation between 2008 and 2012. Observations were carried out at several clinic and pharmacy sites and in-depth interviews were conducted with a purposive sample of 20 women who attended two MSI Cambodia centres and 10 women identified through social networks; six men (women's male partners); eight health care providers at the two MSI centres and four pill sellers at private or informal pharmacies (who also provided health care services in private clinics). Although the level of training among the drug sellers and providers varied, their knowledge about medical abortion regimens, correct usage and common side effects was good. Overall, women were satisfied with the services provided. Medical abortion was not always a women-only process in this study as some male partners were also involved in the care process. The study illustrates positive steps forward being taken in making abortion safe and preventing and reducing unsafe abortion practices in Cambodia. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  6. Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

    Science.gov (United States)

    Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

    2015-02-01

    Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Partnering to develop a continuing professional development program in a low-resource setting: Cambodia.

    Science.gov (United States)

    Mack, Heather G; Meng, Ngy; Parsons, Tanya; Schlenther, Gerhard; Murray, Neil; Hart, Richard

    2017-08-01

    To design and implement a continuing professional development (CPD) program for Cambodian ophthalmologists. Partnering (twinning) between the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and the Cambodian Ophthalmological Society (COS). Practicing ophthalmologists in Cambodia. A conjoint committee comprising 4 ophthalmologists from RANZCO and 3 ophthalmologists from COS was established, supported by a RANZCO administrative team experienced in CPD administration. CPD requirements and recording were adapted from the RANZCO CPD framework. Cambodian ophthalmologists were surveyed during program implementation and after handover to COS. At the end of the 3-year program at handover to COS, a CPD program and online recording system was established. All 47 (100%) practicing ophthalmologists in Cambodia were registered for CPD, and 21/47 (45%) were actively participating in the COS CPD program online recording. Surveys of attitudes toward CPD demonstrated no significant change. Partnering was moderately effective in establishing a CPD program for Cambodian ophthalmologists. Uptake of CPD may have been limited by lack of a requirement for CPD for continuing medical licensure in Cambodia. Follow-up will be necessary to demonstrate CPD program longevity. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  8. Molecular epidemiology of Bordetella pertussis in Cambodia determined by direct genotyping of clinical specimens.

    Science.gov (United States)

    Moriuchi, Takumi; Vichit, Ork; Vutthikol, Yong; Hossain, Md Shafiqul; Samnang, Chham; Toda, Kohei; Grabovac, Varja; Hiramatsu, Yukihiro; Otsuka, Nao; Shibayama, Keigo; Kamachi, Kazunari

    2017-09-01

    This study sought to determine the genotypes of circulating Bordetella pertussis, the causative agent of pertussis, in Cambodia by direct molecular typing of clinical specimens. DNA extracts from nasopharyngeal swabs obtained from 82 pertussis patients in 2008-2016 were analyzed by multilocus variable-number tandem repeat analysis (MLVA). B. pertussis virulence-associated allelic genes (ptxA, prn, and fim3) and the pertussis toxin promoter ptxP were also investigated by DNA sequence-based typing. Forty-four DNA extracts (54%) yielded a complete MLVA profile, and these were sorted into 8 MLVA types (MT18, MT26, MT27, MT29, MT43, MT72, MT95, and MT200). MT27 and MT29, which are common in developed countries, were the predominant strain types (total 73%). The predominant profile of virulence-associated allelic genes was the combination of ptxP3/ptxA1/prn2/fim3A (48%). MT27 strains were detected during the entire study period, whereas MT29 strains were only found in 2014-2016. The B. pertussis population in Cambodia, where a whole-cell pertussis vaccine (WCV) has been continuously used, resembled those observed previously in developed countries where acellular pertussis vaccines are used. Circulating B. pertussis strains in Cambodia were distinct from those in other countries using WCVs. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  9. Prevalence of intestinal helminths among inhabitants of Cambodia (2006-2011).

    Science.gov (United States)

    Yong, Tai-Soon; Chai, Jong-Yil; Sohn, Woon-Mok; Eom, Keeseon S; Jeoung, Hoo-Gn; Hoang, Eui-Hyug; Yoon, Cheong-Ha; Jung, Bong-Kwang; Lee, Soon-Hyung; Sinuon, Muth; Socheat, Duong

    2014-12-01

    In order to investigate the status of intestinal helminthic infections in Cambodia, epidemiological surveys were carried out on a national scale, including 19 provinces. A total of 32,201 fecal samples were collected from schoolchildren and adults between 2006 and 2011 and examined once by the Kato-Katz thick smear technique. The overall egg positive rate of intestinal helminths was 26.2%. The prevalence of hookworms was the highest (9.6%), followed by that of Opisthorchis viverrini/minute intestinal flukes (Ov/MIF) (5.7%), Ascaris lumbricoides (4.6%), and Trichuris trichiura (4.1%). Other types of parasites detected were Enterobius vermicularis (1.1%), Taenia spp. (0.4%), and Hymenolepis spp. (0.2%). The northwestern regions such as the Siem Reap, Oddar Meanchey, and Banteay Meanchey Provinces showed higher prevalences (17.4-22.3%) of hookworms than the other localities. The southwestern areas, including Koh Kong and Preah Sihanouk Provinces showed higher prevalences of A. lumbricoides (17.5-19.2%) and T. trichiura (6.1-21.0%). Meanwhile, the central and southern areas, in particular, Takeo and Kampong Cham Provinces, showed high prevalences of Ov/MIF (23.8-24.0%). The results indicate that a considerably high prevalence of intestinal helminths has been revealed in Cambodia, and thus sustained national parasite control projects are necessary to reduce morbidity due to parasitic infections in Cambodia.

  10. Nuclear security policy in the context of counter-terrorism in Cambodia

    Energy Technology Data Exchange (ETDEWEB)

    Khun, Vuthy, E-mail: vuthy.khun@gmail.com; Wongsawaeng, Doonyapong [Department of Nuclear Engineering, Faculty of Engineering, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330 (Thailand)

    2016-01-22

    The risk of nuclear or dirty bomb attack by terrorists is one of the most urgent and threatening danger. The Cambodian national strategy to combat weapons of mass destruction (WMD) depicts a layered system of preventive measures ranging from securing materials at foreign sources to interdicting weapons or nuclear or other radioactive materials at ports, border crossings, and within the Cambodian institutions dealing with the nuclear security to manage the preventive programs. The aim of this study is to formulate guidance, to identify scenario of threat and risk, and to pinpoint necessary legal frameworks on nuclear security in the context of counterterrorism based on the International Atomic Energy Agency nuclear security series. The analysis of this study is guided by theoretical review, the review of international laws and politics, by identifying and interpreting applicable rules and norms establishing the nuclear security regime and how well enforcement of the regime is carried out and, what is the likelihood of the future reform might be. This study will examine the existing national legal frameworks of Cambodia in the context of counterterrorism to prevent acts of nuclear terrorism and the threat of a terrorist nuclear attack within the Cambodia territory. It will shed light on departmental lanes of national nuclear security responsibility, and provide a holistic perspective on the needs of additional resources and emphasis regarding nuclear security policy in the context of counterterrorism in Cambodia.

  11. A survey for potentially zoonotic gastrointestinal parasites of dogs and pigs in Cambodia

    DEFF Research Database (Denmark)

    Inpankaew, Tawin; Murrell, Kenneth Darwin; Pinyopanuwat, Nongnuch

    2015-01-01

    There is little information available on parasites of zoonotic significance in Cambodia. In 2011, in an effort to obtain data on potentially zoonotic gastrointestinal parasites in domestic animals, 50 dogs and 30 pigs residing in 38 households located in Ang Svay Check village, Takeo province, Ca....... Follow-up studies are required to further taxonomically characterize these dog and pig parasites and to determine their role in human parasites in this community.......There is little information available on parasites of zoonotic significance in Cambodia. In 2011, in an effort to obtain data on potentially zoonotic gastrointestinal parasites in domestic animals, 50 dogs and 30 pigs residing in 38 households located in Ang Svay Check village, Takeo province......, Cambodia were examined for parasites from faecal samples. The samples were processed using the formalin-ethyl acetate concentration technique (FECT). Hookworms were the most common zoonotic parasite found in dogs (80.0%) followed by Echinostomes (18.0%). While, in pigs, Fasciolopsis buski was the most...

  12. Magnitude of arsenic pollution in the Mekong and Red River Deltas - Cambodia and Vietnam

    International Nuclear Information System (INIS)

    Berg, Michael; Stengel, Caroline; Trang, Pham Thi Kim; Hung Viet, Pham; Sampson, Mickey L.; Leng, Moniphea; Samreth, Sopheap; Fredericks, David

    2007-01-01

    Large alluvial deltas of the Mekong River in southern Vietnam and Cambodia and the Red River in northern Vietnam have groundwaters that are exploited for drinking water by private tube-wells, which are of increasing demand since the mid-1990s. This paper presents an overview of groundwater arsenic pollution in the Mekong delta: arsenic concentrations ranged from 1-1610 μg/L in Cambodia (average 217 μg/L) and 1-845 μg/L in southern Vietnam (average 39 μg/L), respectively. It also evaluates the situation in Red River delta where groundwater arsenic concentrations vary from 1-3050 μg/L (average 159 μg/L). In addition to rural areas, the drinking water supply of the city of Hanoi has elevated arsenic concentrations. The sediments of 12-40 m deep cores from the Red River delta contain arsenic levels of 2-33 μg/g (average 7 μg/g, dry weight) and show a remarkable correlation with sediment-bound iron. In all three areas, the groundwater arsenic pollution seem to be of natural origin and caused by reductive dissolution of arsenic-bearing iron phases buried in aquifers. The population at risk of chronic arsenic poisoning is estimated to be 10 million in the Red River delta and 0.5-1 million in the Mekong delta. A subset of hair samples collected in Vietnam and Cambodia from residents drinking groundwater with arsenic levels > 50 μg/L have a significantly higher arsenic content than control groups (< 50 μg/L). Few cases of arsenic related health problems are recognized in the study areas compared to Bangladesh and West Bengal. This difference probably relates to arsenic contaminated tube-well water only being used substantially over the past 7 to 10 years in Vietnam and Cambodia. Because symptoms of chronic arsenic poisoning usually take more than 10 years to develop, the number of future arsenic related ailments in Cambodia and Vietnam is likely to increase. Early mitigation measures should be a high priority

  13. Mental health in primary health care in a rural district of Cambodia: a situational analysis.

    Science.gov (United States)

    Olofsson, Sofia; Sebastian, Miguel San; Jegannathan, Bhoomikumar

    2018-01-01

    While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia. A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia. Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present. There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia

  14. Distribution of selected healthcare resources for influenza pandemic response in Cambodia.

    Science.gov (United States)

    Schwanke Khilji, Sara U; Rudge, James W; Drake, Tom; Chavez, Irwin; Borin, Khieu; Touch, Sok; Coker, Richard

    2013-10-04

    Human influenza infection poses a serious public health threat in Cambodia, a country at risk for the emergence and spread of novel influenza viruses with pandemic potential. Prior pandemics demonstrated the adverse impact of influenza on poor communities in developing countries. Investigation of healthcare resource distribution can inform decisions regarding resource mobilization and investment for pandemic mitigation. A health facility survey performed across Cambodia obtained data on availability of healthcare resources important for pandemic influenza response. Focusing on five key resources considered most necessary for treating severe influenza (inpatient beds, doctors, nurses, oseltamivir, and ventilators), resource distributions were analyzed at the Operational District (OD) and Province levels, refining data analysis from earlier studies. Resources were stratified by respondent type (hospital vs. District Health Office [DHO]). A summary index of distribution inequality was calculated using the Gini coefficient. Indices for local spatial autocorrelation were measured at the OD level using geographical information system (GIS) analysis. Finally, a potential link between socioeconomic status and resource distribution was explored by mapping resource densities against poverty rates. Gini coefficient calculation revealed variable inequality in distribution of the five key resources at the Province and OD levels. A greater percentage of the population resides in areas of relative under-supply (28.5%) than over-supply (21.3%). Areas with more resources per capita showed significant clustering in central Cambodia while areas with fewer resources clustered in the northern and western provinces. Hospital-based inpatient beds, doctors, and nurses were most heavily concentrated in areas of the country with the lowest poverty rates; however, beds and nurses in Non-Hospital Medical Facilities (NHMF) showed increasing concentrations at higher levels of poverty. There is

  15. WinFood data from Kenya and Cambodia: Constraints on field procedures

    International Nuclear Information System (INIS)

    Owino, Victor; Omollo, Selina; Konyole, Silvenus; Skau, Jutta; Roos, Nanna; Friis, Henrik; Michaelsen, Kim

    2014-01-01

    Background: The broad aim of the Winfoods Project was to alleviate childhood malnutrition via utilisation of traditional foods (by incorporating edible termites and spiders in complementary food (CF) formulations in Kenya and Cambodia, respectively). The efficacy of the developed CF on stunting, lean mass accrual, lipid profile, haemoglobin, iron and zinc status and gross motor development was assessed in a 9-month intervention comparing the CF with CSB+ (Kenya) and CSB++ (Cambodia). We aim to highlight methodological difficulties associated with the assessment of lean mass (LM) and blood nutritional indictors (BNI). Methodology: In a randomized controlled design, infants received Winfoods for 9 months from 6-15 months of age. LM accrual and BNI (lipid profile, iron and zinc status) were measured cross-sectionally at 9 and 15 months of age, respectively. To determine LM infants were dosed with 3g deuterium oxide [D2O] (0.5g/Kg body weight) in Kenya or 7g nested D2O both at 6 and 15 months of age in Cambodia. Saliva was collected from each infant before the oral administration of the dose (baseline sample) and then at [1-hour and 3-hours in Kenya or 2-hour and 3-hours –Cambodia] after administration. D2O enrichment in saliva was determined by Fourier Transformed Infrared Spectrophotometry locally in Kenya. For Cambodia, samples were exported to Bangalore, India for lean mass analysis. To determine blood indicators, 3ml blood was drawn by venipuncture. Hemoglobin concentration was measured using a Hemocue machine. Whole blood portion was used for determination of lipid profile in Canada. Serum was used for Fe, Zn status assay in Germany. Results: In Kenya, the food ration was depleted way before the subsequent visit due to food insecurity. Intervention was associated with family planning by a section of the community. High rate of loss to follow up was attributed to relocation for family reunion and household conflicts. Cambodian ethics review committee (ERC) had

  16. Research Report: Female Councilor Forums as a capacity building in the decentralization process of Cambodia. A personal view of an unforgettable stay in Cambodia

    Directory of Open Access Journals (Sweden)

    Georgen, Maraile

    2006-03-01

    Full Text Available In 2001, the Royal Government of Cambodia introduced the decentralization reform in Cambodia, with the enactment of the Law on Elections of Commune/Sangkat Councils and the Law on Administration and Management of Communes/Sangkats. Decentralization means that certain rights, responsibilities and resources are transferred from the central level of government to the democratically elected Communes/Sangkats. Decentralization aims to promote democracy and to improve the living conditions of the population. Citizens have the opportunity to influence decisions on local matters and have the right to elect the members of the Commune/Sangkat Council. In February 2002 the first commune council elections were held in all 1,621 com-munes with 11,261 councilors elected. Depending on the size of the commune, between five and eleven members are working on the council. Although the 1993 constitution guarantees equality between men and women and the government is mainstreaming gender across all major policy initiatives, only 8.5% (983 of these elected councilors are female. This shows that women are still under-represented in Cambodian politics. However, tasks for Cambodian commune councilors are to interact in local com-munes affairs and to be agents of the central government. In terms of local commune affairs, female as well as male councilors have the duties to support the development of the Commune/Sangkat and the well-being of its residents. The councils are close to the citizens and therefore in a good position to find out about their needs and interests in order to develop programs that improve the living standards of their people. The work and conditions on the council can be really challenging and councilors daily have to face new problems. Therefore some ca-pacity buildings for councilors are already implemented.

  17. Diabetes and cardiometabolic risk factors in Cambodia: Results from two screening studies.

    Science.gov (United States)

    Wagner, Julie; Naranjo, Diana; Khun, Touch; Seng, Serey; Horn, Ien S; Suttiratana, Sakinah C; Keuky, Lim

    2018-02-01

    Despite growing attention to diabetes throughout Asia, data from Southeast Asia are limited. This article reports rates of diabetes, hypertension, and obesity in Cambodia. Two studies were conducted across different regions of Cambodia: (i) a 2012 screening study across urban, semi-urban, and rural areas that used point-of-care capillary glucose for determination of diabetes (n = 13 997); and (ii) a 2005 epidemiological study with random selection from two main urban areas that used oral glucose tolerance tests for determination of diabetes (n = 1863). Blood pressure and anthropometrics were also measured. In the screening study, rates of diabetes were significantly higher in urban than rural sites, with intermediate rates in semi-urban areas. There was a significant dose-response effect for urbanicity on overweight, obesity, and waist:hip ratio, with higher rates for urban versus semi-urban and for semi-urban versus rural locales. Rural sites had the lowest rates of hypertension, followed by urban and semi-urban sites. Among people who screened positive for diabetes, there was a dose-response effect for urbanicity on undiagnosed diabetes; rates of previously undiagnosed diabetes were lowest in urban (51%), followed by semi-urban (55%) and rural (67%) locales. Rural participants reported the highest rates of smoking and alcohol use. In the urban epidemiological study, prevalence rates of diabetes and impaired glucose tolerance were approximately 10%, indicating a prevalence of total glucose intolerance of approximately 20%. In Cambodia, diabetes rates are high among urban residents and undiagnosed diabetes is highest among rural residents. A country-wide public health response is urgently needed; as development continues, rates of diabetes are expected to rise. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  18. Industrial pollution load assessment in Phnom Penh, Cambodia using an industrial pollution projection system.

    Science.gov (United States)

    San, Vibol; Spoann, Vin; Schmidt, Johannes

    2018-02-15

    Approximately 56% out of the total 1302 Cambodian firms are operated in the Capital city of Cambodia. The necessary information on industrial pollution to set strategies, priorities and action plans on environmental protection issues is absent in Cambodia. In the absence of this data, effective environmental protection cannot be implemented. The objective of this study is to estimate industrial pollution load by employing the Industrial Pollution Projection System, a rapid environmental management tool for assessment of pollution load, to produce a scientific rational basis for preparing future policy direction to reduce industrial pollution in Phnom Penh city. Factory data between 1994 and 2014 obtained from the Ministry of Industry and Handicraft of Cambodia were used in our study. Due to the high number of employees, the total environmental load generated in Phnom Penh city was estimated to be 476,981Mg in 2014. Phnom Penh city generated 189,109Mg of VOC, 165,411Mg of toxic chemicals to air, 38,523Mg of toxic chemicals to land, and 28,968Mg of SO 2 in 2014. The results of the estimation show that the Textiles and Apparel sector was the highest generators of toxic chemicals into land and air, and toxic metals into land, air and water, while the Basic Metal sector was the greatest contributor of toxic chemicals to water. The Textiles and Apparel sector alone emitted 436,016Mg of total pollution load. The results indicate that the Dangkao and Meanchey districts were the greatest emitters of all pollutants in Phnom Penh. The results suggest that reduction in industrial pollution could be achieved by focusing on the most polluting sectors and areas. Adopting waste minimization strategies, which include cleaner production processes, will not only reduce the cost of controlling pollution, it will also make manufacturing more efficient thereby increasing profits while reducing pollution load in the long run. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Insectivorous bat reproduction and human cave visitation in Cambodia: A perfect conservation storm?

    Science.gov (United States)

    Cappelle, Julien; Hoem, Thavry

    2018-01-01

    Cave roosting bats represent an important component of Southeast Asian bat diversity and are vulnerable to human disturbance during critical reproductive periods (pregnancy, lactation and weaning). Because dramatic growth of cave tourism in recent decades has raised concerns about impacts on cave bats in the region, we assessed the reproductive phenology of two insectivorous species (Hipposideros larvatus sensu lato and Taphozous melanopogon) at three caves in Cambodia for 23 months in 2014–2016 and evaluated human visitation to these sites between 2007 and 2014. Despite the differing foraging strategies employed by the two taxa, the temporal consistency observed in proportions of pregnant, lactating and juvenile bats indicates that their major birth peaks coincide with the time of greatest cave visitation annually, particularly for domestic visitors and namely during the Cambodian new year in April. They also reflect rainfall patterns and correspond with the reproductive phenology of insectivorous cave bats in Vietnam. These findings were predictable because 1) insect biomass and thus food availability for insectivorous bats are optimal for ensuring survival of young following this period, and 2) the Khmer new year is the most significant month for religious ceremonies and thus domestic cave visitation nationally, due to the abundance of Buddhist shrines and temples in Cambodian caves. While the impact of visitor disturbance on bat population recruitment cannot be empirically assessed due to lack of historical data, it is nonetheless likely to have been considerable and raises a conservation concern. Further, because growing evidence suggests that insectivorous cave bats exhibit reproductive synchrony across continental Southeast Asia where countless cave shrines are heavily frequented during April in Theravada Buddhist countries (e.g., Myanmar, Thailand, Cambodia and Laos), our results may have wider applicability in the region. We consequently advocate for

  20. The association between household poverty rates and tuberculosis case notification rates in Cambodia, 2010

    Directory of Open Access Journals (Sweden)

    Mao Yang Eang

    2013-03-01

    Full Text Available Introduction: Poverty is a risk factor for tuberculosis (TB; it increases the risk of infection and active disease but limits diagnostic opportunities. The role of poverty in the stagnant case detection in Cambodia is unclear. This study aims to assess the relationship between district household poverty rates and sputum-positive TB case notification rates (CNRs in Cambodia in 2010. Methods: Poisson regression models were used to calculate the relative risk of new sputum-positive TB CNR for Operational Districts (ODs with different poverty rates using data from the National Centre for Tuberculosis and Leprosy Control and the National Committee for SubNational Democratic Development. Models were adjusted for other major covariates and a geographical information system was used to examine the spatial distribution of these covariates in the country. Results: The univariate model showed a positive association between household poverty rates and sputum-positive TB CNRs. However, in multivariate models, after adjusting for major covariates, household poverty rates showed a significantly negative association with sputum-positive TB CNRs (relative risk [RR] = 0.95 per 5% increase in poverty rate. The negative association was stronger among males than females (RR = 0.93 versus 0.96 per 5% increase in poverty rate. Similar spatial patterns were observed between household poverty rates and other covariates, particularly OD population density. Conclusion: Household poverty rate is associated with a decrease in sputum-positive TB CNR in Cambodia, particularly in men. The potential of combining surveillance data and socioeconomic variables should be explored further to provide more insights for TB control programme planning.

  1. Beliefs about tobacco, health, and addiction among adults in Cambodia: findings from a national survey.

    Science.gov (United States)

    Yel, Daravuth; Bui, Anthony; Job, Jayakaran S; Knutsen, Synnove; Singh, Pramil N

    2013-09-01

    There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n=13,988) of all provinces of Cambodia, we found that (1) 88-93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86-93% believe that the Wat (temple) should be a smoke-free area; (3) 93-95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.

  2. Acute Undifferentiated Febrile Illness in Rural Cambodia: A 3-Year Prospective Observational Study

    Science.gov (United States)

    Mueller, Tara C.; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J.; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier

    2014-01-01

    In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects. PMID:24755844

  3. Beta-lactam resistance among Enterobacteriaceae in Cambodia: The four-year itch

    Directory of Open Access Journals (Sweden)

    Yannick Caron

    2018-01-01

    Full Text Available Although antibiotics are too often used inappropriately in Cambodia, published data on antimicrobial resistance in this country are scarce. Epidemic dissemination and the transfer of resistance genes to other bacterial species put the population at risk. The aim of this study was to evaluate the frequency and characteristics of extended-spectrum beta-lactamase (ESBL-producing Enterobacteriaceae (ESBL-E isolated in consecutive samples tested at Institut Pasteur du Cambodge over a 4-year period (2012–2015. Antimicrobial susceptibility testing was performed by disk diffusion on agar technique and the results were read automatically using an OSIRIS system. The Etest was used to determine minimum inhibitory concentrations (MIC for some resistance phenotypes. The strain most commonly identified was Escherichia coli (63.9%. The proportion of ESBL-E increased gradually over the study period, from 23.8% to 38.4%. ESBL was detected in 42.7% of the E. coli strains and 33.7% of all Klebsiella pneumoniae isolated. The proportion of ESBL-producing E. coli increased significantly from 28.9% in 2012 to 48.2% in 2015, while the increase for K. pneumoniae remained non-significant. Multidrug resistance was high in this Cambodian series, with some strains displaying resistance to all antibiotics available in the country. There is currently no established system for the surveillance of antimicrobial resistance in Cambodia. Collecting samples from clinical settings throughout the country is critical to assess the impact of antimicrobial drug use in patients in Cambodia and in the Mekong Region.

  4. Insectivorous bat reproduction and human cave visitation in Cambodia: A perfect conservation storm?

    Science.gov (United States)

    Lim, Thona; Cappelle, Julien; Hoem, Thavry; Furey, Neil

    2018-01-01

    Cave roosting bats represent an important component of Southeast Asian bat diversity and are vulnerable to human disturbance during critical reproductive periods (pregnancy, lactation and weaning). Because dramatic growth of cave tourism in recent decades has raised concerns about impacts on cave bats in the region, we assessed the reproductive phenology of two insectivorous species (Hipposideros larvatus sensu lato and Taphozous melanopogon) at three caves in Cambodia for 23 months in 2014-2016 and evaluated human visitation to these sites between 2007 and 2014. Despite the differing foraging strategies employed by the two taxa, the temporal consistency observed in proportions of pregnant, lactating and juvenile bats indicates that their major birth peaks coincide with the time of greatest cave visitation annually, particularly for domestic visitors and namely during the Cambodian new year in April. They also reflect rainfall patterns and correspond with the reproductive phenology of insectivorous cave bats in Vietnam. These findings were predictable because 1) insect biomass and thus food availability for insectivorous bats are optimal for ensuring survival of young following this period, and 2) the Khmer new year is the most significant month for religious ceremonies and thus domestic cave visitation nationally, due to the abundance of Buddhist shrines and temples in Cambodian caves. While the impact of visitor disturbance on bat population recruitment cannot be empirically assessed due to lack of historical data, it is nonetheless likely to have been considerable and raises a conservation concern. Further, because growing evidence suggests that insectivorous cave bats exhibit reproductive synchrony across continental Southeast Asia where countless cave shrines are heavily frequented during April in Theravada Buddhist countries (e.g., Myanmar, Thailand, Cambodia and Laos), our results may have wider applicability in the region. We consequently advocate for

  5. Insectivorous bat reproduction and human cave visitation in Cambodia: A perfect conservation storm?

    Directory of Open Access Journals (Sweden)

    Thona Lim

    Full Text Available Cave roosting bats represent an important component of Southeast Asian bat diversity and are vulnerable to human disturbance during critical reproductive periods (pregnancy, lactation and weaning. Because dramatic growth of cave tourism in recent decades has raised concerns about impacts on cave bats in the region, we assessed the reproductive phenology of two insectivorous species (Hipposideros larvatus sensu lato and Taphozous melanopogon at three caves in Cambodia for 23 months in 2014-2016 and evaluated human visitation to these sites between 2007 and 2014. Despite the differing foraging strategies employed by the two taxa, the temporal consistency observed in proportions of pregnant, lactating and juvenile bats indicates that their major birth peaks coincide with the time of greatest cave visitation annually, particularly for domestic visitors and namely during the Cambodian new year in April. They also reflect rainfall patterns and correspond with the reproductive phenology of insectivorous cave bats in Vietnam. These findings were predictable because 1 insect biomass and thus food availability for insectivorous bats are optimal for ensuring survival of young following this period, and 2 the Khmer new year is the most significant month for religious ceremonies and thus domestic cave visitation nationally, due to the abundance of Buddhist shrines and temples in Cambodian caves. While the impact of visitor disturbance on bat population recruitment cannot be empirically assessed due to lack of historical data, it is nonetheless likely to have been considerable and raises a conservation concern. Further, because growing evidence suggests that insectivorous cave bats exhibit reproductive synchrony across continental Southeast Asia where countless cave shrines are heavily frequented during April in Theravada Buddhist countries (e.g., Myanmar, Thailand, Cambodia and Laos, our results may have wider applicability in the region. We consequently

  6. Improving local health through community health workers in Cambodia: challenges and solutions.

    Science.gov (United States)

    Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

    2018-01-06

    Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently

  7. The prevalence and associated factors for prehypertension and hypertension in Cambodia

    Science.gov (United States)

    Gupta, Vinay; LoGerfo, James P; Raingsey, Prak Piseth; Fitzpatrick, Annette L

    2013-01-01

    Background Hypertension is strongly associated with adverse cardiovascular outcomes and was the leading modifiable associated factor for global disease burden in 2010. Analysis of modifiable associated factors will be important to those concerned with mitigating the adverse effects of hypertension. We studied factors associated with hypertension in adults aged 25–64 years of age in Cambodia in order to help develop strategies for planned new initiatives for prevention and control of hypertension. Methods Using data from a nationwide survey in Cambodia assessing the prevalence of associated factors for non-communicable disease in 2010 (WHO STEPs survey), 5017 participants between the ages of 25 and 64 years were included in a secondary analysis of the prevalence and predictors of hypertension. Results The prevalence of prehypertension in this sample was approximately double that of overall hypertension (27.9% vs 15.3%). Male sex, increasing age and known cardiovascular associated factors, including higher Body Mass Index (BMI), dyslipidaemia, impaired fasting glycaemia, and abdominal obesity were all associated with an increased prevalence of hypertension. In multivariate models, increasing age was the strongest associated factor for hypertension (OR 8.79, 95% CI (5.43 to 14.2)), whereas, higher BMI was the primary associated factor associated with prehypertension (OR 3.27, 95% CI 2.21 to 4.82). Conclusions Modifiable cardiovascular-associated factors are strongly correlated with prehypertension and hypertension in Cambodia, and may be a focus of public health and primary care strategies to mitigate subsequent ischaemic heart disease and stroke. A national strategy aimed at increased screening and adherence to medical therapy is a necessary first step to reduce burden of disease and related morbidities. PMID:27326148

  8. Market-based biogas sector development in least developed countries —The case of Cambodia

    International Nuclear Information System (INIS)

    Buysman, Eric; Mol, Arthur P.J.

    2013-01-01

    In many of the least developed countries the energy security conundrum is how to provide affordable, safe and clean energy to a low income rural population. Household level generation of biogas from animal waste for both cooking and lighting, while producing high quality organic fertiliser, is increasingly proposed as a viable part of the solution for farming households. Since the early 1990s international development organisations – often in cooperation with the national government – have attempted to introduce biogas technologies in many least developed countries, but most initiatives failed. In this landscape of failed biogas development programmes the National Biodigester Programme (NBP) Cambodia started in 2006, with the aim to establish a permanent market oriented and self-financed biogas sector. The results show the development of a sustainable domestic biodigester sector, a rapid diffusion of biodigesters among poor rural households, but still ambivalences on financial independency from external funding and carbon finance. The conclusion is that a pure market model for biogas development in the rural area of the least developed countries will not easily work. Governmental regulation and coordination will remain needed, and carbon finance will not easily fully replace ODA and governmental financial support. - Highlights: • The National Biodigester Programme has successfully introduced domestic biogas in Cambodia. • The development of a market based biogas sector is crucial in ensuring a healthy and continuous development after donor funding. • Domestic biogas is of crucial importance to meet rural Cambodia’s energy challenges and to boost the rural economy by providing employment opportunities. • Domestic biogas helps Cambodia to reduce deforestation and to shift to climate-smart agriculture. • Financing of a market-based biogas model remain problematic in the near future

  9. Beta-lactam resistance among Enterobacteriaceae in Cambodia: The four-year itch.

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    Caron, Yannick; Chheang, Rattanak; Puthea, Nop; Soda, Meng; Boyer, Sébastien; Tarantola, Arnaud; Kerléguer, Alexandra

    2018-01-01

    Although antibiotics are too often used inappropriately in Cambodia, published data on antimicrobial resistance in this country are scarce. Epidemic dissemination and the transfer of resistance genes to other bacterial species put the population at risk. The aim of this study was to evaluate the frequency and characteristics of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) isolated in consecutive samples tested at Institut Pasteur du Cambodge over a 4-year period (2012-2015). Antimicrobial susceptibility testing was performed by disk diffusion on agar technique and the results were read automatically using an OSIRIS system. The Etest was used to determine minimum inhibitory concentrations (MIC) for some resistance phenotypes. The strain most commonly identified was Escherichia coli (63.9%). The proportion of ESBL-E increased gradually over the study period, from 23.8% to 38.4%. ESBL was detected in 42.7% of the E. coli strains and 33.7% of all Klebsiella pneumoniae isolated. The proportion of ESBL-producing E. coli increased significantly from 28.9% in 2012 to 48.2% in 2015, while the increase for K. pneumoniae remained non-significant. Multidrug resistance was high in this Cambodian series, with some strains displaying resistance to all antibiotics available in the country. There is currently no established system for the surveillance of antimicrobial resistance in Cambodia. Collecting samples from clinical settings throughout the country is critical to assess the impact of antimicrobial drug use in patients in Cambodia and in the Mekong Region. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Mercury contamination in human hair and fish from Cambodia: levels, specific accumulation and risk assessment

    International Nuclear Information System (INIS)

    Agusa, Tetsuro; Kunito, Takashi; Iwata, Hisato; Monirith, In; Tana, Touch Seang; Subramanian, Annamalai; Tanabe, Shinsuke

    2005-01-01

    Mercury (Hg) concentrations in human hair and fish samples from Phnom Penh, Kien Svay, Tomnup Rolork and Batrong, Cambodia, collected in November 1999 and December 2000 were determined to understand the status of contamination, and age- and sex-dependent accumulation in humans and to assess the intake of mercury via fish consumption. Mercury concentrations in human hair ranged from 0.54 to 190 μg/g dry wt. About 3% of the samples contained Hg levels exceeding the no observed adverse effects level (NOAEL) of WHO (50 μg/g) and the levels in some hair samples of women also exceeded the NOAEL (10 μg/g) associated with fetus neurotoxicity. A weak but significant positive correlation was observed between age and Hg levels in hair of residents. Mercury concentrations in muscle of marine and freshwater fish from Cambodia ranged from <0.01 to 0.96 μg/g wet wt. Mercury intake rates were estimated on the basis of the Hg content in fish and daily fish consumption. Three samples of marine fish including sharp-tooth snapper and obtuse barracuda, and one sample of sharp-tooth snapper exceeded the guidelines by US EPA and by Joint FAO/WHO Expert Committee on Food Additives (JECFA), respectively, which indicates that some fish specimens examined (9% and 3% for US EPA and JECFA guidelines, respectively) were hazardous for consumption at the ingestion rate of Cambodian people (32.6 g/day). It is suggested that fish is probably the main source of Hg for Cambodian people. However, extremely high Hg concentrations were observed in some individuals and could not be explained by Hg intake from fish consumption, indicating some other contamination sources of Hg in Cambodia. - A source other than fish may be responsible for high Hg in some Cambodians

  11. Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children.

    Science.gov (United States)

    Forrer, Armelle; Khieu, Virak; Schär, Fabian; Hattendorf, Jan; Marti, Hanspeter; Neumayr, Andreas; Char, Meng Chuor; Hatz, Christoph; Muth, Sinuon; Odermatt, Peter

    2017-10-01

    Strongyloides stercoralis is a soil-transmitted nematode that can replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and highly prevalent in Cambodia. The extent of morbidity associated with S. stercoralis infection is difficult to assess due to the broad spectrum of symptoms and, thus, remains uncertain. Clinical signs were compared among S. stercoralis infected vs. non-infected participants in a cross-sectional survey conducted in 2012 in eight villages of Northern Cambodia, and before and after treatment with a single oral dose of ivermectin (200μg/kg BW) among participants harboring S. stercoralis. Growth retardation among schoolchildren and adolescents was assessed using height-for-age and thinness using body mass index-for-age. S. stercoralis prevalence was 31.1% among 2,744 participants. Urticaria (55% vs. 47%, OR: 1.4, 95% CI: 1.1-1.6) and itching (52% vs. 48%, OR: 1.2, 95% CI: 1.0-1.4) were more frequently reported by infected participants. Gastrointestinal, dermatological, and respiratory symptoms were less prevalent in 103 mono-infected participants after treatment. Urticaria (66% vs. 11%, OR: 0.03, 95% CI: 0.01-0.1) and abdominal pain (81 vs. 27%, OR: 0.07, 95% CI: 0.02-0.2) mostly resolved by treatment. S. stercoralis infection was associated with stunting, with 2.5-fold higher odds in case of heavy infection. The morbidity associated with S. stercoralis confirmed the importance of gastrointestinal and dermatological symptoms unrelated to parasite load, and long-term chronic effects when associated with malnutrition. The combination of high prevalence and morbidity calls for the integration of S. stercoralis into ongoing STH control measures in Cambodia.

  12. The Molecular and Spatial Epidemiology of Typhoid Fever in Rural Cambodia.

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    Duy Pham Thanh

    2016-06-01

    Full Text Available Typhoid fever, caused by the bacterium Salmonella Typhi, is an endemic cause of febrile disease in Cambodia. The aim of this study was to better understand the epidemiology of pediatric typhoid fever in Cambodia. We accessed routine blood culture data from Angkor Hospital for Children (AHC in Siem Reap province between 2007 and 2014, and performed whole genome sequencing (WGS on the isolated bacteria to characterize the S. Typhi population. The resulting phylogenetic information was combined with conventional epidemiological approaches to investigate the spatiotemporal distribution of S. Typhi and population-level risk factors for reported disease. During the study period, there were 262 cases of typhoid within a 100 km radius of AHC, with a median patient age of 8.2 years (IQR: 5.1-11.5 years. The majority of infections occurred during the rainy season, and commune incidences as high as 11.36/1,000 in children aged <15 years were observed over the study period. A population-based risk factor analysis found that access to water within households and increasing distance from Tonle Sap Lake were protective. Spatial mapping and WGS provided additional resolution for these findings, and confirmed that proximity to the lake was associated with discrete spatiotemporal disease clusters. We confirmed the dominance of MDR H58 S. Typhi in this population, and found substantial evidence of diversification (at least seven sublineages within this single lineage. We conclude that there is a substantial burden of pediatric typhoid fever in rural communes in Cambodia. Our data provide a platform for additional population-based typhoid fever studies in this location, and suggest that this would be a suitable setting in which to introduce a school-based vaccination programme with Vi conjugate vaccines.

  13. [Deployment of a dermatologist in Cambodia and Somalia: Personal experience of a medical officer].

    Science.gov (United States)

    Dieterle, R

    2015-05-01

    Throughout history, physicians of the armed forces have gained experience in tropical medicine during deployment in tropical countries. During deployments in Cambodia and Somalia, dermatologists treated participants of the UN missions and also local people to win their confidence. The experience acquired during these missions is reported. The dermatologist was mainly confronted with the diagnosis and treatment of infectious skin diseases, including genitourinary diseases. Therapy of parasitic infections rarely imported to Europe was a challenge. Training and experience in Tropical Medicine are essential for medical officers deployed on missions as well as for physicians advising travellers.

  14. Exploring the influence of context and policy on health district productivity in Cambodia.

    Science.gov (United States)

    Ensor, Tim; So, Sovannarith; Witter, Sophie

    2016-01-01

    Cambodia has been reconstructing its economy and health sector since the end of conflict in the 1990s. There have been gains in life expectancy and increased health expenditure, but Cambodia still lags behind neighbours One factor which may contribute is the efficiency of public health services. This article aims to understand variations in efficiency and the extent to which changes in efficiency are associated with key health policies that have been introduced to strengthen access to health services over the past decade. The analysis makes use of data envelopment analysis (DEA) to measure relative efficiency and changes in productivity and regression analysis to assess the association with the implementation of health policies. Data on 28 operational districts were obtained for 2008-11, focussing on the five provinces selected to represent a range of conditions in Cambodia. DEA was used to calculate efficiency scores assuming constant and variable returns to scale and Malmquist indices to measure productivity changes over time. This analysis was combined with qualitative findings from 17 key informant interviews and 19 in-depth interviews with managers and staff in the same provinces. The DEA results suggest great variation in the efficiency scores and trends of scores of public health services in the five provinces. Starting points were significantly different, but three of the five provinces have improved efficiency considerably over the period. Higher efficiency is associated with more densely populated areas. Areas with health equity funds in Special Operating Agency (SOA) and non-SOA areas are associated with higher efficiency. The same effect is not found in areas only operating voucher schemes. We find that the efficiency score increased by 0.12 the year any of the policies was introduced. This is the first study published on health district productivity in Cambodia. It is one of the few studies in the region to consider the impact of health policy changes

  15. Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia.

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    Fukushi Morishita

    Full Text Available Despite free TB services available in public health facilities, TB patients often face severe financial burden due to TB. WHO set a new global target that no TB-affected families experience catastrophic costs due to TB. To monitor the progress and strategize the optimal approach to achieve the target, there is a great need to assess baseline cost data, explore potential proxy indicators for catastrophic costs, and understand what intervention mitigates financial burden. In Cambodia, nationwide active case finding (ACF targeting household and neighbourhood contacts was implemented alongside routine passive case finding (PCF. We analyzed household cost data from ACF and PCF to determine the financial benefit of ACF, update the baseline cost data, and explore whether any dissaving patterns can be a proxy for catastrophic costs in Cambodia.In this cross-sectional comparative study, structured interviews were carried out with 108 ACF patients and 100 PCF patients. Direct and indirect costs, costs before and during treatment, costs as percentage of annual household income and dissaving patterns were compared between the two groups.The median total costs were lower by 17% in ACF than in PCF ($240.7 [IQR 65.5-594.6] vs $290.5 [IQR 113.6-813.4], p = 0.104. The median costs before treatment were significantly lower in ACF than in PCF ($5.1 [IQR 1.5-25.8] vs $22.4 [IQR 4.4-70.8], p<0.001. Indirect costs constituted the largest portion of total costs (72.3% in ACF and 61.5% in PCF. Total costs were equivalent to 11.3% and 18.6% of annual household income in ACF and PCF, respectively. ACF patients were less likely to dissave to afford TB-related expenses. Costs as percentage of annual household income were significantly associated with an occurrence of selling property (p = 0.02 for ACF, p = 0.005 for PCF.TB-affected households face severe financial hardship in Cambodia. ACF has the great potential to mitigate the costs incurred particularly before treatment

  16. The Question of Land in Cambodia: Perceptions, Access, and Use since De-collectivization

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    Anne Y. Guillou

    2013-05-01

    Full Text Available Introduction Cambodia is one of the countries in the world which experienced the most radical disruption of its land tenure. Almost its entire present adult population has been forced at one time or another to leave its lands and houses, whether because of the American bombings (1969-1973 which were particularly murderous in the south-eastern part of the country (the bombs’ holes are still visible from an airplane; or on a far greater scale, during the Democratic Kampuchea regime, called th...

  17. A Report from the Cambodia Training Event for Awareness of Melioidosis (C-TEAM, October 2017

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    Sotharith Bory

    2018-02-01

    Full Text Available Melioidosis is an endemic infection in Cambodia, a lower middle income SE Asian country. Despite more laboratories isolating and identifying Burkholderia pseudomallei in recent years, the infection remains under-recognised and under-diagnosed, particularly in the adult population. Lack of knowledge about the disease and lack of utilization of microbiology laboratories contributes to this, along with laboratory capacity issues. Treatment costs often hamper optimal management. In response to these issues, a national one-health training event was held in October 2017 to raise awareness of the disease amongst clinical, laboratory, and public health professionals. The meeting format, findings, and outcomes are described here.

  18. Estimation of solar radiation over Cambodia from long-term satellite data

    Energy Technology Data Exchange (ETDEWEB)

    Janjai, S.; Pankaew, P.; Laksanaboonsong, J. [Solar Energy Research Laboratory, Department of Physics, Faculty of Science, Silpakorn University, Nakhon Pathom 73000 (Thailand); Kitichantaropas, P. [Department of Alternative Energy Development and Efficiency, Ministry of Energy, 17 Rama 1 Road, Patumwan, Bangkok 10330 (Thailand)

    2011-04-15

    In this work, monthly average daily global solar irradiation over Cambodia was estimated from a long-term satellite data. A 14-year period (1995-2008) of visible channel data from GMS5, GOES9 and MTSAT-1R satellites were used to provide earth-atmospheric reflectivity. A satellite-based solar radiation model developed for a tropical environment was used to estimate surface solar radiation. The model relates the satellite-derived earth-atmospheric reflectivity to absorption and scattering coefficients of various atmospheric constituents. The absorption of solar radiation due to water vapour was calculated from precipitable water derived from ambient relative humidity and temperature. Ozone data from the TOMS and OMI satellite data were employed to compute the solar radiation absorption by ozone. The depletion of radiation due to aerosols was estimated from the visibility data. Five new solar radiation measuring stations were established at Cambodian cities, namely Siem Reap (13.87 N, 103.85 E), Kompong Thom (12.68 N, 104.88 E), Phnom Penh (11.55 N, 104.83 E), Sihanouke Ville (10.67 N, 103.63 E) and Kampot (10.70 N, 104.28 E). Global solar radiation measured at these stations was used to validate the model. The validation was also carried out by using solar radiation measured at four Thai meteorological stations. These stations are situated near the Cambodian border. Monthly average daily global irradiation from these stations was compared with that calculated from the model. The measured and calculated irradiation is in good agreement, with the root mean square difference of 6.3%, with respect to the mean values. After the validation, the model was used to calculate monthly average daily global solar irradiation over Cambodia. Based on this satellite-derived irradiation, solar radiation maps for Cambodia were generated. These maps show that solar radiation climate of this country is strongly influenced by the monsoons. A solar radiation database was also generated

  19. The sale of tarantulas in Cambodia for food or medicine: is it sustainable?

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    A.L. Yen

    2013-01-01

    Full Text Available The sale of tarantulas for either human consumption or for preparation of medicines has become more widespread in Cambodia over the last 10-20 years. With increased media exposure, the trade seems to be increasing, but there are serious questions as to its sustainability because of possible over-collecting of the spiders and also loss of habitats. This note outlines some of the fundamental questions that need to be addressed if this spider trade is to be sustainable or else we could see the loss of an important link in the forest food chain.

  20. Health seeking and access to care for children with suspected dengue in Cambodia: An ethnographic study

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    Manderson Lenore

    2007-09-01

    Full Text Available Abstract Background The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Methods Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Results Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. Conclusion The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue.

  1. Health seeking and access to care for children with suspected dengue in Cambodia: an ethnographic study.

    Science.gov (United States)

    Khun, Sokrin; Manderson, Lenore

    2007-09-24

    The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue.

  2. Participatory approach to improving safety, health and working conditions in informal economy workplaces in Cambodia.

    Science.gov (United States)

    Kawakami, Tsuyoshi; Tong, Leng; Kannitha, Yi; Sophorn, Tun

    2011-01-01

    The present study aimed to improve safety and health in informal economy workplaces such as home workplaces, small construction sites, and rural farms in Cambodia by using "participatory" approach. The government, workers' and employers' organizations and NGOs jointly assisted informal economy workers in improving safety and health by using participatory training methodologies. The steps taken were: (1) to collect existing good practices in safety and health in Cambodia; (2) to develop new participatory training programmes for home workers and small construction sites referring to ILO's WISE training programme, and (3) to train government officers, workers, employers and NGOs as safety and health trainers. The participatory training programmes developed consisted of action-checklists associated with illustrations, good example photo sheets, and texts explaining practical, low-cost improvement measures. The established safety and health trainers reached many informal economy workers through their human networks, and trained them by using the developed participatory training programmes. More than 3,000 informal economy workers were trained and they implemented improvements by using low-cost methods. Participatory training methodologies and active cooperation between the government, workers, employers and NGOs made it possible to provide practical training for those involved in the informal economy workplaces.

  3. Forest plunder in Southeast Asia: an environmental security nexus in Burma and Cambodia.

    Science.gov (United States)

    Talbott, K; Brown, M

    1998-01-01

    This article discusses the cycle of conversion, consumption, and corruption that undermines the environment and civil society in Cambodia and Burma (Myanmar). In these countries, forests are declining in patterns similar to other Southeast Asian deforestation. Illegal logging, prostitution, and heroin trafficking constitute the bulk of Cambodia's shadow economy. Revenues are used to provide financial support for political causes and build the private wealth of the elite. Major political and guerilla groups and the Cambodian military have been major beneficiaries of logging revenue, supported private sector forestry in many military zones, and facilitated logging and trade. About 40% of land goes to forest concessions granted to Southeast Asian companies, and revenues bypass the regular state budget. In Burma, the cease fire agreements in the early 1990s, led to remote border area forests being opened up to large, nonsustainable commercial timber mining. Land was divided into ethnic and government controlled areas. Timber profits were funneled into a business owned by members of the new ruling force, the SLORC, and used to launder drug exports and profits. Trading partners include Thailand, and most recently, China. It is speculated that deforested areas are replanted with opium poppies, and trade routes carry timber and heroin. The unregulated logging industry and the lack of financial accounting of the timber trade undermine the structures of civil society and good governance. Forest policies appear progressive but are in reality unenforced. Politics and agreements in both countries are closely tied to deforestation issues.

  4. Diversity of Monogononta rotifer species among standing waterbodies in northern Cambodia

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    Ratha Sor

    2014-08-01

    Full Text Available The incidence and abundance of Monogononta rotifer species were recorded from lakes and reservoirs in the upper part of the Cambodian Mekong River basin in April and November 2010. One hundred and seven species are reported, 25 of which are new records to Cambodia and 8 taxa were unidentifiable to species level. Species richness at the regional and local scale was not significantly different between habitat types or between seasons, whether it was estimated using incidence or abundance data. Comparison of incidence data also revealed no significant difference from species richness of ponds concurrently sampled in the same region. There appeared to be a high level of diversity among sites that could not be attributed to nestedness or to the 5 environmental variables measured. Each habitat type and season offered substantially different rotifer communities, with the proportion of unshared species between sample sets ranging from 14-49%. Non-metric multidimensional scaling and PERMANOVA analyses also revealed clustering and significant differences among sample sets based on habitat type and season. Therefore, each habitat type and season contributed to the overall rotifer biodiversity. When the incidence data from this study are combined with those in previously reported studies, the overall species richness estimate for Cambodia is 403 species (95% CI = 386-432 and the number of species records has reached 306. 

  5. Metacyclops woni n. sp., a New Cyclopoid Species (Copepoda: Cyclopoida: Cyclopidae from Cambodia

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    Lee, Jimin

    2015-10-01

    Full Text Available A new cyclopoid species belonging to the genus Metacyclops Kiefer, 1927 is described, based upon the specimens from a temporary pool in a forest of Mt. Phnom Domnak Dambouk, situated in the southwestern part of Cambodia. Metacyclops woni sp. nov. is characterized by its quite short caudal rami, about 2.5 times longer than wide, with a spinule row on anterior quarter of lateral margin. This new species belongs to the species group with the spine formula 3,4,4,3 of swimming legs 1-4. Among the members of the species group with the combination of characters of 11-segmented antennule and a single apical spine on the second endopodal segment of leg 4, it most resembles M. deserticus Mercado-Salas and Suárez-Morales, 2013 from Mexico in carrying an outermost caudal seta slightly longer than the innermost caudal seta and an apical spine on the second endopodal segment of leg 4 slightly shorter than the segment. However, it differs clearly from the present new species by much longer caudal rami with lateral caudal seta at nearly halfway of lateral margin of the ramus and smooth posterior margin of intercoxal sclerites of legs 1-4. This is the first record of the genus Metacyclops from Cambodia and the fourth one from Southeast Asia.

  6. Intensive Circulation of Japanese Encephalitis Virus in Peri-urban Sentinel Pigs near Phnom Penh, Cambodia.

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    Julien Cappelle

    2016-12-01

    Full Text Available Despite the increased use of vaccination in several Asian countries, Japanese Encephalitis (JE remains the most important cause of viral encephalitis in Asia in humans with an estimated 68,000 cases annually. Considered a rural disease occurring mainly in paddy-field dominated landscapes where pigs are amplifying hosts, JE may nevertheless circulate in a wider range of environment given the diversity of its potential hosts and vectors. The main objective of this study was to assess the intensity of JE transmission to pigs in a peri-urban environment in the outskirt of Phnom Penh, Cambodia. We estimated the force of JE infection in two cohorts of 15 sentinel pigs by fitting a generalised linear model on seroprevalence monitoring data observed during two four-month periods in 2014. Our results provide evidence for intensive circulation of JE virus in a periurban area near Phnom Penh, the capital and most populated city of Cambodia. Understanding JE virus transmission in different environments is important for planning JE virus control in the long term and is also an interesting model to study the complexity of vector-borne diseases. Collecting quantitative data such as the force of infection will help calibrate epidemiological model that can be used to better understand complex vector-borne disease epidemiological cycles.

  7. Abortion choices among women in Cambodia after introduction of a socially marketed medicated abortion product.

    Science.gov (United States)

    Sotheary, Khim; Long, Dianna; Mundy, Gary; Madan, Yasmin; Blumenthal, Paul D

    2017-02-01

    To assess whether a social marketing initiative focusing on medicated abortion via a mifepristone/misoprostol "combipack" has contributed to reducing unsafe abortion in Cambodia. In a questionnaire-based cross-sectional study, annual household surveys were conducted across 13 Cambodian provinces in 2010, 2011, and 2012. One married woman of reproductive age who was not pregnant and did not wish to be within the next 2 years in each randomly selected household was approached for inclusion. Participants were interviewed using a structured questionnaire. The questionnaire was completed by 1843 women in 2010, 2068 in 2011, and 2059 in 2012. Manual vacuum aspiration was reported by 61 (72.6%) of 84 women surveyed in 2010 who reported an abortion in the previous 12 months, compared with only 28 (52.8%) of 53 in 2012 (P=0.001). The numbers of women undergoing medicated abortion increased from 22 (26.2%) of 84 in 2010 to 27 (49.1%) of 53 in 2012 (P=0.003), whereas the numbers undergoing unsafe abortion decreased from 4 (4.8%) in 2010 to 0 in 2012 (P=0.051). Social marketing of medication abortion coupled with provider training in clinical and behavioral change could have contributed to a reduction in the prevalence of unsafe abortion and shifted the types of abortion performed in Cambodia, while not increasing the overall number of abortions. © 2016 International Federation of Gynecology and Obstetrics.

  8. Predictors of exclusive breast-feeding in early infancy: a survey report from Phnom Penh, Cambodia.

    Science.gov (United States)

    Sasaki, Yuri; Ali, Moazzam; Kakimoto, Kazuhiro; Saroeun, Ou; Kanal, Koum; Kuroiwa, Chushi

    2010-12-01

    Exclusive breast-feeding (EBF) is recommended in the first 6 months of an infant's life. This study aims to investigate the present status of infant feeding practices and identify factors that affect EBF practices during the first 6 months following infant birth in Phnom Penh, Cambodia. A cross-sectional survey with a semistructured questionnaire was given to 312 mothers with children aged 6 to 24 months who visited the immunization clinic in the National Maternal and Child Health Centre in Phnom Penh, Cambodia, from December 2005 to February 2006. Eighty-three percent of mothers fed breast milk exclusively in the first month, whereas only 51.3% continued EBF in the first 6 months. Within 30 minutes after delivery, 39% of mothers began breast-feeding. Results from logistic regression analysis indicate that the lack of a maternal antenatal EBF plan (odds ratio [OR] = 10.01, 95% confidence interval [CI] = 3.68-27.24, p feeding classes (OR = 1.93, 95% CI = 1.13-3.28, p feed their babies, keeping in mind the benefits it may yield. Paternal involvement in breast-feeding classes may increase their awareness and consequently complement EBF practices. Finally, development of conducive working environments and policies for working mothers should be carefully explored because it could have positive influence in better care and promotion of EBF. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Resistance and Contingent Contestations to Large-Scale Land Concessions in Southern Laos and Northeastern Cambodia

    Directory of Open Access Journals (Sweden)

    Ian G. Baird

    2017-02-01

    Full Text Available Over the last decade, there have been considerable concerns raised regarding the social and environmental impacts of large-scale land concessions for plantation development in various parts of the world, especially in the tropics, including in Laos and Cambodia. However, there is still much to learn about the various connections and interactions associated with reactions to what are often referred to as “land grabs”, and the ways they are associated or not associated with broader social movements and networks opposed to land grabbing. There is also the need to develop language for discussing these circumstances, something I aim to contribute to in this article. Here, I present four different cases of types of resistance, or what I refer to as contingent contestations, to land concessions in southern Laos and northeastern Cambodia (two from each country, focusing on the perspectives and associated strategies of smallholder farmers, but without ignoring broader issues. I consider the roles of locals in these contestations, through emphasizing the importance of histories, identities/ethnicities, politics, and geography in determining the types of responses to these land deals that emerge, and the strategies that are adopted for contesting these developments.

  10. Impact of Helmet Use on Severity of Epidural Hematomas in Cambodia.

    Science.gov (United States)

    Gupta, Saksham; Iv, Vycheth; Sam, Nang; Vuthy, Din; Klaric, Katherine; Shrime, Mark G; Park, Kee B

    2017-04-01

    Traumatic brain injury is a major cause of morbidity and mortality worldwide, often necessitating neurosurgical intervention to evacuate intracranial bleeding. Since the early 2000s, Cambodia has been undergoing a rapid increase in motorcycle transit and in road traffic accidents, but the prevalence of helmet usage remains low. Epidural hematomas are severe traumatic brain injuries that can necessitate neurosurgical intervention. This is a retrospective cohort study of patients with epidural hematoma secondary to motorcycle accidents who presented to a major national tertiary care center in Phnom Penh, Cambodia, between November 2013 and March 2016. All patients were diagnosed with computed tomography of the head. In this cohort, 21.6% of patients in motorcycle accidents presented with epidural hematoma and 89.1% of patients were men, 47.6% were intoxicated, and were 87.8% were not wearing helmets at the moment of impact. Not wearing a helmet was associated with a 6.90-fold increase in odds of presenting with a moderate-to-severe Glasgow coma scale score and a 3.76-fold increase in odds of requiring craniotomy or craniectomy for evacuation of hematoma. Male sex was also associated with increased odds of higher clinical severity at presentation and indication for craniotomy or craniectomy, and alcohol intoxication at the time of accident was not associated with either. Helmet usage is protective in reducing the severity of presentation and need for neurosurgical intervention for patients with epidural hematoma secondary to motorcycle accidents. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Zoonotic Trematode Metacercariae in Fish from Phnom Penh and Pursat, Cambodia

    Science.gov (United States)

    Chai, Jong-Yil; Na, Byoung-Kuk; Yong, Tai-Soon; Eom, Keeseon S.; Yoon, Cheong-Ha; Hoang, Eui-Hyug; Jeoung, Hoo-Gn; Socheat, Duong

    2014-01-01

    A survey was performed to investigate the infection status of freshwater fish with zoonotic trematode metacercariae in Phnom Penh and Pursat Province, Cambodia. All collected fish with ice were transferred to our laboratory and examined using the artificial digestion method. In fish from Phnom Penh, 2 kinds of metacercariae (Opisthorchis viverrini and Haplorchis yokogawai) were detected. O. viverrini metacercariae were positive in 37 (50.0%) of 74 fish in 11 species (average no. metacercariae/fish, 18.6). H. yokogawai metacercariae were detected in 23 (57.5%) of 40 fish in 5 species (average no. metacercariae/fish, 21.0). In fish from Pursat Province, 5 kinds of metacercariae (O. viverrini, H. yokogawai, Haplorchis pumilio, Centrocestus formosanus, and Procerovum sp.) were detected; O. viverrini metacercariae (n=3) in 2 fish species (Henicorhynchus lineatus and Puntioplites falcifer), H. yokogawai metacercariae (n=51) in 1 species (P. falcifer), H. pumilio metacercariae (n=476) in 2 species (H. lineatus and Pristolepis fasciata), C. formosanus metacercariae (n=1) in 1 species (H. lineatus), and Procerovum sp. metacercariae (n=63) in 1 species (Anabas testudineus). From the above results, it has been confirmed that various freshwater fish play the role of a second intermediate host for zoonotic trematodes (O. viverrini, H. yokogawai, H. pumilio, C. formosanus, and Procerovum sp.) in Cambodia. PMID:24623879

  12. Closing the irrigation deficit in Cambodia: Implications for transboundary impacts on groundwater and Mekong River flow

    Science.gov (United States)

    Erban, Laura E.; Gorelick, Steven M.

    2016-04-01

    Rice production in Cambodia, essential to food security and exports, is largely limited to the wet season. The vast majority (96%) of land planted with rice during the wet season remains fallow during the dry season. This is in large part due to lack of irrigation capacity, increases in which would entail significant consequences for Cambodia and Vietnam, located downstream on the Mekong River. Here we quantify the extent of the dry season ;deficit; area in the Cambodian Mekong River catchment, using a recent agricultural survey and our analysis of MODIS satellite data. Irrigation of this land for rice production would require a volume of water up to 31% of dry season Mekong River flow to Vietnam. However, the two countries share an aquifer system in the Mekong Delta, where irrigation demand is increasingly met by groundwater. We estimate expansion rates of groundwater-irrigated land to be >10% per year in the Cambodian Delta using LANDSAT satellite data and simulate the effects of future expansion on groundwater levels over a 25-year period. If groundwater irrigation continues to expand at current rates, the water table will drop below the lift limit of suction pump wells, used for domestic supply by >1.5 million people, throughout much of the area within 15 years. Extensive groundwater irrigation jeopardizes access for shallow domestic water supply wells, raises the costs of pumping for all groundwater users, and may exacerbate arsenic contamination and land subsidence that are already widespread hazards in the region.

  13. Molecular characterization of sympatrically distributed Neotricula aperta-like snails in the Mekong River, Kratie, Cambodia.

    Science.gov (United States)

    Wang, Chennan; Saijuntha, Weerachai; Kirinoki, Masashi; Hayashi, Naoko; Chigusa, Yuichi; Muth, Sinuon; Meng, Chuor Char; Ai, Yingchun; Agatsuma, Takeshi

    2016-01-01

    Fifty-six samples of Neotricula aperta-like snails were collected from six locations in Cambodia. Their mitochondrial cytochrome c oxidase subunit 1 (cox1) sequences were examined using haplotype network and neighbor-joining (NJ) tree analysis. Twenty-seven haplotypes (H1-H27) were observed and were divided into two different groups/lineages. Of 27, 17 haplotypes (H11-H27) were clustered with the reference samples of the γ-race N. aperta. The remaining 10 haplotypes (H1-H10) were clustered in a separate group/lineage, differing from the reference samples of the α-, β-, and γ-race N. aperta, suggesting a new lineage belonging the genus Neotricula. Our results show that both the γ-race and a new lineage were sympatrically present approximately 60 km upstream of the Mekong River near the Kratie port, Cambodia. Further morphological and molecular studies are required to confirm the taxonomic status of this new, unidentified lineage.

  14. Preliminary study of river water in gold mining areas of Cambodia

    International Nuclear Information System (INIS)

    Murao, Satoshi; Nishiyama, Fumitaka; Sieng, Sotham

    2004-01-01

    In Cambodia, artisanal mining has recently come to a social concern because of the possibility to cause environmental degradation and human health problems. The General Department of Mineral Resources of Cambodia is collecting environmental specimens in mining sites to watch the situation. This time, four water samples from Sampov Loon and one from Memong mining site were sent from the Department to Hiroshima University, Japan, and the samples were analyzed by means of PIXE at the University. A volume of 10 μl from each sample was separated and dropped onto 4 μm polypropylene backing foil. The measurement was carried out by using 2.5 MV single-ended Vande Graaff accelerator. A Si(Li) detector (active area, 80mm 2 ; sensitive depth, 5 mm; Be-window's thickness, 25 μm; resolution, 167 eV fwhm at 5.9 keV) was used for both of in vacuo PIXE and non-vacuum external beam PIXE measurement. A computer code PIXS was used for the quantification. The result indicates that there are at least two kinds of water in Sampov Loon and one of them possibly represents polluted condition. (author)

  15. Plasmodium falciparum Resistance to Artemisinin Derivatives and Piperaquine: A Major Challenge for Malaria Elimination in Cambodia

    Science.gov (United States)

    Duru, Valentine; Witkowski, Benoit; Ménard, Didier

    2016-01-01

    Artemisinin-based combination therapies (ACTs) are the cornerstone of current strategies for fighting malaria. Over the last decade, ACTs have played a major role in decreasing malaria burden. However, this progress is being jeopardized by the emergence of artemisinin-resistant Plasmodium falciparum parasites. Artemisinin resistance was first detected in western Cambodia in 2008 and has since been observed in neighboring countries in southeast Asia. The problem of antimalarial drug resistance has recently worsened in Cambodia, with reports of parasites resistant to piperaquine, the latest generation of partner drug used in combination with dihydroartemisinin, leading to worrying rates of clinical treatment failure. The monitoring and the comprehension of both types of resistance are crucial to prevent the spread of multidrug-resistant parasites outside southeast Asia, and particularly to Africa, where the public health consequences would be catastrophic. To this end, new tools are required for studying the biological and molecular mechanisms underlying resistance to antimalarial drugs and for monitoring the geographic distribution of the resistant parasites. In this review, we detail the major advances in our understanding of resistance to artemisinin and piperaquine and define the challenges that the malaria community will have to face in the coming years. PMID:27928074

  16. Seroprevalence of bovine immunodeficiency virus and bovine leukemia virus in draught animals in Cambodia.

    Science.gov (United States)

    Meas, S; Ohashi, K; Tum, S; Chhin, M; Te, K; Miura, K; Sugimoto, C; Onuma, M

    2000-07-01

    Since bovine immunodeficiency virus (BIV), known as bovine lentivirus, has been detected in dairy and beef cattle in various countries around the world, a prevalence study of antibodies to BIV and bovine leukemia virus (BLV) was conducted in draught animals in five provinces in Cambodia, where protozoan parasite infections were suspected in some animals. To clarify the status of draught animals including Haryana, Brahman, mixed-breed, local breed cattle and muscle water buffaloes, a total of 544 cattle and 42 buffaloes were tested, and 26.3 and 16.7%, respectively, were found positive for anti-BIV p26 antibodies determined by Western blotting. There were 5.3% positive for anti-BLV antibodies detected by immunodiffusion test among the cattle, but no reactors among buffaloes and no dual infection for both BIV and BLV was determined in this study. Peripheral blood mononuclear cells from BIV-seropositive cattle were found to have BIV-provirus DNA, as detected by polymerase chain reaction and subsequent Southern blot hybridization. This is the first evidence for the presence of BIV and BLV infections in draught animals in tropical countries such as Cambodia. This wide distribution of BIV suggests its association with problems in animal health as reported worldwide, and that a primary BIV infection can predispose death of affected animals by other aggressive pathogens or stresses.

  17. Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Carriage in Children in Cambodia

    Science.gov (United States)

    Nickerson, Emma K.; Wuthiekanun, Vanaporn; Kumar, Varun; Amornchai, Premjit; Wongdeethai, Nattavut; Chheng, Kheng; Chantratita, Narisara; Putchhat, Hor; Thaipadungpanit, Janjira; Day, Nicholas P.; Peacock, Sharon J.

    2011-01-01

    We previously described the first reported isolation of methicillin-resistant Staphylococcus aureus (MRSA) (a case series of pediatric community-associated MRSA infections) in Cambodia. We define the rate of pediatric MRSA carriage in the same population and characterize the associated bacterial genotypes by using pulsed-field gel electrophoresis and multilocus sequence typing. A prospective cohort study of MRSA carriage conducted over one month at the Angkor Hospital for Children, Siem Reap, Cambodia, identified MRSA carriage in 87 (3.5%) of 2,485 children who came to the outpatient department, and 6 (4.1%) of 145 inpatients, including at least two with cases of nosocomial acquisition. Genotyping of all 93 MRSA isolates resolved 5 genotypes. Most (91%) isolates were assigned to sequence type 834. Only 28 (32%) of 87 MRSA carriers identified in the outpatient department had no history of recent healthcare contact. The study findings have important implications for healthcare in a setting where diagnostic microbiology and access to antimicrobial drugs with efficacy against MRSA are limited. PMID:21292906

  18. [Epidemiological study on HIV/AIDS in Cambodia seroprevalence of HIV/STD among commercial sex workers].

    Science.gov (United States)

    Ohshige, K; Morio, S; Mizushima, S; Kitamura, K; Tajima, K; Ito, A; Suyama, A; Usuku, S; Phalla, T; Leng, H B; Sopheab, H; Eab, B; Soda, K

    1999-01-01

    To describe epidemiological features of HIV prevalence among female commercial sex workers (CSWs) in Cambodia, a cross-sectional study using a questionnaire study and serological tests was carried out from December 1997 to January 1998. We report the main results of the analyses of serological tests in this article. Two hundred ninety six CSWs working in Sisophon and Poi Pet, located in northwest Cambodia, Bantey Mean Chey province, were recruited for interview based on a questionnaire on sexual behavior, and serological tests. The blood samples were examined for HIV antibody, Chlamydia trachomatis IgG antibody, TPHA, Hepatitis B surface antigen, and Hepatitis B surface antibody. The relationship between HIV and the other STD's was analyzed by using logistic regression analysis. The HIV seroprevalence rate was 43.9% (130 out of 296). The seropositive rate of Chlamydia trachomatis IgG antibody (C.T.-IgG-Ab) was 73.3% (217 out of 296). Logistic regression analysis showed a significant association between C.T.-IgG-Ab positive and HIV prevalence. (Odds Ratio: 5.33; 95% Confidence Interval, 2.82-10.07). This study suggests that the existence of Chlamydia trachomatis is closely related with HIV prevalence among CSWs in Cambodia. Other STDs may also increase susceptibility to male-to-female sexual transmission of HIV. This suggests that appropriate prevention against STDs will be needed for the control of HIV prevalence in Cambodia.

  19. Glass Barriers : Constraints to Women's Small-Scale Cross-Border Trade in Cambodia and Lao PDR

    OpenAIRE

    Seror, Marlon; Record, Richard; Clarke, Julian

    2017-01-01

    Trade facilitation projects often assume indirect benefits for small-scale, cross-border traders. Recent studies have shown the challenges faced in Africa by this population, especially women, but it remains unknown in Cambodia and the Lao People's Democratic Republic, despite large trade facilitation investments. This paper fills this gap, thanks to an innovative mix of original qualitati...

  20. Dynamics of soil carbon, nitrogen and soil respiration in farmer’s field with conservation agriculture Siem Reap, Cambodia

    Science.gov (United States)

    The years of intensive tillage in many countries, including Cambodia, have caused significant decline in agriculture’s natural resources that could threaten the future of agricultural production and sustainability worldwide. Long-term tillage system and site-specific crop management can affect chang...

  1. Diets and Feeding Practices during the First 1000 Days Window in the Phnom Penh and North Eastern Districts of Cambodia

    Directory of Open Access Journals (Sweden)

    Somphos Vicheth Som

    2018-04-01

    Full Text Available Although several health and development indicators have improved significantly in Cambodia, inadequate breastfeeding and inappropriate complementary feeding practices leave many children at high risk of malnutrition during the early stages of life. In 2014, the prevalence of wasting and stunting among Cambodian children under 5 were 10% and 32%, respectively. Thus, a strong focus on improving feeding practices within the first 1000 days window to reduce child malnutrition prevalence in Cambodia is needed. This cross-sectional study assessed the current feeding practices among of women of reproductive age, pregnant women, lactating women and children less than 24 months living in six districts from Phnom Penh and two rural provinces in the North East of Cambodia. The nutritional status of pregnant women was poor, with 21.4% having a Middle Upper arm circumference below 23 cm. While breastfeeding was predominant within the first 6 months of age in every district, feeding practices of pregnant women and children were a concern, as >70% of the children were not meeting the minimum acceptable diet, and most of the women did not improve their diet during pregnancy. Inadequate nutrition during the first 1000 days is highly prevalent in Cambodia. A comprehensive national Mother, Infant and Young Child Nutrition strategy needs to be developed and operationalized to improve feeding practices of Cambodian women and children.

  2. Distortions and Dichotomies in Inclusive Education for Children with Disabilities in Cambodia in the Context of Globalisation and International Development

    Science.gov (United States)

    Kalyanpur, Maya

    2014-01-01

    This paper explores the consequences of transferring technical information on disability and inclusive education from the North to the South within the context of international development. Based on data from the author's experiences as a US-trained Indian international consultant in Cambodia, it analyses how problems with translation and…

  3. Sero-epidemiological evaluation of changes in Plasmodium falciparum and Plasmodium vivax transmission patterns over the rainy season in Cambodia

    DEFF Research Database (Denmark)

    Cook, Jackie; Speybroeck, Nico; Sochanta, Tho

    2012-01-01

    In Cambodia, malaria transmission is low and most cases occur in forested areas. Sero-epidemiological techniques can be used to identify both areas of ongoing transmission and high-risk groups to be targeted by control interventions. This study utilizes repeated cross-sectional data to assess...

  4. Trauma and Poor Mental Health in Relation to Economic Status: The Case of Cambodia 35 Years Later.

    Directory of Open Access Journals (Sweden)

    Johan Jarl

    Full Text Available Cambodia is one of the poorest countries in south-east Asia and is still emerging from the events of the Khmer Rouge reign. It has been suggested that the atrocities experienced by the Cambodian population can explain why Cambodia continues to lag behind its neighbours in economic outcomes. The purpose of this study is to investigate whether there is an association between exposure to past trauma and/or current poor mental health and current economic status in Cambodia.A newly conducted survey performed in two regions (north-west and south-east Cambodia collected information on trauma exposure, psychiatric symptoms, self-rated health outcomes and socio-economic information for 3200 persons aged 18-60. Economic outcomes were measured as household debt and poverty status and whether the respondent was economically inactive. All models were analysed using logistic regression.No association was found between high exposure to conflict-related or civilian trauma and any economic outcomes save for a negative association between civilian trauma and poverty in the south-east. Current post-traumatic stress was related solely to poverty status. All other measures of current mental health status, however, were found to be strongly negatively associated with all measures of economic status. Thus, mental health interventions could potentially be utilised in poverty reduction strategies, but greater efficacy is likely to be achieved by targeting current mental health status rather than previous trauma exposure.

  5. Issues and Techniques in Translating Scientific Terms from English to Khmer for a University-Level Text in Cambodia

    Science.gov (United States)

    Quigley, Cassie; Oliviera, Alandeom W.; Curry, Alastair; Buck, Gayle

    2011-01-01

    Teachers and students spend much time interacting with written resources such as textbooks, tests, or worksheets during classroom instruction. What if no text is available, however, in the language of the learners? This case study describes the processes and techniques adopted by two university lecturers in Cambodia, as they translated an L1…

  6. What Makes the Difference? An Analysis of a Reading Intervention Programme Implemented in Rural Schools in Cambodia

    Science.gov (United States)

    Courtney, Jane; Gravelle, Maggie

    2014-01-01

    This article compares the existing single-strategy approach towards the teaching of early literacy in schools in rural Cambodia with a multiple-strategy approach introduced as part of a reading intervention programme. Classroom observations, questionnaires and in-depth interviews with teachers were used to explore teachers' practices and…

  7. Effectiveness of Bilingual Education in Cambodia: A Longitudinal Comparative Case Study of Ethnic Minority Children in Bilingual and Monolingual Schools

    Science.gov (United States)

    Lee, Scott; Watt, Ron; Frawley, Jack

    2015-01-01

    There is little research in the developing countries of South East Asia on the effectiveness of bilingual education programmes that use first language instruction for ethnic minority children. This study investigated the effectiveness of a bilingual education programme involving ethnic minority children in Cambodia by comparing their performance…

  8. Poor thiamin and riboflavin status is common among women of childbearing age in rural and urban Cambodia.

    Science.gov (United States)

    Whitfield, Kyly C; Karakochuk, Crystal D; Liu, Yazheng; McCann, Adrian; Talukder, Aminuzzaman; Kroeun, Hou; Ward, Mary; McNulty, Helene; Lynd, Larry D; Kitts, David D; Li-Chan, Eunice C Y; McLean, Judy; Green, Timothy J

    2015-03-01

    Thiamin deficiency in infancy is the underlying cause of beriberi, which can be fatal without rapid treatment. Reports of thiamin deficiency are common in Cambodia; however, population representative data are unavailable. Because B-complex vitamin deficiencies commonly occur in combination, riboflavin was also investigated. We determined the biomarker status of thiamin and riboflavin in women of childbearing age in rural and urban Cambodia. We measured thiamin (erythrocyte thiamin diphosphate; TDP) and riboflavin (erythrocyte glutathione reductase activity coefficient; EGRac) status in a representative sample of Cambodian women (aged 20-45 y) in urban Phnom Penh (n = 146) and rural Prey Veng (n = 156), Cambodia, and, for comparison purposes, in a convenience sample of women in urban Vancouver, British Columbia, Canada (n = 49). Thiamin insufficiency (TDP ≤ 90 nmol/L) was common among both urban (39%) and rural (59%) Cambodian women (P Cambodia. The unexpected finding of high riboflavin inadequacy status in Vancouver women warrants further investigation. © 2015 American Society for Nutrition.

  9. Trauma and Poor Mental Health in Relation to Economic Status: The Case of Cambodia 35 Years Later.

    Science.gov (United States)

    Jarl, Johan; Cantor-Graae, Elizabeth; Chak, Thida; Sunbaunat, Ka; Larsson, Charlotte A

    2015-01-01

    Cambodia is one of the poorest countries in south-east Asia and is still emerging from the events of the Khmer Rouge reign. It has been suggested that the atrocities experienced by the Cambodian population can explain why Cambodia continues to lag behind its neighbours in economic outcomes. The purpose of this study is to investigate whether there is an association between exposure to past trauma and/or current poor mental health and current economic status in Cambodia. A newly conducted survey performed in two regions (north-west and south-east Cambodia) collected information on trauma exposure, psychiatric symptoms, self-rated health outcomes and socio-economic information for 3200 persons aged 18-60. Economic outcomes were measured as household debt and poverty status and whether the respondent was economically inactive. All models were analysed using logistic regression. No association was found between high exposure to conflict-related or civilian trauma and any economic outcomes save for a negative association between civilian trauma and poverty in the south-east. Current post-traumatic stress was related solely to poverty status. All other measures of current mental health status, however, were found to be strongly negatively associated with all measures of economic status. Thus, mental health interventions could potentially be utilised in poverty reduction strategies, but greater efficacy is likely to be achieved by targeting current mental health status rather than previous trauma exposure.

  10. Non-tuberculosis mycobacteria: Trend of isolation rate and characteristics of NTM in Cambodia during 2011–2013

    Directory of Open Access Journals (Sweden)

    S Khann

    2015-01-01

    Conclusions: The isolation rate of NTM in Cambodia among presumptive MDR-TB patients was found to be remarkably high and increasing over the last 3 years and strongly correlated with the grade of smear result. Further studies and appropriate managements should be done for those patients.

  11. Reevaluating the Relationship between Education and Child Labour Using the Capabilities Approach: Policy and Implications for Inequality in Cambodia

    Science.gov (United States)

    Kluttz, Jenalee

    2015-01-01

    Cambodia has experienced rapid economic growth in the last two decades, improving living standards and diminishing poverty. Unfortunately, it has failed to do so evenly. Growth within the country has widened the gap between rich and poor and exacerbated the rural/urban divide. This inequality is mirrored in the school system. Inequality within the…

  12. 27 October 2014 - H.E. Mr Ney Samol Ambassador Permanent Representative of the Kingdom of Cambodia to the United Nations Office and other international organizations in Geneva

    CERN Multimedia

    Brice, Maximilien

    2014-01-01

    His Excellency Mr Ney Samol Ambassador Permanent Representative of the Kingdom of Cambodia to the United Nations Office and other international organizations in Geneva signing the Guest Book with Deputy Head of International Relations E. Tsesmelis

  13. Development of Legal Norms on Marriage and Divorce in Cambodia : The Civil Code Between Foreign Inputs and Local Growth (2)

    OpenAIRE

    KUONG, Teilee

    2016-01-01

    This second part of the research focuses on the development of law on divorce in Cambodia, aiming at identifying the continuation and changes in the legislative development of Cambodia in regulating divorce and post-divorce relationship. It starts with a brief overview of the legislative development from the early 20th century up till the latest codification of the 2007 Civil Code. Along this line of historical narratives, the research then examines two important elements in the legal effects...

  14. Geostatistical modelling of soil-transmitted helminth infection in Cambodia: do socioeconomic factors improve predictions?

    Science.gov (United States)

    Karagiannis-Voules, Dimitrios-Alexios; Odermatt, Peter; Biedermann, Patricia; Khieu, Virak; Schär, Fabian; Muth, Sinuon; Utzinger, Jürg; Vounatsou, Penelope

    2015-01-01

    Soil-transmitted helminth infections are intimately connected with poverty. Yet, there is a paucity of using socioeconomic proxies in spatially explicit risk profiling. We compiled household-level socioeconomic data pertaining to sanitation, drinking-water, education and nutrition from readily available Demographic and Health Surveys, Multiple Indicator Cluster Surveys and World Health Surveys for Cambodia and aggregated the data at village level. We conducted a systematic review to identify parasitological surveys and made every effort possible to extract, georeference and upload the data in the open source Global Neglected Tropical Diseases database. Bayesian geostatistical models were employed to spatially align the village-aggregated socioeconomic predictors with the soil-transmitted helminth infection data. The risk of soil-transmitted helminth infection was predicted at a grid of 1×1km covering Cambodia. Additionally, two separate individual-level spatial analyses were carried out, for Takeo and Preah Vihear provinces, to assess and quantify the association between soil-transmitted helminth infection and socioeconomic indicators at an individual level. Overall, we obtained socioeconomic proxies from 1624 locations across the country. Surveys focussing on soil-transmitted helminth infections were extracted from 16 sources reporting data from 238 unique locations. We found that the risk of soil-transmitted helminth infection from 2000 onwards was considerably lower than in surveys conducted earlier. Population-adjusted prevalences for school-aged children from 2000 onwards were 28.7% for hookworm, 1.5% for Ascaris lumbricoides and 0.9% for Trichuris trichiura. Surprisingly, at the country-wide analyses, we did not find any significant association between soil-transmitted helminth infection and village-aggregated socioeconomic proxies. Based also on the individual-level analyses we conclude that socioeconomic proxies might not be good predictors at an

  15. Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia.

    Science.gov (United States)

    Reinbott, Anika; Jordan, Irmgard

    2016-01-01

    Women's diets often decrease with regard to amounts per meal and day as well as diversity if a household's access to food is limited. The result is a monotonous diet that, in particular, negatively affects women's nutritional status during pregnancy and lactation and, thus, the infant. The infant's diet is of utmost importance, as it needs to meet the nutrient requirements especially during the first 2 years of life, a critical window for the child's healthy development. In Cambodia, infant and young child feeding (IYCF) practices are poor. Preparation of a special complementary meal in addition to breast milk feeds for children aged 6-23 months is often not a common habit. Instead, children eat watery, plain rice porridges that do not meet the nutrient requirements at this young age. A lack of adequate caring practices such as responsive feeding exacerbates the risk of malnutrition. Caregivers are often unaware of the importance of nutrition during the first 2 years of life regarding its effects on children's growth. In 2012, a randomized controlled trial (RCT) was started in two provinces of northern Cambodia: Oddar Meanchey and Preah Vihear. To contribute to reducing child mortality by addressing malnutrition among children 6-23 months of age, the Food and Agriculture Organization of the United Nations (FAO) implemented a nutrition-sensitive agriculture project with nutrition-specific actions, i.e. a nutrition education intervention was embedded in a food security project. Wealth, a child's age, and maternal education were identified as determinants of a child's dietary diversity. The older the child and/or the wealthier the household, the more diverse the child's diet. Maternal education was positively associated with the child's dietary diversity. Household dietary diversity was significantly associated with child dietary diversity in a model including group, child's age, maternal education, and wealth as confounders. The RCT also showed that a 2- to 3-month

  16. Strongyloides stercoralis and hookworm co-infection: spatial distribution and determinants in Preah Vihear Province, Cambodia.

    Science.gov (United States)

    Forrer, Armelle; Khieu, Virak; Schär, Fabian; Vounatsou, Penelope; Chammartin, Frédérique; Marti, Hanspeter; Muth, Sinuon; Odermatt, Peter

    2018-01-12

    Strongyloides stercoralis and hookworm are two soil-transmitted helminths (STH) that are highly prevalent in Cambodia. Strongyloides stercoralis causes long-lasting infections and significant morbidity but is largely neglected, while hookworm causes the highest public health burden among STH. The two parasites have the same infection route, i.e. skin penetration. The extent of co-distribution, which could result in potential high co-morbidities, is unknown in highly endemic settings like Cambodia. The aim of this study was to predict the spatial distribution of S. stercoralis-hookworm co-infection risk and to investigate determinants of co-infection in Preah Vihear Province, North Cambodia. A cross-sectional survey was conducted in 2010 in 60 villages of Preah Vihear Province. Diagnosis was performed on two stool samples, using combined Baermann technique and Koga agar culture plate for S. stercoralis and Kato-Katz technique for hookworm. Bayesian multinomial geostatistical models were used to assess demographic, socioeconomic, and behavioural determinants of S. stercoralis-hookworm co-infection and to predict co-infection risk at non-surveyed locations. Of the 2576 participants included in the study, 48.6% and 49.0% were infected with S. stercoralis and hookworm, respectively; 43.8% of the cases were co-infections. Females, preschool aged children, adults aged 19-49 years, and participants who reported regularly defecating in toilets, systematically boiling drinking water and having been treated with anthelmintic drugs had lower odds of co-infection. While S. stercoralis infection risk did not appear to be spatially structured, hookworm mono-infection and co-infection exhibited spatial correlation at about 20 km. Co-infection risk was positively associated with longer walking distances to a health centre and exhibited a small clustering tendency. The association was only partly explained by climatic variables, suggesting a role for underlying factors, such as

  17. A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia.

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    Kheng Chheng

    Full Text Available Febrile illnesses are pre-eminent contributors to morbidity and mortality among children in South-East Asia but the causes are poorly understood. We determined the causes of fever in children hospitalised in Siem Reap province, Cambodia.A one-year prospective study of febrile children admitted to Angkor Hospital for Children, Siem Reap. Demographic, clinical, laboratory and outcome data were comprehensively analysed. Between October 12(th 2009 and October 12(th 2010 there were 1225 episodes of febrile illness in 1180 children. Median (IQR age was 2.0 (0.8-6.4 years, with 850 (69% episodes in children <5 years. Common microbiological diagnoses were dengue virus (16.2%, scrub typhus (7.8%, and Japanese encephalitis virus (5.8%. 76 (6.3% episodes had culture-proven bloodstream infection, including Salmonella enterica serovar Typhi (22 isolates, 1.8%, Streptococcus pneumoniae (13, 1.1%, Escherichia coli (8, 0.7%, Haemophilus influenzae (7, 0.6%, Staphylococcus aureus (6, 0.5% and Burkholderia pseudomallei (6, 0.5%. There were 69 deaths (5.6%, including those due to clinically diagnosed pneumonia (19, dengue virus (5, and melioidosis (4. 10 of 69 (14.5% deaths were associated with culture-proven bloodstream infection in logistic regression analyses (odds ratio for mortality 3.4, 95% CI 1.6-6.9. Antimicrobial resistance was prevalent, particularly in S. enterica Typhi, (where 90% of isolates were resistant to ciprofloxacin, and 86% were multi-drug resistant. Comorbid undernutrition was present in 44% of episodes and a major risk factor for acute mortality (OR 2.1, 95% CI 1.1-4.2, as were HIV infection and cardiac disease.We identified a microbiological cause of fever in almost 50% of episodes in this large study of community-acquired febrile illness in hospitalized children in Cambodia. The range of pathogens, antimicrobial susceptibility, and co-morbidities associated with mortality described will be of use in the development of rational guidelines

  18. Ex vivo piperaquine resistance developed rapidly in Plasmodium falciparum isolates in northern Cambodia compared to Thailand

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    Suwanna Chaorattanakawee

    2016-10-01

    Full Text Available Abstract Background The recent dramatic decline in dihydroartemisinin-piperaquine (DHA-PPQ efficacy in northwestern Cambodia has raised concerns about the rapid spread of piperaquine resistance just as DHA-PPQ is being introduced as first-line therapy in neighbouring countries. Methods Ex vivo parasite susceptibilities were tracked to determine the rate of progression of DHA, PPQ and mefloquine (MQ resistance from sentinel sites on the Thai–Cambodian and Thai–Myanmar borders from 2010 to 2015. Immediate ex vivo (IEV histidine-rich protein 2 (HRP-2 assays were used on fresh patient Plasmodium falciparum isolates to determine drug susceptibility profiles. Results IEV HRP-2 assays detected the precipitous emergence of PPQ resistance in Cambodia beginning in 2013 when 40 % of isolates had an IC90 greater than the upper limit of prior years, and this rate doubled to 80 % by 2015. In contrast, Thai–Myanmar isolates from 2013 to 14 remained PPQ-sensitive, while northeastern Thai isolates appeared to have an intermediate resistance profile. The opposite trend was observed for MQ where Cambodian isolates appeared to have a modest increase in overall sensitivity during the same period, with IC50 declining to median levels comparable to those found in Thailand. A significant association between increased PPQ IC50 and IC90 among Cambodian isolates with DHA-PPQ treatment failure was observed. Nearly all Cambodian and Thai isolates were deemed artemisinin resistant with a >1 % survival rate for DHA in the ring-stage assay (RSA, though there was no correlation among isolates to indicate cross-resistance between PPQ and artemisinins. Conclusions Clinical DHA-PPQ failures appear to be associated with declines in the long-acting partner drug PPQ, though sensitivity appears to remain largely intact for now in western Thailand. Rapid progression of PPQ resistance associated with DHA-PPQ treatment failures in northern Cambodia limits drugs of choice in

  19. Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia.

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    Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Tith, Khimuy; Brody, Carinne

    2015-07-31

    To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia. Cross-sectional study. Phnom Penh and Siem Reap, Cambodia. This study included 556 FEWs aged 18-47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire. History of induced abortion during the time working as a FEW. Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar (AOR=1.75, 95% CI 1.10 to 2.78), to have worked longer as a FEW (AOR=1.42, 95% CI 1.06 to 1.43), to have had a greater number of sexual partners in the past 12 months (AOR=1.86, 95% CI 1.02 to 1.54), to be currently using a contraceptive method (AOR=1.52, 95% CI 1.01 to 2.29), to be able to find condoms when they needed them (AOR=2.03, 95% CI 1.09 to 3.82), and to report inconsistent condom use with non-commercial partners in the past 3 months (AOR=1.62, 95% CI 1.06 to 3.44). This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  20. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia.

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    Amy Weissman

    Full Text Available Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia.Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ≥18 years, identified as male at birth and self-identified/expressed as a different gender, and reported having sex with at least one male partner in past year. From six major urban centers of Cambodia, 891 transgender individuals were recruited.The majority of the 891 participants self-identified as third gender or female (94.5%, were young (median age 23, IQR [20-27], had secondary education or higher (80.5%, not married (89.7%, and employed (90.2%. The majority had first sex before 18 years (66.8%, with a male (79.9%, 37.9% having been paid or paying for this first sex. The rate of HIV positivity among participants was found to be 4.15%. Consistent condom use with male and female partners was low with all partner types, but particularly low with male partners when paying for sex (20.3%. The majority of participants reported having experienced discrimination in their lifetime (54.8% and 30.3% had been assaulted. Multivariate analysis revealed that older age (adjusted OR = 14.73 [4.20, 51.67] for age 35-44 and adjusted OR = 7.63 [2.55, 22.81] for age 30-34, only having a primary school education or no schooling at all (adjusted OR = 2.62 [1.18, 5.80], being a resident of Siem Reap (adjusted OR = 7.44 [2.37, 23.29], receiving payment at first sex (adjusted OR = 2.26 [1.00, 5.11], having sex during/after using drugs (adjusted OR = 2.90 [1.09, 7.73], inconsistent condom use during last anal sex (adjusted OR = 3.84 [1.58, 9.33], and reporting low self-esteem (adjusted OR = 3.25 [1.35, 7.85] were

  1. Achieving universal access and moving towards elimination of new HIV infections in Cambodia

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    Vun, Mean Chhi; Fujita, Masami; Rathavy, Tung; Eang, Mao Tang; Sopheap, Seng; Sovannarith, Samreth; Chhorvann, Chhea; Vanthy, Ly; Sopheap, Oum; Welle, Emily; Ferradini, Laurent; Sedtha, Chin; Bunna, Sok; Verbruggen, Robert

    2014-01-01

    Introduction In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia’s response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections. Methods A literature review of published and unpublished documents, including programme data and presentations, was conducted. Results and discussion Cambodia classifies its response to one of the most serious HIV epidemics in Asia into three phases. In Phase I (1991–2000), when adult HIV prevalence peaked at 1.7% and incidence exceeded 20,000 cases, a nationwide HIV prevention programme targeted brothel-based sex work. Voluntary confidential counselling and testing and home-based care were introduced, and peer support groups of people living with HIV emerged. Phase II (2001–2011) observed a steady decline in adult prevalence to 0.8% and incidence to 1600 cases by 2011, and was characterized by: expanding antiretroviral treatment (coverage reaching more than 80%) and continuum of care; linking with tuberculosis and maternal and child health services; accelerated prevention among key populations, including entertainment establishment-based sex workers, men having sex with men, transgender persons, and people who inject drugs; engagement of health workers to deliver quality services; and strengthening health service delivery systems. The third phase (2012–2020) aims to attain zero new infections by 2020 through: sharpening responses to key populations at higher risk; maximizing access to community and facility-based testing and retention in prevention and care; and accelerating the transition from vertical approaches to linked/integrated approaches. Conclusions Cambodia has tailored its prevention strategy to its own epidemic, established

  2. Pfmdr1 copy number and arteminisin derivatives combination therapy failure in falciparum malaria in Cambodia

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    Wongsrichanalai Chansuda

    2009-01-01

    Full Text Available Abstract Background The combination of artesunate and mefloquine was introduced as the national first-line treatment for Plasmodium falciparum malaria in Cambodia in 2000. However, recent clinical trials performed at the Thai-Cambodian border have pointed to the declining efficacy of both artesunate-mefloquine and artemether-lumefantrine. Since pfmdr1 modulates susceptibility to mefloquine and artemisinin derivatives, the aim of this study was to assess the link between pfmdr1 copy number, in vitro susceptibility to individual drugs and treatment failure to combination therapy. Methods Blood samples were collected from P. falciparum-infected patients enrolled in two in vivo efficacy studies in north-western Cambodia: 135 patients were treated with artemether-lumefantrine (AL group in Sampovloun in 2002 and 2003, and 140 patients with artesunate-mefloquine (AM group in Sampovloun and Veal Veng in 2003 and 2004. At enrollment, the in vitro IC50 was tested and the strains were genotyped for pfmdr1 copy number by real-time PCR. Results The pfmdr1 copy number was analysed for 115 isolates in the AM group, and for 109 isolates in the AL group. Parasites with increased pfmdr1 copy number had significantly reduced in vitro susceptibility to mefloquine, lumefantrine and artesunate. There was no association between pfmdr1 polymorphisms and in vitro susceptibilities. In the patients treated with AM, the mean pfmdr1copy number was lower in subjects with adequate clinical and parasitological response compared to those who experienced late treatment failure (n = 112, p p = 0.364. The presence of three or more copies of pfmdr1 were associated with recrudescence in artesunate-mefloquine treated patients (hazard ratio (HR = 7.80 [95%CI: 2.09–29.10], N = 115, p = 0.002 but not with recrudescence in artemether-lumefantrine treated patients (HR = 1.03 [95%CI: 0.24–4.44], N = 109, p = 0.969. Conclusion This study shows that pfmdr1 copy number is a molecular

  3. Epidemiological and Virological Characteristics of Influenza Viruses Circulating in Cambodia from 2009 to 2011

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    Ly, Sovann; Heng, Seng; Vong, Sirenda; Kitsutani, Paul; Ieng, Vannra; Tarantola, Arnaud; Ly, Sowath; Sar, Borann; Chea, Nora; Sokhal, Buth; Barr, Ian; Kelso, Anne; Horwood, Paul F.; Timmermans, Ans; Hurt, Aeron; Lon, Chanthap; Saunders, David; Ung, Sam An; Asgari, Nima; Roces, Maria Concepcion; Touch, Sok; Komadina, Naomi; Buchy, Philippe

    2014-01-01

    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

  4. Tuberculosis active case finding in Cambodia: a pragmatic, cost-effectiveness comparison of three implementation models.

    Science.gov (United States)

    James, Richard; Khim, Keovathanak; Boudarene, Lydia; Yoong, Joanne; Phalla, Chea; Saint, Saly; Koeut, Pichenda; Mao, Tan Eang; Coker, Richard; Khan, Mishal Sameer

    2017-08-22

    Globally, almost 40% of tuberculosis (TB) patients remain undiagnosed, and those that are diagnosed often experience prolonged delays before initiating correct treatment, leading to ongoing transmission. While there is a push for active case finding (ACF) to improve early detection and treatment of TB, there is extremely limited evidence about the relative cost-effectiveness of different ACF implementation models. Cambodia presents a unique opportunity for addressing this gap in evidence as ACF has been implemented using different models, but no comparisons have been conducted. The objective of our study is to contribute to knowledge and methodology on comparing cost-effectiveness of alternative ACF implementation models from the health service perspective, using programmatic data, in order to inform national policy and practice. We retrospectively compared three distinct ACF implementation models - door to door symptom screening in urban slums, checking contacts of TB patients, and door to door symptom screening focusing on rural populations aged above 55 - in terms of the number of new bacteriologically-positive pulmonary TB cases diagnosed and the cost of implementation assuming activities are conducted by the national TB program of Cambodia. We calculated the cost per additional case detected using the alternative ACF models. Our analysis, which is the first of its kind for TB, revealed that the ACF model based on door to door screening in poor urban areas of Phnom Penh was the most cost-effective (249 USD per case detected, 737 cases diagnosed), followed by the model based on testing contacts of TB patients (308 USD per case detected, 807 cases diagnosed), and symptomatic screening of older rural populations (316 USD per case detected, 397 cases diagnosed). Our study provides new evidence on the relative effectiveness and economics of three implementation models for enhanced TB case finding, in line with calls for data from 'routine conditions' to be included

  5. A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia.

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    Chheng, Kheng; Carter, Michael J; Emary, Kate; Chanpheaktra, Ngoun; Moore, Catrin E; Stoesser, Nicole; Putchhat, Hor; Sona, Soeng; Reaksmey, Sin; Kitsutani, Paul; Sar, Borann; van Doorn, H Rogier; Uyen, Nguyen Hanh; Van Tan, Le; Paris, Daniel H; Paris, Daniel; Blacksell, Stuart D; Amornchai, Premjit; Wuthiekanun, Vanaporn; Parry, Christopher M; Day, Nicholas P J; Kumar, Varun

    2013-01-01

    Febrile illnesses are pre-eminent contributors to morbidity and mortality among children in South-East Asia but the causes are poorly understood. We determined the causes of fever in children hospitalised in Siem Reap province, Cambodia. A one-year prospective study of febrile children admitted to Angkor Hospital for Children, Siem Reap. Demographic, clinical, laboratory and outcome data were comprehensively analysed. Between October 12(th) 2009 and October 12(th) 2010 there were 1225 episodes of febrile illness in 1180 children. Median (IQR) age was 2.0 (0.8-6.4) years, with 850 (69%) episodes in children <5 years. Common microbiological diagnoses were dengue virus (16.2%), scrub typhus (7.8%), and Japanese encephalitis virus (5.8%). 76 (6.3%) episodes had culture-proven bloodstream infection, including Salmonella enterica serovar Typhi (22 isolates, 1.8%), Streptococcus pneumoniae (13, 1.1%), Escherichia coli (8, 0.7%), Haemophilus influenzae (7, 0.6%), Staphylococcus aureus (6, 0.5%) and Burkholderia pseudomallei (6, 0.5%). There were 69 deaths (5.6%), including those due to clinically diagnosed pneumonia (19), dengue virus (5), and melioidosis (4). 10 of 69 (14.5%) deaths were associated with culture-proven bloodstream infection in logistic regression analyses (odds ratio for mortality 3.4, 95% CI 1.6-6.9). Antimicrobial resistance was prevalent, particularly in S. enterica Typhi, (where 90% of isolates were resistant to ciprofloxacin, and 86% were multi-drug resistant). Comorbid undernutrition was present in 44% of episodes and a major risk factor for acute mortality (OR 2.1, 95% CI 1.1-4.2), as were HIV infection and cardiac disease. We identified a microbiological cause of fever in almost 50% of episodes in this large study of community-acquired febrile illness in hospitalized children in Cambodia. The range of pathogens, antimicrobial susceptibility, and co-morbidities associated with mortality described will be of use in the development of rational

  6. Dengue in Thailand and Cambodia: An Assessment of the Degree of Underrecognized Disease Burden Based on Reported Cases

    Science.gov (United States)

    Wichmann, Ole; Yoon, In-Kyu; Vong, Sirenda; Limkittikul, Kriengsak; Gibbons, Robert V.; Mammen, Mammen P.; Ly, Sowath; Buchy, Philippe; Sirivichayakul, Chukiat; Buathong, Rome; Huy, Rekol; Letson, G. William; Sabchareon, Arunee

    2011-01-01

    Background Disease incidence data are needed to guide decision-making for public health interventions. Although dengue is a reportable disease in Thailand and Cambodia, the degree that reported incidence underrecognizes true disease burden is unknown. We utilized dengue incidence calculated from laboratory-confirmed outpatient and inpatient cases in prospective cohort studies to estimate the magnitude of dengue underrecognition and to establish more accurate disease burden estimates for these countries. Methods and Findings Cohort studies were conducted among children aged dengue field site consortium over at least 2 dengue seasons. Age-group specific multiplication factors (MFs) were computed by comparing data from three cohort studies to national surveillance data in the same province and year. In Thailand, 14,627 person-years of prospective cohort data were obtained in two provinces and 14,493 person-years from one province in Cambodia. Average annual incidence of laboratory-confirmed dengue was 23/1,000 and 25/1,000 in Thailand, and 41/1,000 in Cambodia. Calculated MFs in these provinces varied by age-group and year (range 0.4–29). Average age-group specific MFs were then applied to country-level reporting data and indicated that in Thailand a median 229,886 (range 210,612–331,236) dengue cases occurred annually during 2003–2007 and a median 111,178 (range 80,452–357,135) cases occurred in Cambodia in children dengue cases was 8.7 and 2.6-fold in Thailand, and 9.1 and 1.4-fold in Cambodia, respectively. During the high-incidence year 2007, >95,000 children in Thailand and >58,000 children in Cambodia were estimated to be hospitalized due to dengue. Conclusion Calculating MFs by comparing prospective cohort study data to locally-reported national surveillance data is one approach to more accurately assess disease burden. These data indicate that although dengue is regularly reported in many countries, national surveillance data significantly

  7. Key Factors Affecting Construction Safety Performance in Developing Countries: Evidence from Cambodia

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    Serdar Durdyev

    2017-12-01

    Full Text Available Although proper safety management in construction is of utmost importance; anecdotal evidence suggests that safety is not adequately considered in many developing countries. This paper considers the key variables affecting construction safety performance in Cambodia. Using an empirical questionnaire survey targeting local construction professionals, respondents were invited to rate the level of importance of 30 variables identified from the seminal literature. The data set was subjected to factor analysis. Correlations between the variables show that five key factors underlie the challenges facing the local industry; management and organisation, resources, site management, cosmetic and workforce. It is found that the forefront construction professionals (top management and government authorities should take more responsibilities for further improvements in safety performance on project sites. Findings and recommendations of this study may be useful to construction professional who are seeking ways to improve safety records in developing countries.

  8. Prevalence of blindness and cataract surgical outcomes in Takeo Province, Cambodia.

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    Mörchen, Manfred; Langdon, Toby; Ormsby, Gail M; Meng, Ngy; Seiha, Do; Piseth, Kong; Keeffe, Jill E

    2015-01-01

    To estimate the prevalence of blindness and cataract surgical outcomes in persons 50 years or older above in Takeo Province, Cambodia. A population based survey. A total of 93 villages were selected through probability proportionate to size using the Rapid Assessment of Avoidable Blindness methodology. Households from 93 villages were selected using compact segment sampling. Visual acuity (VA) of 4650 people 50 years or older was tested and lens status and cause of visual impairment were assessed. The response rate was 96.2%. The age- and sex-adjusted prevalence of bilateral blindness [presenting visual acuity (PVA) blind in Takeo Province. The age- and sex-adjusted prevalence of low vision (PVA blind was 64.7% (female 59.5%, male 78.1%). Cataract surgical outcome was poor (best-corrected visual acuity blindness. A repeated survey using the same methodology after 8-12 years might be helpful in proving genuine change over time.

  9. Characterizing HIV epidemiology in stable couples in Cambodia, the Dominican Republic, Haiti, and India.

    Science.gov (United States)

    Chemaitelly, H; Abu-Raddad, L J

    2016-01-01

    Using a set of statistical methods and HIV mathematical models applied on nationally representative Demographic and Health Survey data, we characterized HIV serodiscordancy patterns and HIV transmission dynamics in stable couples (SCs) in four countries: Cambodia, the Dominican Republic, Haiti, and India. The majority of SCs affected by HIV were serodiscordant, and about a third of HIV-infected persons had uninfected partners. Overall, nearly two-thirds of HIV infections occurred in individuals in SCs, but only about half of these infections were due to transmissions within serodiscordant couples. The majority of HIV incidence in the population occurred through extra-partner encounters in SCs. There is similarity in HIV epidemiology in SCs between these countries and countries in sub-Saharan Africa, despite the difference in scale of epidemics. It appears that HIV epidemiology in SCs may share similar patterns globally, possibly because it is a natural 'spillover' effect of HIV dynamics in high-risk populations.

  10. SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia.

    Science.gov (United States)

    Nguyen, Thuong T; McKinney, Barbara; Pierson, Antoine; Luong, Khue N; Hoang, Quynh T; Meharwal, Sandeep; Carvalho, Humberto M; Nguyen, Cuong Q; Nguyen, Kim T; Bond, Kyle B

    2014-01-01

    The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. However, the paper-based format of the checklist makes administration cumbersome and limits timely analysis and communication of results. In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors' feedback about usability. The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries.

  11. Becoming and being academic women in Cambodia: Cultural and other understandings

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    TW Maxwell

    2015-12-01

    Full Text Available Cambodia’s higher education is under development. This is the first study of the role of women teaching in a university in Cambodia. There has been many studies of academic women in western countries and these guided the 16 interviews in Khmer that were carried out by young female researchers, translated by them and then analysed with the assistance of NVivo. Becoming an academic for many Cambodian women meant support from their parents and others close to them. Receipt of an international scholarship may have been critical. Perhaps the most important issue for these academic women was the need to balance demands on their time. Teaching hours could be negotiated, potentially at least, but only where the student numbers warranted it. An affirmative action approach appears to have developed at one of the two universities. Areas for future research are identified.

  12. Lost in translation? How project actors shape REDD+ policy and outcomes in Cambodia

    DEFF Research Database (Denmark)

    Pasgaard, Maya

    2015-01-01

    Forest protection policies to Reduce Emissions from Deforestation and forest Degradation (REDD+) are currently being implemented by international donors, governments and conservation agencies across the developing world aiming for reduction of greenhouse gases while ensuring fair distribution...... of benefits. This paper draws on a case study in northern Cambodia to analyse how conservation practitioners and the local forest management committees engaged in implementing REDD+ actively translate and influence the policy and its implementation in accordance with their respective interests through...... particular communication strategies. When assessing project progress and outcomes, the conservation practitioners involved in implementing projects show an interest in emphasising positive project assessments by downplaying potential project complications, and by primarily communicating with pro...

  13. Financial protection of patients through compensation of providers: the impact of Health Equity Funds in Cambodia.

    Science.gov (United States)

    Flores, Gabriela; Ir, Por; Men, Chean R; O'Donnell, Owen; van Doorslaer, Eddy

    2013-12-01

    Public providers have no financial incentive to respect their legal obligation to exempt the poor from user fees. Health Equity Funds (HEFs) aim to make exemptions effective by giving NGOs responsibility for assessing eligibility and compensating providers for lost revenue. We use the geographic spread of HEFs over time in Cambodia to identify their impact on out-of-pocket (OOP) payments. Among households with some OOP payment, HEFs reduce the amount paid by 35%, on average. The effect is larger for households that are poorer and mainly use public health care. Reimbursement of providers through a government operated scheme also reduces household OOP payments but the effect is not as well targeted on the poor. Both compensation models raise household non-medical consumption but have no impact on health-related debt. HEFs reduce the probability of primarily seeking care in the private sector. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Moringa oleifera from Cambodia Ameliorates Oxidative Stress, Hyperglycemia, and Kidney Dysfunction in Type 2 Diabetic Mice.

    Science.gov (United States)

    Tang, Yujiao; Choi, Eun-Ju; Han, Weon Cheol; Oh, Mirae; Kim, Jin; Hwang, Ji-Young; Park, Pyo-Jam; Moon, Sang-Ho; Kim, Yon-Suk; Kim, Eun-Kyung

    2017-05-01

    Recent reports have shown the antidiabetic effect of Moringa oleifera from various parts of the world. However, M. oleifera from Cambodia has never determined. Therefore, the aim of this study was to assess the antidiabetic effect of M. oleifera extract from Cambodia. The leaf ethanolic extract contained flavonoids (31.90 mg/mL), polyphenols (53.03 mg/mL), lycopene (0.042 mg/mL), and ß-carotene (0.170 mg/mL), and possessed 2,2-diphenyl-1-picrylhydrazyl, hydrogen peroxide, and hydroxyl radical scavenging activities of 92.40, 99.25, and 83.57 TE/μM at 1 mg/mL, respectively. Db/db mice were orally administered the leaf extract (150 mg/kg/day) for 5 weeks. M. oleifera treatment significantly ameliorated the altered fasting plasma glucose (from 483 to 312 mg/dL), triglyceride (from 42.12 to 23.00 mg/dL), and low-density lipoprotein cholesterol (from 107.21 to 64.25 mg/dL) compared to control group, and increased the insulin levels from 946 ± 92 to 1678 ± 268 pg/mL. The histopathological damage and expression levels of tumor necrosis factor-alpha, interleukin (IL)-1β, IL-6, cyclooxygenase-2, and inducible nitric oxide synthase in renal tissue decreased. These results indicate the potential antidiabetic benefits of M. oleifera ethanolic leaf extract.

  15. Nutritional and Micronutrient Status of Female Workers in a Garment Factory in Cambodia.

    Science.gov (United States)

    Makurat, Jan; Friedrich, Hanna; Kuong, Khov; Wieringa, Frank T; Chamnan, Chhoun; Krawinkel, Michael B

    2016-11-02

    Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant) at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined). Bivariate correlations were used to assess associations. Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative) and serum retinol-binding protein (positive) concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.

  16. The multi-step process of building TB/HIV collaboration in Cambodia

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    Eang Mao

    2012-10-01

    Full Text Available Abstract Tuberculosis and HIV/AIDS have synergistic health impacts in terms of disease development and progression. Therefore, collaborative TB and HIV/AIDS activities are a logical health systems response. However, the establishment of these activities presents a challenge for countries that have strong vertical disease programs that differ in their implementation philosophies. Here, we review the process by which TB/HIV collaboration was established in Cambodia. A cycle of overlapping and mutually reinforcing initiatives – local research; piloted implementation with multiple options; and several rounds of policy formulation guided by a cross-functional Technical Working Group – was used to drive nationwide introduction of a full set of TB/HIV collaborative activities. Senior Ministry of Health officials and partner organizations brought early attention to TB/HIV. Both national programs implemented initial screening and testing interventions, even in the absence of a detailed, overarching framework. The use of multiple options for HIV testing identified which programmatic options worked best, and early implementation and pilots determined what unanswered questions required further research. Local conduct of this research – on co-treatment timing and TB symptom screening – speeded adoption of the results into policy guidance, and clarified the relative roles of the two programs. Roll-out is continuing, and results for a variety of key indicators, including screening PLHIV for TB, and testing TB patients for HIV, are at 70-80% and climbing. This experience in Cambodia illustrates the influence of health research on policy, and demonstrates that clear policy guidance, the pursuit of incremental advances, and the use of different approaches to generate evidence can overcome structural barriers to change and bring direct benefits to patients.

  17. Artemisinin resistance without pfkelch13 mutations in Plasmodium falciparum isolates from Cambodia.

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    Mukherjee, Angana; Bopp, Selina; Magistrado, Pamela; Wong, Wesley; Daniels, Rachel; Demas, Allison; Schaffner, Stephen; Amaratunga, Chanaki; Lim, Pharath; Dhorda, Mehul; Miotto, Olivo; Woodrow, Charles; Ashley, Elizabeth A; Dondorp, Arjen M; White, Nicholas J; Wirth, Dyann; Fairhurst, Rick; Volkman, Sarah K

    2017-05-12

    Artemisinin resistance is associated with delayed parasite clearance half-life in vivo and correlates with ring-stage survival under dihydroartemisinin in vitro. Both phenotypes are associated with mutations in the PF3D7_1343700 pfkelch13 gene. Recent spread of artemisinin resistance and emerging piperaquine resistance in Southeast Asia show that artemisinin combination therapy, such as dihydroartemisinin-piperaquine, are losing clinical effectiveness, prompting investigation of drug resistance mechanisms and development of strategies to surmount emerging anti-malarial resistance. Sixty-eight parasites isolates with in vivo clearance data were obtained from two Tracking Resistance to Artemisinin Collaboration study sites in Cambodia, culture-adapted, and genotyped for pfkelch13 and other mutations including pfmdr1 copy number; and the RSA 0-3h survival rates and response to antimalarial drugs in vitro were measured for 36 of these isolates. Among these 36 parasites one isolate demonstrated increased ring-stage survival for a PfKelch13 mutation (D584V, RSA 0-3h  = 8%), previously associated with slow clearance but not yet tested in vitro. Several parasites exhibited increased ring-stage survival, yet lack pfkelch13 mutations, and one isolate showed evidence for piperaquine resistance. This study of 68 culture-adapted Plasmodium falciparum clinical isolates from Cambodia with known clearance values, associated the D584V PfKelch13 mutation with increased ring-stage survival and identified parasites that lack pfkelch13 mutations yet exhibit increased ring-stage survival. These data suggest mutations other than those found in pfkelch13 may be involved in conferring artemisinin resistance in P. falciparum. Piperaquine resistance was also detected among the same Cambodian samples, consistent with reports of emerging piperaquine resistance in the field. These culture-adapted parasites permit further investigation of mechanisms of both artemisinin and piperaquine

  18. Economic inequality and undernutrition in women: multilevel analysis of individual, household, and community levels in Cambodia.

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    Hong, Rathavuth; Hong, Rathmony

    2007-03-01

    Many people in developing countries are still struggling to emerge from the realm of extreme poverty, where economic improvements tend to benefit a small, affluent group of the population and cause growing inequality in health and nutrition that affects the most vulnerable groups of the population, including women and children. To examine how household and community economic inequality affects nutritional status in women using information on 6,922 nonpregnant women aged 15 to 49 years included in the 2000 Cambodia Demographic and Health Survey. Nutritional status is defined with the use of the body-mass index (BMI). BMI less than 18.5 kg/m2 is defined as undernourishment. The household wealth index was calculated from household ownership of durable assets and household characteristics. Community wealth is an average household wealth index at the community level. Household and community economic inequalities were measured by dividing the wealth index into quintiles. The effects of household and community economic inequality were estimated by multilevel analysis. Independently of community economic status and other risk factors, women in the poorest 20% of households are more likely to be undernourished than women in the richest 20% of households (RR = 1.63; p = .008). The results also show variation among communities in the nutritional status of women. Age, occupation, and access to safe sources of drinking water are significantly associated with women's nutritional status. Improving household income and creating employment opportunities for women, in particular poor women, may be a key to improving the nutritional status of women in Cambodia.

  19. Development of a participatory tool for the evaluation of Village Animal Health Workers in Cambodia.

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    Calba, Clementine; Ponsich, Aurelia; Nam, Sophorn; Collineau, Lucie; Min, Sophoan; Thonnat, Jerome; Goutard, Flavie Luce

    2014-06-01

    In countries with a lack of primary care systems, health workers are of crucial importance to improving the delivery of health and animal health services at community level. But somehow they are rarely evaluated and usually with a top-down approach. This is the case in Cambodia, where thousands of Village Animal Health Workers (VAHWs) have been trained by the government, and where no standardized evaluation tool is available to accurately assess the situation. Based on methodology developed by the French NGO Agronomes et Vétérinaires Sans Frontières (AVSF) in Madagascar for farmers' association evaluation, we developed our own participatory methods to collect information about the VAHW context and build a criteria grid for their evaluation. In this framework, several participatory approaches were used such as problem trees, semi-structured interviews, pair-wise ranking and focus groups. The grid was built with the help of relevant stakeholders involved in the animal health system in Cambodia in order to (i) identify VAHW functions; (ii) set up criteria and associated questionnaires, and (iii) score the grid with all the stakeholders. The tool was divided into five categories of evaluation criteria: sustainability, treatment, production, vaccination and disease reporting. Our approach looked at local indicators of success developed and used by VAHWs themselves, which should lead to better acceptability of evaluation. This method gave priority to dialog aiming to engage decision makers and other stakeholders in a mutual learning process and could be applied in other countries to develop trust between health workers and official service representatives as well as to foster corrective action after evaluation. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  20. The Cultural Epigenesis of Gender-Based Violence in Cambodia: Local and Buddhist Perspectives.

    Science.gov (United States)

    Eisenbruch, Maurice

    2018-06-01

    Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. The study aims to provide a comprehensive understanding of the ways in which Cambodians see its causes and effects and to identify and analyse the cultural forces that underpin and shape its landscape. An ethnographic study was carried out with 102 perpetrators and survivors of emotional, physical and sexual violence against women and 228 key informants from the Buddhist and healing sectors. Their views and experiences of it were recorded-the popular idioms expressed and the symptoms of distress experienced by survivors and perpetrators. From these results, the eight cultural forces, or cultural attractors, that are seen to propel a person to violence were identified. Violence stemmed from blighted endowment, or 'bad building' (sɑmnaaŋ mɨn lʔɑɑ) determined by deeds in a previous life (kam). Children with a vicious character (kmeeŋ kaac or doṣa-carita) might grow to be abusers, and particular birthmarks on boys were thought to be portents. Krʊəh, or mishap, especially when a female's horoscope predicted a zodiac house on the descent (riesəy), explained vulnerability to violence and its timing. Astrological incompatibility (kuu kam) was a risk factor. Lust, anger and ignorance, the 'Triple Poison', fuelled it. 'Entering the road to ruin' (apāyamuk), including alcohol abuse, womanising and gambling, triggered it. Confusion and loss of judgement (mohā) led to moral blindness (mo baŋ). These were the eight cultural attractors that shaped the landscape of violence against women. The cultural epigenesis of violence against women in Cambodia is an insight which can be used to build culturally responsive interventions and strengthen the primary prevention of violence against women. An understanding of the epigenesis of violence could strengthen the primary prevention of violence against women.

  1. Betel quid use in relation to infectious disease outcomes in Cambodia.

    Science.gov (United States)

    Singh, Pramil N; Natto, Zuhair; Yel, Daravuth; Job, Jayakaran; Knutsen, Synnove

    2012-04-01

    The habitual chewing of betel quid (areca nut, betel leaf, tobacco) is estimated to occur among 600 million persons in Asia and the Asia-Pacific Region. Emerging data from rural Asia indicate that the betel quid is part of traditional medicine practices that promote its use for a wide range of ailments, including infectious disease. In the present study, we examined the association between betel quid, traditional medicine, and infectious disease outcomes. For the purpose of a nationwide, interviewer-administered, cross-sectional survey of tobacco use (including betel quid), we conducted a stratified three-stage cluster sampling of 13 988 adults aged 18 years and older from all provinces of Cambodia. We found an association between the intensity of betel quid use and HIV/AIDS (odds ratio (OR) 2.06, 95% CI 1.09-3.89), dengue fever (OR 2.40, 95% CI 1.55-2.72), tuberculosis (OR 1.50, 95% CI 0.96-2.36), and typhoid (OR 1.48, 95% CI 0.95-2.30). These associations were even stronger in women - the primary users of betel quid in Cambodia. Multivariable analyses that controlled for age, gender, income, education, urban versus rural dwelling, receiving care from traditional medicine practitioners, and cigarette smoking did not alter the betel quid-infectious disease association. Our findings raise the possibility of a role of betel quid use in the transmission of infectious disease through pathways such as immunosuppression, oral route of entry for a pathogen (i.e., through injury to the oral mucosa), and contamination (i.e., fecal-oral) of the betel quid ingredients. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  2. Geochemistry of aquifer sediments and arsenic-rich groundwaters from Kandal Province, Cambodia

    International Nuclear Information System (INIS)

    Rowland, Helen A.L.; Gault, Andrew G.; Lythgoe, Paul; Polya, David A.

    2008-01-01

    Elevated As is well known to be present in aquifers utilised for drinking water and irrigation in West Bengal and Bangladesh. This problem has also more recently been discovered in other parts of Asia, including Vietnam, Cambodia, Inner Mongolia and the Middle Ganges Plain. Analysis of groundwaters in Kandal Province of Cambodia found waters with comparable geochemistry to the As-rich groundwaters of the West Bengali Delta. Similarities included high but heterogeneous As distributions, predominantly in the form As(III), high Fe, moderate to high HCO 3 - , circumneutral pH, low SO 4 2- and geochemical components indicative of reducing conditions. Good positive correlations between As, Fe, HCO 3 - and NH 4 + , and dissolved organic C is consistent with As release predominantly via microbially mediated reductive dissolution of As bearing Fe(III) oxides. Further evidence for such a process is found from correlations between As, Fe and organic matter from analysis of aquifer sediments, by the presence of goethite in the finer fractions and from the association of As with amorphous, poorly crystalline and well crystallised hydrous Fe oxides. The presence of several high As, but low Fe, wells implies that microbes could have a more direct role in mediating As release via the direct utilisation of Fe(III) or As(V) as electron acceptors. The presence of elevated As in waters with short aquifer residence times (as indicated by their geochemical signature) highlights the possible vulnerability of these aquifers to the influx of surface derived waters, providing an additional source of labile organic C that could exacerbate As release by stimulating microbial activity

  3. Optimising strategies for Plasmodium falciparum malaria elimination in Cambodia: primaquine, mass drug administration and artemisinin resistance.

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    Richard J Maude

    Full Text Available Malaria elimination requires a variety of approaches individually optimized for different transmission settings. A recent field study in an area of low seasonal transmission in South West Cambodia demonstrated dramatic reductions in malaria parasite prevalence following both mass drug administration (MDA and high treatment coverage of symptomatic patients with artemisinin-piperaquine plus primaquine. This study employed multiple combined strategies and it was unclear what contribution each made to the reductions in malaria.A mathematical model fitted to the trial results was used to assess the effects of the various components of these interventions, design optimal elimination strategies, and explore their interactions with artemisinin resistance, which has recently been discovered in Western Cambodia. The modelling indicated that most of the initial reduction of P. falciparum malaria resulted from MDA with artemisinin-piperaquine. The subsequent continued decline and near elimination resulted mainly from high coverage with artemisinin-piperaquine treatment. Both these strategies were more effective with the addition of primaquine. MDA with artemisinin combination therapy (ACT increased the proportion of artemisinin resistant infections, although much less than treatment of symptomatic cases with ACT, and this increase was slowed by adding primaquine. Artemisinin resistance reduced the effectiveness of interventions using ACT when the prevalence of resistance was very high. The main results were robust to assumptions about primaquine action, and immunity.The key messages of these modelling results for policy makers were: high coverage with ACT treatment can produce a long-term reduction in malaria whereas the impact of MDA is generally only short-term; primaquine enhances the effect of ACT in eliminating malaria and reduces the increase in proportion of artemisinin resistant infections; parasite prevalence is a better surveillance measure for

  4. Tuberculosis case-finding in Cambodia: analysis of case notification data, 2000 to 2013

    Science.gov (United States)

    Furphy, Valérie Burrus; Kobayashi, Miwako; Nishikiori, Nobuyuki; Eang, Mao Tan; Yadav, Rajendra-Prasad

    2015-01-01

    The routine tuberculosis (TB) surveillance system in Cambodia has been strengthened under the National TB Programme (NTP). This paper provides an overview of the TB surveillance data for Cambodia at the national level for the period 2000 to 2013 and at the subnational level for 2013. The proportion of the total population that were screened for TB rose from 0.4% in 2001 to 1.1% in 2013, while the smear-positivity rate decreased from 28.9% to 8.1% in the same period. The total number of notified TB cases increased steadily from 2000; this has stabilized in recent years with 39 055 cases notified in 2013. The proportion of all TB cases that were smear-positive decreased from 78% in 2000 to 36% in 2013. Case notification rates (CNRs) for all forms of TB and new smear-positive TB in 2013 were 261 and 94 per 100 000 population, respectively. Higher CNRs were found in the north-western and south-eastern parts of the country and were higher for males especially in older age groups. The increase in TB screening, decline in the smear-positive rate and decline in notified smear-positive TB cases likely reflect a long-term positive impact of the NTP. A negative correlation between the proportion of the population screened and the smear-positivity rate at the subnational level helped identify where to find undiagnosed cases. Subnational differences in case notification of the elderly and in children provide more specific targets for case-finding and further encourage strategic resource allocation. PMID:25960919

  5. Survey of smallholder beef cattle production systems in different agro-ecological zones of Cambodia.

    Science.gov (United States)

    Samkol, Pok; Sath, Keo; Patel, Mikaela; Windsor, Peter Andrew; Holtenius, Kjell

    2015-10-01

    A survey was conducted to better understand the contribution of farm productivity to rural household income and identify differences in production systems, feeding practices and development constraints to smallholder beef cattle producers in the four agro-ecological zones (AEZs) of Cambodia. A semi-structured questionnaire was used to interview 360 households in the four AEZs: I, the Great Lake Floodplain; II, the Mekong Floodplain; III, the Coastal and IV, the Plateau/Mountainous. In addition, samples of common nutritional resources used for cattle feed were collected for nutrient composition analysis, plus cattle were scored for body condition. Rice farming and cattle production were the most common sources of income in all AEZs. The average cattle herd size was 3.7 (SD = 2.4), but the majority of households raised 1-3 animals. The most common cattle management system was grazing with supplementation, mainly with rice straw and 'cut-and-carry' natural grasses fed during the wet season in all AEZs. The body condition score of all cattle types was 3.2 (SD = 0.8), except for cows in lactation that were 1.8. Major constraints to cattle production in AEZs I, II and III were lack of quality feed resources, capital for cattle production and concerns on breed quality, whereas in AEZ IV, diseases were identified as the main constraint. This survey confirms the importance of cattle to smallholders in the four AEZs. Interventions including farmer education to improve husbandry skills, increase the utilisation of forages and crop residues and address disease issues are necessary to enhance cattle production and rural livelihoods in Cambodia.

  6. Artyfechinostomum malayanum: Metacercariae Encysted in Pila sp. Snails Purchased from Phnom Penh, Cambodia.

    Science.gov (United States)

    Sohn, Woon-Mok; Yong, Tai-Soon; Eom, Keeseon S; Sinuon, Muth; Jeoung, Hoo-Gn; Chai, Jong-Yil

    2017-06-01

    The metacercariae of Artyfechinostomum malayanum (Leiper, 1911) Mendheim, 1943 were discovered in Pila sp. snails purchased from a market in Phnom Penh, Cambodia. They were isolated from the snails using the artificial digestion technique and were orally fed to 2 hamsters, 1 rat, and 2 mice to obtain the adult flukes. The metacercariae were round, 145-165 μm in diameter, having a cyst wall of 6-10 μm in thickness, a head collar and collar spines, and characteristic features of excretory granules. Adult flukes were recovered in the small intestines of the animals at days 14 and 32 post infection and were morphologically observed using a light microscope and a scanning electron microscope. They were plump or elongated, ventrally curved, 6.0-8.1 × 1.6-2.0 mm in size, and characterized by the head collar bearing 43 collar spines, including 5 end group ones on each side, a long cirrus sac extending beyond the posterior margin of the ventral sucker, a submedian ovary, and 2 deeply lobed testes. Eggs in uteri were operculate, ovoid to ellipsoid, and 120-135 × 68-75 μm in size. In scanning electron microscopy, the head collar was prominent with collar spines looking like horns. Scale-like tegumental spines were densely distributed on the ventral surface between the head collar and ventral sucker. Sensory papillae were distributed mainly on the tegument around suckers. By this study, it has been first confirmed that the life cycle of A. malayanum exists in Cambodia.

  7. Removing arsenic from groundwater in Cambodia using high performance iron adsorbent.

    Science.gov (United States)

    Kang, Y; Takeda, R; Nada, A; Thavarith, L; Tang, S; Nuki, K; Sakurai, K

    2014-09-01

    In Cambodia, groundwater has been contaminated with arsenic, and purification of the water is an urgent issue. From 2010 to 2012, an international collaborative project between Japan and Cambodia for developing arsenic-removing technology from well water was conducted and supported by the foundation of New Energy and Industrial Technology Development Organization, Japan. Quality of well water was surveyed in Kandal, Prey Veng, and Kampong Cham Provinces, and a monitoring trial of the arsenic removal equipment using our patented amorphous iron (hydr)oxide adsorbent was performed. Of the 37 wells surveyed, arsenic concentration of 24 exceeded the Cambodian guideline value (50 μg L(-1)), and those of 27 exceeded the WHO guideline for drinking water (10 μg L(-1)). Levels of arsenic were extremely high in some wells (>1,000-6,000 μg L(-1)), suggesting that arsenic pollution of groundwater is serious in these areas. Based on the survey results, 16 arsenic removal equipments were installed in six schools, three temples, two health centers, four private houses, and one commune office. Over 10 months of monitoring, the average arsenic concentrations of the treated water were between 0 and 10 μg L(-1) at four locations, 10-50 μg L(-1) at eight locations, and >50 μg L(-1) at four locations. The arsenic removal rate ranged in 83.1-99.7%, with an average of 93.8%, indicating that the arsenic removal equipment greatly lower the risk of arsenic exposure to the residents. Results of the field trial showed that As concentration of the treated water could be reduced to condition. This is one of the succeeding As removal techniques that could reduce As concentration of water below the WHO guideline value for As in situ.

  8. Comparing two survey methods for estimating maternal and perinatal mortality in rural Cambodia.

    Science.gov (United States)

    Chandy, Hoeuy; Heng, Yang Van; Samol, Ha; Husum, Hans

    2008-03-01

    We need solid estimates of maternal mortality rates (MMR) to monitor the impact of maternal care programs. Cambodian health authorities and WHO report the MMR in Cambodia at 450 per 100,000 live births. The figure is drawn from surveys where information is obtained by interviewing respondents about the survival of all their adult sisters (sisterhood method). The estimate is statistically imprecise, 95% confidence intervals ranging from 260 to 620/100,000. The MMR estimate is also uncertain due to under-reporting; where 80-90% of women deliver at home maternal fatalities may go undetected especially where mortality is highest, in remote rural areas. The aim of this study was to attain more reliable MMR estimates by using survey methods other than the sisterhood method prior to an intervention targeting obstetric rural emergencies. The study was carried out in rural Northwestern Cambodia where access to health services is poor and poverty, endemic diseases, and land mines are endemic. Two survey methods were applied in two separate sectors: a community-based survey gathering data from public sources and a household survey gathering data direct from primary sources. There was no statistically significant difference between the two survey results for maternal deaths, both types of survey reported mortality rates around the public figure. The household survey reported a significantly higher perinatal mortality rate as compared to the community-based survey, 8.6% versus 5.0%. Also the household survey gave qualitative data important for a better understanding of the many problems faced by mothers giving birth in the remote villages. There are detection failures in both surveys; the failure rate may be as high as 30-40%. PRINCIPLE CONCLUSION: Both survey methods are inaccurate, therefore inappropriate for evaluation of short-term changes of mortality rates. Surveys based on primary informants yield qualitative information about mothers' hardships important for the design

  9. Nutritional and Micronutrient Status of Female Workers in a Garment Factory in Cambodia

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    Jan Makurat

    2016-11-01

    Full Text Available Background: Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. Methods: A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined. Bivariate correlations were used to assess associations. Results: Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative and serum retinol-binding protein (positive concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. Conclusions: The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.

  10. Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Associated with Pediatric Infection in Cambodia

    Science.gov (United States)

    Chheng, Kheng; Tarquinio, Sarah; Wuthiekanun, Vanaporn; Sin, Lina; Thaipadungpanit, Janjira; Amornchai, Premjit; Chanpheaktra, Ngoun; Tumapa, Sarinna; Putchhat, Hor; Day, Nicholas P. J.; Peacock, Sharon J.

    2009-01-01

    Background The incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is rising in the developed world but appears to be rare in developing countries. One explanation for this difference is that resource poor countries lack the diagnostic microbiology facilities necessary to detect the presence of CA-MRSA carriage and infection. Methodology and Principal Findings We developed diagnostic microbiology capabilities at the Angkor Hospital for Children, Siem Reap, western Cambodia in January 2006 and in the same month identified a child with severe community-acquired impetigo caused by CA-MRSA. A study was undertaken to identify and describe additional cases presenting between January 2006 and December 2007. Bacterial isolates underwent molecular characterization using multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec) typing, and PCR for the presence of the genes encoding Panton-Valentine Leukocidin (PVL). Seventeen children were identified with CA-MRSA infection, of which 11 had skin and soft tissue infection and 6 had invasive disease. The majority of cases were unrelated in time or place. Molecular characterization identified two independent MRSA clones; fifteen isolates were sequence type (ST) 834, SCCmec type IV, PVL gene-negative, and two isolates were ST 121, SCCmec type V, PVL gene-positive. Conclusions This represents the first ever report of MRSA in Cambodia, spread of which would pose a significant threat to public health. The finding that cases were mostly unrelated in time or place suggests that these were sporadic infections in persons who were CA-MRSA carriers or contacts of carriers, rather than arising in the context of an outbreak. PMID:19675670

  11. Intestinal parasite infections in symptomatic children attending hospital in Siem Reap, Cambodia.

    Science.gov (United States)

    Moore, Catrin E; Nget, Phot; Saroeun, Mao; Kuong, Suy; Chanthou, Seng; Kumar, Varun; Bousfield, Rachel; Nader, Johanna; Bailey, J Wendi; Beeching, Nicholas J; Day, Nicholas P; Parry, Christopher M

    2015-01-01

    Infections with helminths and other intestinal parasites are an important but neglected problem in children in developing countries. Accurate surveys of intestinal parasites in children inform empirical treatment regimens and can assess the impact of school based drug treatment programmes. There is limited information on this topic in Cambodia. In a prospective study of intestinal parasites in symptomatic children attending Angkor Hospital for Children, Siem Reap, Cambodia, April-June 2012, samples were examined by microscopy of a direct and concentrated fecal sample. Two culture methods for hookworm and Strongyloides stercoralis were employed when sufficient sample was received. Demographic, clinical and epidemiological data were collected. We studied 970 samples from 865 children. The median (inter-quartile range) age of the children was 5.4 (1.9-9.2) years, 54% were male. The proportion of children with abdominal pain was 66.8%, diarrhea 34.9%, anemia 12.7% and malnutrition 7.4%. 458 parasitic infections were detected in 340 (39.3%) children. The most common parasites using all methods of detection were hookworm (14.3%), Strongyloides stercoralis (11.6%) and Giardia lamblia (11.2%). Giardia lamblia was most common in children aged 1-5 years, hookworm and Strongyloides stercoralis were more common with increasing age. Hookworm, Strongloides stercoralis and Giardia lamblia were more common in children living outside of Siem Reap town. In a multivariate logistic regression increasing age was associated with all three infections, defecating in the forest for hookworm infection, the presence of cattle for S. stercoralis and not using soap for handwashing for G. lamblia. This study confirms the importance of intestinal parasitic infections in symptomatic Cambodian children and the need for adequate facilities for laboratory diagnosis together with education to improve personal hygiene and sanitation.

  12. Effects of weather factors on dengue fever incidence and implications for interventions in Cambodia

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    Youngjo Choi

    2016-03-01

    Full Text Available Abstract Background Dengue viruses and their mosquito vectors are sensitive to their environment. Temperature, rainfall and humidity have well-defined roles in the transmission cycle. Therefore changes in these conditions may contribute to increasing incidence. The aim of this study was to examine the relationship between weather factors and dengue incidence in three provinces in Cambodia, in order to strengthen the evidence basis of dengue control strategies in this high-burden country. Methods We developed negative binomial models using monthly average maximum, minimum, mean temperatures and monthly cumulative rainfall over the period from January 1998 to December 2012. We adopted piecewise linear functions to estimate the incidence rate ratio (IRR between dengue incidence and weather factors for simplicity in interpreting the coefficients. We estimated the values of parameters below cut-points defined in terms of the results of sensitivity tests over a 0-3 month lagged period. Results Mean temperature was significantly associated with dengue incidence in all three provinces, but incidence did not correlate well with maximum temperature in Banteay Meanchey, nor with minimum temperature in Kampong Thom at a lag of three months in the negative binomial model. The monthly cumulative rainfall influence on the dengue incidence was significant in all three provinces, but not consistently over a 0-3 month lagged period. Rainfall significantly affected the dengue incidence at a lag of 0 to 3 months in Siem Reap, but it did not have an impact at a lag of 2 to 3 months in Banteay Meanchey, nor at a lag of 2 months in Kampong Thom. Conclusions The association between dengue incidence and weather factors also apparently varies by locality, suggesting that a prospective dengue early warning system would likely be best implemented at a local or regional scale, rather than nation-wide in Cambodia. Such spatial down-scaling would also enable dengue control

  13. Intestinal parasite infections in symptomatic children attending hospital in Siem Reap, Cambodia.

    Directory of Open Access Journals (Sweden)

    Catrin E Moore

    Full Text Available Infections with helminths and other intestinal parasites are an important but neglected problem in children in developing countries. Accurate surveys of intestinal parasites in children inform empirical treatment regimens and can assess the impact of school based drug treatment programmes. There is limited information on this topic in Cambodia.In a prospective study of intestinal parasites in symptomatic children attending Angkor Hospital for Children, Siem Reap, Cambodia, April-June 2012, samples were examined by microscopy of a direct and concentrated fecal sample. Two culture methods for hookworm and Strongyloides stercoralis were employed when sufficient sample was received. Demographic, clinical and epidemiological data were collected.We studied 970 samples from 865 children. The median (inter-quartile range age of the children was 5.4 (1.9-9.2 years, 54% were male. The proportion of children with abdominal pain was 66.8%, diarrhea 34.9%, anemia 12.7% and malnutrition 7.4%. 458 parasitic infections were detected in 340 (39.3% children. The most common parasites using all methods of detection were hookworm (14.3%, Strongyloides stercoralis (11.6% and Giardia lamblia (11.2%. Giardia lamblia was most common in children aged 1-5 years, hookworm and Strongyloides stercoralis were more common with increasing age. Hookworm, Strongloides stercoralis and Giardia lamblia were more common in children living outside of Siem Reap town. In a multivariate logistic regression increasing age was associated with all three infections, defecating in the forest for hookworm infection, the presence of cattle for S. stercoralis and not using soap for handwashing for G. lamblia.This study confirms the importance of intestinal parasitic infections in symptomatic Cambodian children and the need for adequate facilities for laboratory diagnosis together with education to improve personal hygiene and sanitation.

  14. Emergence of community-associated methicillin-resistant Staphylococcus aureus associated with pediatric infection in Cambodia.

    Directory of Open Access Journals (Sweden)

    Kheng Chheng

    2009-08-01

    Full Text Available The incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA infection is rising in the developed world but appears to be rare in developing countries. One explanation for this difference is that resource poor countries lack the diagnostic microbiology facilities necessary to detect the presence of CA-MRSA carriage and infection.We developed diagnostic microbiology capabilities at the Angkor Hospital for Children, Siem Reap, western Cambodia in January 2006 and in the same month identified a child with severe community-acquired impetigo caused by CA-MRSA. A study was undertaken to identify and describe additional cases presenting between January 2006 and December 2007. Bacterial isolates underwent molecular characterization using multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec typing, and PCR for the presence of the genes encoding Panton-Valentine Leukocidin (PVL. Seventeen children were identified with CA-MRSA infection, of which 11 had skin and soft tissue infection and 6 had invasive disease. The majority of cases were unrelated in time or place. Molecular characterization identified two independent MRSA clones; fifteen isolates were sequence type (ST 834, SCCmec type IV, PVL gene-negative, and two isolates were ST 121, SCCmec type V, PVL gene-positive.This represents the first ever report of MRSA in Cambodia, spread of which would pose a significant threat to public health. The finding that cases were mostly unrelated in time or place suggests that these were sporadic infections in persons who were CA-MRSA carriers or contacts of carriers, rather than arising in the context of an outbreak.

  15. An explorative study of the practice of light trapping and the informal market for crickets in Cambodia

    DEFF Research Database (Denmark)

    Münke-Svendsen, C.; Ao, V.; Lach, T.

    2018-01-01

    was to describe the informal food sector for wild caught crickets in Cambodia. The information was collected in April-May 2012. Information on collection equipment and techniques, processing and trade were obtained from light trap owners, traders, market vendors and governmental representatives. Five cricket......Edible insects are an integrated part of the food sector in many South-East Asian countries. While the majority of studies focus on Thailand and its cricket farming sector, neighbouring countries like Cambodia and Laos also form a regional market for edible insects. The aim of this research...... species were identified to be the main trade object. Cricket trapping contributed to livelihoods of rural households operating in a self-governing market. As the crickets are caught from the wild, the sustainability of the market has to be questioned. The use of a framework to structure future studies...

  16. Factors associated with post-treatment E. coli contamination in households practising water treatment: a study of rural Cambodia.

    Science.gov (United States)

    Benwic, Aaron; Kim, Erin; Khema, Cinn; Phanna, Chet; Sophary, Phan; Cantwell, Raymond E

    2018-04-01

    The purpose of this study was to assess factors associated with Escherichia coli (E. coli) contamination in rural households in Cambodia that have adopted household water treatment. The following factors were significantly associated (α E. coli contamination: cleaning the drinking vessel with untreated water, not drying the cup (with a cloth), accessing treated water by the use of a scoop (ref: using a tap), having more than one untreated water storage container, having an untreated water storage container that appeared dirty on the outside, and cows living within 10 m of the household. This study provides further evidence confirming previous studies reporting an association between inadequate cleanliness of water storage containers and household drinking water contamination, and identifies practical recommendations statistically associated with reduced post-treatment E. coli contamination in the household setting in rural Cambodia.

  17. The village/commune safety policy and HIV prevention efforts among key affected populations in Cambodia: finding a balance

    Directory of Open Access Journals (Sweden)

    Thomson Nick

    2012-07-01

    Full Text Available Abstract The Village/Commune Safety Policy was launched by the Ministry of Interior of the Kingdom of Cambodia in 2010 and, due to a priority focus on “cleaning the streets”, has created difficulties for HIV prevention programs attempting to implement programs that work with key affected populations including female sex workers and people who inject drugs. The implementation of the policy has forced HIV program implementers, the UN and various government counterparts to explore and develop collaborative ways of delivering HIV prevention services within this difficult environment. The following case study explores some of these efforts and highlights the promising development of a Police Community Partnership Initiative that it is hoped will find a meaningful balance between the Village/Commune Safety Policy and HIV prevention efforts with key affected populations in Cambodia.

  18. Point‐of‐sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania

    Science.gov (United States)

    Pereira, Catherine; Sweet, Lara; Khin, Mengkheang; Ndiaye Coly, Aminata; Sy Gueye, Ndeye Yaga; Adhikary, Indu; Dhungel, Shrid; Makafu, Cecilia; Zehner, Elizabeth; Huffman, Sandra L.

    2016-01-01

    Abstract In order to assess the prevalence of point‐of‐sale promotions of infant and young child feeding products in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania, approximately 30 retail stores per site, 121 in total, were visited. Promotional activity for breastmilk substitutes (BMS) and commercially produced complementary foods in each site were recorded. Point‐of‐sale promotion of BMS occurred in approximately one‐third of sampled stores in Phnom Penh and Dakar Department but in 3.2% and 6.7% of stores in Kathmandu Valley and Dar es Salaam, respectively. Promotion of commercially produced complementary foods was highly prevalent in Dakar Department with half of stores having at least one promotion, while promotions for these products occurred in 10% or less of stores in the other three sites. While promotion of BMS in stores is legal in Senegal, it is prohibited in Cambodia without prior permission of the Ministry of Health/Ministry of Information and prohibited in both Nepal and Tanzania. Strengthening legislation in Senegal and enforcing regulations in Cambodia could help to prevent such promotion that can negatively affect breastfeeding practices. Key messages Even in countries such as Cambodia, Nepal and Tanzania where point‐of‐sale promotion is restricted, promotions of BMS were observed (in nearly one‐third of stores in Phnom Penh and less than 10% in Dar es Salaam and Kathmandu).Limited promotion of commercially produced complementary foods was evident (less than 10% of stores had a promotion for such foods), except in Dakar Department, where promotions were found in half of stores.Efforts are needed to strengthen monitoring, regulation and enforcement of restrictions on the promotion of BMS.Manufacturers and distributors should take responsibility for compliance with national regulations and global policies pertaining to the promotion of breastmilk substitutes. PMID:27061961

  19. Health and safety management practices of contractors in South East Asia: A multi country study of Cambodia, Vietnam, and Malaysia

    OpenAIRE

    Manu, P.; Mahamadu, A.-M. ed; Phung, V. M.; Nguyen, T. T.; Ath, C.; Heng, A. Y. T.; Kit, S. C.

    2017-01-01

    The construction sector is notorious for accounting for numerous occupational deaths, injuries and illnesses in many countries. In emerging economies this situation could be direr, and health and safety (H&S) management by contractors is important to tackling this. This study investigated the H&S management practices of contractors in three South East Asian countries (Malaysia, Vietnam, and Cambodia) with the view to highlighting implementation issues. A questionnaire instrument containing 40...

  20. Point-of-sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania.

    Science.gov (United States)

    Champeny, Mary; Pereira, Catherine; Sweet, Lara; Khin, Mengkheang; Ndiaye Coly, Aminata; Sy Gueye, Ndeye Yaga; Adhikary, Indu; Dhungel, Shrid; Makafu, Cecilia; Zehner, Elizabeth; Huffman, Sandra L

    2016-04-01

    In order to assess the prevalence of point-of-sale promotions of infant and young child feeding products in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania, approximately 30 retail stores per site, 121 in total, were visited. Promotional activity for breastmilk substitutes (BMS) and commercially produced complementary foods in each site were recorded. Point-of-sale promotion of BMS occurred in approximately one-third of sampled stores in Phnom Penh and Dakar Department but in 3.2% and 6.7% of stores in Kathmandu Valley and Dar es Salaam, respectively. Promotion of commercially produced complementary foods was highly prevalent in Dakar Department with half of stores having at least one promotion, while promotions for these products occurred in 10% or less of stores in the other three sites. While promotion of BMS in stores is legal in Senegal, it is prohibited in Cambodia without prior permission of the Ministry of Health/Ministry of Information and prohibited in both Nepal and Tanzania. Strengthening legislation in Senegal and enforcing regulations in Cambodia could help to prevent such promotion that can negatively affect breastfeeding practices. Even in countries such as Cambodia, Nepal and Tanzania where point-of-sale promotion is restricted, promotions of BMS were observed (in nearly one-third of stores in Phnom Penh and less than 10% in Dar es Salaam and Kathmandu). Limited promotion of commercially produced complementary foods was evident (less than 10% of stores had a promotion for such foods), except in Dakar Department, where promotions were found in half of stores. Efforts are needed to strengthen monitoring, regulation and enforcement of restrictions on the promotion of BMS. Manufacturers and distributors should take responsibility for compliance with national regulations and global policies pertaining to the promotion of breastmilk substitutes. © 2016 The Authors. Maternal & Child Nutrition

  1. Hepatitis E Virus in Cambodia: Prevalence among the General Population and Complete Genome Sequence of Genotype 4.

    Science.gov (United States)

    Yamada, Hiroko; Takahashi, Kazuaki; Lim, Olline; Svay, Somana; Chuon, Channarena; Hok, Sirany; Do, Son Huy; Fujimoto, Mayumi; Akita, Tomoyuki; Goto, Noboru; Katayama, Keiko; Arai, Masahiro; Tanaka, Junko

    2015-01-01

    Hepatitis E virus (HEV) is a growing public health problem in many countries. In this study, we investigated HEV seroprevalence among the general population in the Siem Reap province, Cambodia, and performed HEV genetic analysis with the aim to develop an HEV prevention strategy. This seroepidemiological cross-sectional study conducted from 2010 to 2014 included 868 participants from four different locations in Siem Reap province, Cambodia. They answered questionnaires and provided blood samples for the analysis of hepatitis virus infections. Among the participants (360 men and 508 women; age range, 7-90 years), the prevalence of anti-HEV IgG was 18.4% (95% confidence interval: 15.9-21.0); HEV RNA was detected in two participants (0.23%) and was classified as genotype 3 and 4. Full-length genome of the genotype 4 isolate, CVS-Sie10, was sequenced; it contained 7,222 nucleotides and three ORFs and demonstrated high sequence identity with the swine China isolates swGX40 (95.57%), SS19 (94.37%), and swDQ (91.94%). Multivariate logistic regression analysis revealed that men, elderly people, and house workers were risk groups significantly associated with the positivity for anti-HEV IgG. This is the first report on the detection of HEV genotype 4 in humans in Cambodia and on the complete genome sequence of HEV genotype 4 from this country. Our study demonstrates that new HEV infection cases occur frequently among the general population in Cambodia, and effective preventive measures are required.

  2. Performance-based financing with GAVI health system strengthening funding in rural Cambodia: a brief assessment of the impact.

    Science.gov (United States)

    Matsuoka, Sadatoshi; Obara, Hiromi; Nagai, Mari; Murakami, Hitoshi; Chan Lon, Rasmey

    2014-07-01

    Though Cambodia made impressive gains in immunization coverage between the years 2000 and 2005, it recognized several health system challenges to greater coverage of immunization and sustainability. The Global Alliance for Vaccines and Immunization (GAVI) opened a Health System Strengthening (HSS) funding window in 2006. To address the health system challenges, Cambodia has been receiving the GAVI HSS fund since October 2007. The major component of the support is performance-based financing (PBF) for maternal, neonatal and child health (MNCH) services. To examine the impact of the PBF scheme on MNCH services and administrative management in rural Cambodia. Quantitative and qualitative studies were conducted in Kroch Chhmar Operational District (OD), Cambodia. Quantitative analyses were conducted on the trends of the numbers of MNCH services. A brief analysis was conducted using qualitative data. After the commencement of the PBF support, the volume of MNCH services was significantly boosted. In addition, strengthened financial and operational management was observed in the study area. However, the quality of the MNCH services was not ensured. Technical assistance, rather than the PBF scheme, was perceived by stakeholders to play a vital role in increasing the quality of the services. To improve the quality of the health services provided, it is better to include indicators on the quality of care in the PBF scheme. Mutual co-operation between PBF models and technical assistance may ensure better service quality while boosting the quantity. A robust but feasible data validation mechanism should be in place, as a PBF could incentivize inaccurate reporting. The capacity for financial management should be strengthened in PBF recipient ODs. To address the broader aspects of MNCH, a balanced input of resources and strengthening of all six building blocks of a health system are necessary. Published by Oxford University Press in association with The London School of Hygiene

  3. Hepatitis E Virus in Cambodia: Prevalence among the General Population and Complete Genome Sequence of Genotype 4.

    Directory of Open Access Journals (Sweden)

    Hiroko Yamada

    Full Text Available Hepatitis E virus (HEV is a growing public health problem in many countries. In this study, we investigated HEV seroprevalence among the general population in the Siem Reap province, Cambodia, and performed HEV genetic analysis with the aim to develop an HEV prevention strategy. This seroepidemiological cross-sectional study conducted from 2010 to 2014 included 868 participants from four different locations in Siem Reap province, Cambodia. They answered questionnaires and provided blood samples for the analysis of hepatitis virus infections. Among the participants (360 men and 508 women; age range, 7-90 years, the prevalence of anti-HEV IgG was 18.4% (95% confidence interval: 15.9-21.0; HEV RNA was detected in two participants (0.23% and was classified as genotype 3 and 4. Full-length genome of the genotype 4 isolate, CVS-Sie10, was sequenced; it contained 7,222 nucleotides and three ORFs and demonstrated high sequence identity with the swine China isolates swGX40 (95.57%, SS19 (94.37%, and swDQ (91.94%. Multivariate logistic regression analysis revealed that men, elderly people, and house workers were risk groups significantly associated with the positivity for anti-HEV IgG. This is the first report on the detection of HEV genotype 4 in humans in Cambodia and on the complete genome sequence of HEV genotype 4 from this country. Our study demonstrates that new HEV infection cases occur frequently among the general population in Cambodia, and effective preventive measures are required.

  4. Drug-resistant tuberculosis in HIV-infected patients in a national referral hospital, Phnom Penh, Cambodia.

    Science.gov (United States)

    Walls, Genevieve; Bulifon, Sophie; Breysse, Serge; Daneth, Thol; Bonnet, Maryline; Hurtado, Northan; Molfino, Lucas

    2015-01-01

    There are no recent data on the prevalence of drug-resistant tuberculosis (DR TB) in Cambodia. We aim to describe TB drug resistance amongst adults with pulmonary and extra-pulmonary TB and human immunodeficiency virus (HIV) co-infection in a national referral hospital in Phnom Penh, Cambodia. Between 22 November 2007 and 30 November 2009, clinical specimens from HIV-infected patients suspected of having TB underwent routine microscopy, Mycobacterium tuberculosis culture, and drug susceptibility testing. Laboratory and clinical data were collected for patients with positive M. tuberculosis cultures. M. tuberculosis was cultured from 236 HIV-infected patients. Resistance to any first-line TB drug occurred in 34.7% of patients; 8.1% had multidrug resistant tuberculosis (MDR TB). The proportion of MDR TB amongst new patients and previously treated patients was 3.7 and 28.9%, respectively (pCambodia may be higher than previously recognised, particularly amongst HIV-infected patients. Additional prevalence studies are needed. This study also illustrates the feasibility and utility of analysis of non-respiratory specimens in the diagnosis of TB, even in low-resource settings, and suggests that extra-pulmonary specimens should be included in TB diagnostic algorithms.

  5. Median Urinary Iodine Concentrations Are Indicative of Adequate Iodine Status among Women of Reproductive Age in Prey Veng, Cambodia.

    Science.gov (United States)

    Karakochuk, Crystal D; Michaux, Kristina D; Chai, Tze L; Chan, Benny B; Whitfield, Kyly C; Barr, Susan I; McLean, Judy; Talukder, Aminuzzaman; Hou, Kroeun; Ly, Sokhoing; Green, Tim J

    2016-03-03

    Iodine deficiency disorders are estimated to affect over 1.9 million people worldwide. Iodine deficiency is especially serious for women during pregnancy and lactation because of the negative consequences for both mother and infant. The aim of this cross-sectional study was to determine the median urinary iodine concentration (UIC) as a population-level indicator of iodine status among rural women farmers of reproductive age (18-45 years) in the province of Prey Veng, Cambodia. A total of 450 women provided a spot morning urine sample in 2012. Of those women, 93% (n = 420) were non-pregnant and 7% (n = 30) were pregnant at the time of collection. UIC was quantified using the Sandell-Kolthoff reaction with modifications. The median UIC of non-pregnant (139 μg/L) and pregnant women (157 μg/L) were indicative of adequate iodine status using the WHO/UNICEF/ICCIDD epidemiological criteria for both groups (median UIC between 100-199 and 150-249 μg/L, respectively). We conclude that non-pregnant and pregnant women in rural Prey Veng, Cambodia had adequate iodine status based on single spot morning urine samples collected in 2012. More research is warranted to investigate iodine status among larger and more representative populations of women in Cambodia, especially in light of recent policy changes to the national program for universal salt iodization.

  6. Is importing second-hand products a good thing? The cases of computers and tires in Cambodia

    International Nuclear Information System (INIS)

    Chanthy, Lay; Nitivattananon, Vilas

    2011-01-01

    Is importing second-hand products (SHPs) good for Cambodia? To answer this question, one must seriously consider environmental and social effects. The main objective of this study is to identify and assess the economic, social, and environmental impacts of imported SHPs to determine whether or not Cambodia benefits. Imported second-hand computers (SHPCs) and second-hand tires (SHTs) were selected as cases for the study. The study used a scaling checklist to identify significant impacts of these two imported items. Significant impacts were ranked and rated into a single value (score) for integration. Integrated impact assessment showed that imported SHPCs create a very small positive impact (+ 0.1 of + 5) and imported SHTs generate a large negative impact (- 2.83 of - 5). These scores are mainly the result of environmental impact, predominantly waste issues. Thus, current imports of SHPCs and SHTs do not really benefit Cambodia, but instead cause serious environmental problems from their waste issues. The import serves as a channel to transfer waste into developing countries.

  7. 'A preferred consultant and partner to the Royal Government, NGOs, and the community': British American Tobacco's access to policy-makers in Cambodia.

    Science.gov (United States)

    MacKenzie, Ross; Collin, Jeff

    2017-04-01

    British American Tobacco Cambodia (BATC) has dominated the country's tobacco market since its launch in 1996. Aggressive marketing in a weak regulatory environment and strategies to influence tobacco control policy have contributed to an emerging tobacco-related public health crisis. Analysis of internal tobacco industry documents, issues of BATC's in-house newsletter, civil society reports and media demonstrate that BATC officials have successfully sought to align the company with Cambodia's increasingly controversial political and business leadership that is centred around the Cambodian People's Party with the aim of gaining access to policy-makers and influencing the policy process. Connections to the political elite have resulted in official recognition of the company's ostensible contribution to Cambodia's economic and social development and, more significantly, provided BATC with opportunities to petition policy-makers and to dilute tobacco control regulation. Corporate promotion of its contribution to Cambodia's economic and social development is at odds with its determined efforts to thwart public health regulation and Cambodia's compliance with the Framework Convention on Tobacco Control.

  8. Perinatal Consumption of Thiamine-Fortified Fish Sauce in Rural Cambodia: A Randomized Clinical Trial.

    Science.gov (United States)

    Whitfield, Kyly C; Karakochuk, Crystal D; Kroeun, Hou; Hampel, Daniela; Sokhoing, Ly; Chan, Benny B; Borath, Mam; Sophonneary, Prak; McLean, Judy; Talukder, Aminuzzaman; Lynd, Larry D; Li-Chan, Eunice C Y; Kitts, David D; Allen, Lindsay H; Green, Timothy J

    2016-10-03

    Infantile beriberi, a potentially fatal disease caused by thiamine deficiency, remains a public health concern in Cambodia and regions where thiamine-poor white rice is a staple food. Low maternal thiamine intake reduces breast milk thiamine concentrations, placing breastfed infants at risk of beriberi. To determine if consumption of thiamine-fortified fish sauce yields higher erythrocyte thiamine diphosphate concentrations (eTDP) among lactating women and newborn infants and higher breast milk thiamine concentrations compared with a control sauce. In this double-blind randomized clinical trial, 90 pregnant women were recruited in the Prey Veng province, Cambodia. The study took place between October 2014 and April 2015. Women were randomized to 1 of 3 groups (n = 30) for ad libitum fish sauce consumption for 6 months: control (no thiamine), low-concentration (2 g/L), or high-concentration (8 g/L) fish sauce. Maternal eTDP was assessed at baseline (October 2014) and endline (April 2015). Secondary outcomes, breast milk thiamine concentration and infant eTDP, were measured at endline. Women's mean (SD) age and gestational stage were 26 (5) years and 23 (7) weeks, respectively. April 2015 eTDP was measured among 28 women (93%), 29 women (97%), and 23 women (77%) in the control, low-concentration, and high-concentration groups, respectively. In modified intent-to-treat analysis, mean baseline-adjusted endline eTDP was higher among women in the low-concentration (282nM; 95% CI, 235nM to 310nM) and high-concentration (254nM; 95% CI, 225nM to 284nM) groups compared with the control group (193nM; 95% CI, 164nM to 222M; P sauce through pregnancy and early lactation had higher eTDP and breast milk thiamine concentrations and their infants had higher eTDP, which was more pronounced in the high group. Thiamine-fortified fish sauce has the potential to prevent infantile beriberi in this population. Clinicaltrials.gov Identifier: NCT02221063.

  9. The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015.

    Directory of Open Access Journals (Sweden)

    Laura M F Kuijpers

    2017-09-01

    Full Text Available Enteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi.A retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015. Demographic, clinical and laboratory data were collected from clinical charts and antibiotic susceptibility testing was performed. Whole genome sequence analysis was performed on a subset of 121 isolates.One-hundred-and-ninety unique patients were diagnosed with Salmonella Paratyphi A and 64 with Salmonella Typhi. In the period 2008-2012, Salmonella Paratyphi A comprised 25.5% of 47 enteric fever cases compared to 86.0% of 207 cases during 2013-2015. Presenting symptoms were identical for both serovars but higher median leukocyte counts (6.8 x 109/L vs. 6.3 x 109/L; p = 0.035 and C-reactive protein (CRP values (47.0 mg/L vs. 36 mg/L; p = 0.034 were observed for Salmonella Typhi infections. All but one of the Salmonella Typhi isolates belonged to haplotype H58 associated with multidrug resistance (MDR (i.e. resistance to ampicillin, chloramphenicol and co-trimoxazole.;42.9% actually displayed MDR compared to none of the Salmonella Paratyphi A isolates. Decreased ciprofloxacin susceptibility (DCS was observed in 96.9% (62/64 of Salmonella Typhi isolates versus 11.5% (21/183 of Salmonella Paratyphi A isolates (all but one from 2015. All isolates were susceptible to azithromycin and ceftriaxone.In Phnom Penh, Cambodia, Salmonella Paratyphi A now causes the majority of enteric fever cases and decreased susceptibility against ciprofloxacin is increasing. Overall, Salmonella Typhi was significantly more associated with MDR and

  10. Genetic diversity of coronaviruses in bats in Lao PDR and Cambodia.

    Science.gov (United States)

    Lacroix, Audrey; Duong, Veasna; Hul, Vibol; San, Sorn; Davun, Hull; Omaliss, Keo; Chea, Sokha; Hassanin, Alexandre; Theppangna, Watthana; Silithammavong, Soubanh; Khammavong, Kongsy; Singhalath, Sinpakone; Greatorex, Zoe; Fine, Amanda E; Goldstein, Tracey; Olson, Sarah; Joly, Damien O; Keatts, Lucy; Dussart, Philippe; Afelt, Aneta; Frutos, Roger; Buchy, Philippe

    2017-03-01

    South-East Asia is a hot spot for emerging zoonotic diseases, and bats have been recognized as hosts for a large number of zoonotic viruses such as Severe Acute Respiratory Syndrome (SARS), responsible for acute respiratory syndrome outbreaks. Thus, it is important to expand our knowledge of the presence of viruses in bats which could represent a risk to humans. Coronaviruses (CoVs) have been reported in bat species from Thailand, China, Indonesia, Taiwan and the Philippines. However no such work was conducted in Cambodia or Lao PDR. Between 2010 and 2013, 1965 bats were therefore sampled at interfaces with human populations in these two countries. They were tested for the presence of coronavirus by consensus reverse transcription-PCR assay. A total of 93 samples (4.7%) from 17 genera of bats tested positive. Sequence analysis revealed the presence of potentially 37 and 56 coronavirus belonging to alpha-coronavirus (αCoV) and beta-CoV (βCoV), respectively. The βCoVs group is known to include some coronaviruses highly pathogenic to human, such as SARS-CoV and MERS-CoV. All coronavirus sequences generated from frugivorous bats (family Pteropodidae) (n=55) clustered with other bat βCoVs of lineage D, whereas one coronavirus from Pipistrellus coromandra fell in the lineage C of βCoVs which also includes the MERS-CoV. αCoVs were all detected in various genera of insectivorous bats and clustered with diverse bat αCoV sequences previously published. A closely related strain of PEDV, responsible for severe diarrhea in pigs (PEDV-CoV), was detected in 2 Myotis bats. We highlighted the presence and the high diversity of coronaviruses circulating in bats from Cambodia and Lao PDR. Three new bat genera and species were newly identified as host of coronaviruses, namely Macroglossus sp., Megaerops niphanae and Myotis horsfieldii. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Neurobehavioral effects of arsenic exposure among secondary school children in the Kandal Province, Cambodia

    Energy Technology Data Exchange (ETDEWEB)

    Vibol, Sao [United Nations University – International Institute for Global Health, Kuala Lumpur (Malaysia); Faculty of Agricultural Technology and Management, Royal University of Agriculture, Phnom Penh (Cambodia); Hashim, Jamal Hisham, E-mail: jamalhas@hotmail.com [United Nations University – International Institute for Global Health, Kuala Lumpur (Malaysia); Department of Community Health, National University of Malaysia, Kuala Lumpur (Malaysia); Sarmani, Sukiman [Faculty of Science and Technology, National University of Malaysia, Bangi (Malaysia)

    2015-02-15

    The research was carried out at 3 study sites with varying groundwater arsenic (As) levels in the Kandal Province of Cambodia. Kampong Kong Commune was chosen as a highly contaminated site (300–500 μg/L), Svay Romiet Commune was chosen as a moderately contaminated site (50–300 μg/L) and Anlong Romiet Commune was chosen as a control site. Neurobehavioral tests on the 3 exposure groups were conducted using a modified WHO neurobehavioral core test battery. Seven neurobehavioral tests including digit symbol, digit span, Santa Ana manual dexterity, Benton visual retention, pursuit aiming, trail making and simple reaction time were applied. Children's hair samples were also collected to investigate the influence of hair As levels on the neurobehavioral test scores. The results from the inductively coupled plasma-mass spectrometry (ICP-MS) analyses of hair samples showed that hair As levels at the 3 study sites were significantly different (p<0.001), whereby hair samples from the highly contaminated site (n=157) had a median hair As level of 0.93 μg/g, while the moderately contaminated site (n=151) had a median hair As level of 0.22 μg/g, and the control site (n=214) had a median hair As level of 0.08 μg/g. There were significant differences among the 3 study sites for all the neurobehavioral tests scores, except for digit span (backward) test. Multiple linear regression clearly shows a positive significant influence of hair As levels on all the neurobehavioral test scores, except for digit span (backward) test, after controlling for hair lead (Pb), manganese (Mn) and cadmium (Cd). Children with high hair As levels experienced 1.57–4.67 times greater risk of having lower neurobehavioral test scores compared to those with low hair As levels, after adjusting for hair Pb, Mn and Cd levels and BMI status. In conclusion, arsenic-exposed school children from the Kandal Province of Cambodia with a median hair As level of 0.93 µg/g among those from the highly

  12. Indiscriminate Fisheries: Understanding the Foodweb of the Great Tonle Sap Lake, Cambodia

    Science.gov (United States)

    Hannah, L.; Kaufman, L.

    2014-12-01

    Indiscriminate fisheries target multiple species with multiple gear types. In contrast to well-studied, industrialized single-species, single-gear fisheries, little theory and little but growing literature on practice exists for indiscriminate fisheries. Indiscriminate fisheries are disproportionately important in low-income countries, providing most of the animal protein intake in countries such as Cambodia and Bangladesh. Indiscriminate fisheries may be either freshwater or marine, but here we focus on what may be the largest freshwater indiscriminate fishery in the world. Cambodia's freshwater fishery stands out because it provides the majority of animal protein to over 3 million people living in poverty. The fishery of the Tonle Sap lake is one of the largest, if not the largest contributor to this freshwater fish take, and is perhaps the largest freshwater fishery in the world. In contrast to its importance, very little is known about the foodweb ecology of this system, or how community management which now governs the entire fishery, interacts with biological and physical factors such as climate change.The foodweb of the Tonle Sap has changed dramatically due to high fishing pressure. A system that once harbored giant catfish, barbs and stingrays is now dominated by fish under 20cm in length. The simplification of the system may not have reduced its productivity. Theory of indiscriminate fisheries suggests that r-selected species may be favored and that biomass available for harvest may be maximized, while being more sensitive to environmental fluctuations such as climate change due to food web simplification. The r-selection and size predictions of theory have been confirmed by observations of the Tonle Sap. Early model results suggest sensitivity to environmental stochasticity. The interaction of these ecological changes with social systems will be tested in the Tonle Sap. Fisheries management across the lake has been transferred to community management

  13. Mobile phone use among female entertainment workers in Cambodia: an observation study.

    Science.gov (United States)

    Brody, Carinne; Tatomir, Brent; Sovannary, Tuot; Pal, Khuondyla; Mengsrun, Song; Dionosio, Jennifer; Luong, Minh-Anh; Yi, Siyan

    2017-01-01

    Text or voice messages containing health behavior change content may be an inexpensive, discreet, sustainable and scalable way to reach populations at high risk for HIV. In Cambodia, one of the important high-risk populations is female entertainment workers (FEWs). This ethnographic study aims to explore typical phone use, examining patterns and behaviors that may influence the design of future mHealth interventions. The study consisted of one 8-hour non-participant observation session for 15 randomly sampled FEWs. Observations focused on capturing normal daily use of mobile devices. Observation checklists were populated by observers during the observations and a post-observation survey was conducted. Findings were discussed with Cambodian HIV outreach workers and HIV research fellows and their interpretations are summarized below. In this ethnographic study, all 15 participants made calls, checked the time and received research-related texts. More than half (n=8) of the participants engaged in texting to a non-research recipient. About half (n=7) went on Facebook (FB) and some (n=5) listened to music and looked at their FB newsfeed. Fewer played a mobile game, posted a photo to FB, went on YouTube, used FB chat/messenger, watched a video on FB, played a game on FB, used FB call/voice chat, looked at their phone's background or used the LINE app. Fewer still shared their phones, left them unattended, added airtime or changed their SIM cards. When participants received a research text message, most did not share the text message with anyone, did not ask for help deciphering the message and did not receive help composing a response. Notable themes from observer notes, HIV outreach workers and researchers include reasons why phone calls were the most frequent mode of communication, examples of how cell phone company text messages are used as a form of behavior change, literacy as a persistent barrier for some FEWs, and FEWs' high interest in receiving health

  14. Neurobehavioral effects of arsenic exposure among secondary school children in the Kandal Province, Cambodia

    International Nuclear Information System (INIS)

    Vibol, Sao; Hashim, Jamal Hisham; Sarmani, Sukiman

    2015-01-01

    The research was carried out at 3 study sites with varying groundwater arsenic (As) levels in the Kandal Province of Cambodia. Kampong Kong Commune was chosen as a highly contaminated site (300–500 μg/L), Svay Romiet Commune was chosen as a moderately contaminated site (50–300 μg/L) and Anlong Romiet Commune was chosen as a control site. Neurobehavioral tests on the 3 exposure groups were conducted using a modified WHO neurobehavioral core test battery. Seven neurobehavioral tests including digit symbol, digit span, Santa Ana manual dexterity, Benton visual retention, pursuit aiming, trail making and simple reaction time were applied. Children's hair samples were also collected to investigate the influence of hair As levels on the neurobehavioral test scores. The results from the inductively coupled plasma-mass spectrometry (ICP-MS) analyses of hair samples showed that hair As levels at the 3 study sites were significantly different (p<0.001), whereby hair samples from the highly contaminated site (n=157) had a median hair As level of 0.93 μg/g, while the moderately contaminated site (n=151) had a median hair As level of 0.22 μg/g, and the control site (n=214) had a median hair As level of 0.08 μg/g. There were significant differences among the 3 study sites for all the neurobehavioral tests scores, except for digit span (backward) test. Multiple linear regression clearly shows a positive significant influence of hair As levels on all the neurobehavioral test scores, except for digit span (backward) test, after controlling for hair lead (Pb), manganese (Mn) and cadmium (Cd). Children with high hair As levels experienced 1.57–4.67 times greater risk of having lower neurobehavioral test scores compared to those with low hair As levels, after adjusting for hair Pb, Mn and Cd levels and BMI status. In conclusion, arsenic-exposed school children from the Kandal Province of Cambodia with a median hair As level of 0.93 µg/g among those from the highly

  15. Social cost of land mines in four countries: Afghanistan, Bosnia, Cambodia, and Mozambique.

    Science.gov (United States)

    Andersson, N; da Sousa, C P; Paredes, S

    1995-09-16

    To document the effects of land mines on the health and social conditions of communities in four affected countries. A cross design of cluster survey and rapid appraisal methods including a household questionnaire and qualitative data from key informants, institutional reviews, and focus groups of survivors of land mines from the same communities. 206 communities, 37 in Afghanistan, 66 in Bosnia, 38 in Cambodia, and 65 in Mozambique. 174,489 people living in 32,904 households in the selected communities. Effects of land mines on food security, residence, livestock, and land use; risk factors: extent of individual land mine injuries; physical, psychological, social, and economic costs of injuries during medical care and rehabilitation. Between 25% and 87% of households had daily activities affected by land mines. Based on expected production without the mines, agricultural production could increase by 88-200% in different regions of Afghanistan, 11% in Bosnia, 135% in Cambodia, and 3.6% in Mozambique. A total of 54,554 animals was lost because of land mines, with a minimum cash value of $6.5m, or nearly $200 per household. Overall, 6% of households (1964) reported a land mine victim; a third of victims died in the blast. One in 10 of the victims was a child. The most frequent activities associated with land mine incidents were agricultural or pastoral, except in Bosnia where more than half resulted from military activities, usually during patrols. Incidences have more than doubled between 1980-3 and 1990-3, excluding the incidents in Bosnia. Some 22% of victims (455/2100) were from households reporting attempts to remove land mines; in these households there was a greatly increased risk of injury (odds ratio 4.2 and risk difference 19% across the four countries). Lethality of the mines varied; in Bosnia each blast killed an average of 0.54 people and injured 1.4, whereas in Mozambique each blast killed 1.45 people and wounded 1.27. Households with a land mine victim

  16. Iron isotope constraints on arsenic release from Mekong Delta sediments, Cambodia

    Science.gov (United States)

    Matsumoto, T.; Yamaguchi, K. E.; Hirata, T.; Yamagata, Y.; Yamaguchi, A.; Abe, G.

    2017-12-01

    Arsenic-contaminated groundwater is a world-wide environmental problem and threatens more than 100 million people living in delta areas of South, SE and East Asia. It is typically associated with reducing aquifers with organic-rich alluvial sediments, little thermal gradients, low sulfate concentrations, and slow flushing rates. Such conditions are typical for low-lying countries in Asian deltas; however, compared to Bangladesh, Cambodia has received far less attention. Upon reductive dissolution of Fe-(oxyhydr)oxides that adsorbed As, Fe and As are released into solution as dissolved Fe2+ and arsenate, respectively. Following the oxidation of dissolved Fe2+, newly-formed Fe-(oxyhydr)oxides adsorb As again. Thus, in anoxic waters, concentrations of As correlate with those of dissolved Fe2+. Fluctuating redox conditions in the aquifer are control As release, although inhibition of adsorption of arsenate and arsenite onto the Fe-(oxyhydr)oxides occurs when the concentrations of phosphate, bicarbonate, silicate, and/or organic matter become sufficiently high. Biogeochemical redox reactions of Fe result in significant isotope fractionation (e.g., Johnson et al., 2008). We hypothesized that magnitude of isotope fractionation of Fe in the aquifer sediments, reflecting repeated (incomplete) redox reactions of Fe, may be proportional to the amount of total As release. We aim to calibrate the As release from aquifer sediment by Fe isotope analysis. As a preliminary study, series of sediment samples were collected from the Mekong Delta, Cambodia, in September 2016. Based on measurements by XRF, ICP-AES and ICP-MS, concentrations of As varied significantly covering the range from 4.5 to 15.5 µg/g with a median value of 11 µg/g (higher than the average crustal value of 5 µg/g), and those of Fe is from 2.6 to 9.7 wt.% with a median value of 7.1 wt.%. Concentrations of As and Fe show positive correlation (R2 = 0.72), indicating an effective redox cycling of Fe and As as

  17. THE ANALYSIS OF ORGANIC RICE CONTRACT FARMING IN CAMBODIA: A LESSON LEARNED FOR INDONESIA

    Directory of Open Access Journals (Sweden)

    Betti Rosita Sari

    2015-12-01

    Full Text Available  This study examines organic rice contract farming inCambodiaand its impact on farmers’ livelihood. The study’s objective is to gain a better insight of the terms and conditions of rice contract farming scheme inCambodia, and determine under what conditions contract farming could bring improvements to farmers’ livelihoods. This study contributes new research findings on contract farming practices and farmers’ livelihood due to organic-rice contract farming with a case study in Kampong Speu province,Cambodia.Rice contract farming is not widespread inCambodiaat present, but is expected to expand significantly in the near future. Contract farming can increase investment into agricultural and infrastructure in rural areas. Contract farming can also enable farmers to access credit, inputs, technical advice and information about market condition and pricing trends. Yet, the disadvantages of contract farming include loss of farmer bargaining power and a potential reduction in profit margins, increased emphasis on improving production quality, land consolidation in favor of participating contract farmers, and less secure livelihoods.In this study, the contract farming arrangements of Angkor Kasekam Rongroeung (AKR Company is studied. A survey of 16 contract farmers and 20 non-contract farmers in Kampong Speu province has been undertaken to examine the AKR contract farming scheme arrangements and to identify farmer’s motivations to participate in contract farming and its impact on farmers’ livelihood.AKR rice contract farming improves farmers’ livelihood because they get a higher income and rice yields. Higher price, good rice seed, and access to market are the main reasons for farmers to participate in AKR contract farming. However, strict requirements, heavy penalties, poor extension services, and lack of information about the contract terms and conditions reduce farmers’ long-term participation in contract farming. In addition

  18. Using social network analysis to evaluate health-related adaptation decision-making in Cambodia.

    Science.gov (United States)

    Bowen, Kathryn J; Alexander, Damon; Miller, Fiona; Dany, Va

    2014-01-30

    Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or 'shadow networks') in the context of climate change adaptation policy and activities. The health governance 'map' in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes.

  19. Risk aversion, time preference and health production: theory and empirical evidence from Cambodia.

    Science.gov (United States)

    Rieger, Matthias

    2015-04-01

    This paper quantifies the relationship between risk aversion and discount rates on the one hand and height and weight on the other. It studies this link in the context of poor households in Cambodia. Evidence is based on an original dataset that contains both experimental measures of risk taking and impatience along with anthropometric measurements of children and adults. The aim of the paper is to (i) explore the importance of risk and time preferences in explaining undernutrition and (ii) compare the evidence stemming from poor households to strikingly similar findings from industrialized countries. It uses an inter-generational approach to explain observed correlations in adults and children that is inspired by the height premium on labor markets. Parents can invest in the health capital of their child to increase future earnings and their consumption when old: better nutrition during infancy translates into better human capital and better wages, and ultimately better financial means to take care of elderly parents. However this investment is subject to considerable uncertainty, since parents neither perfectly foresee economic conditions when the child starts earning nor fully observe the ability to transform nutritional investments into long-term health capital. As a result, risk taking households have taller and heavier children. Conversely, impatience does not affect child health. In the case of adults, only weight and the body mass index (BMI), but not height, are positively and moderately correlated with risk taking and impatience. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Active prospective surveillance study with post-discharge surveillance of surgical site infections in Cambodia

    Directory of Open Access Journals (Sweden)

    José Guerra

    2015-05-01

    Full Text Available Summary: Barriers to the implementation of the Centers for Disease Control and Prevention (CDC guidelines for surgical site infection (SSI surveillance have been described in resource-limited settings. This study aimed to estimate the SSI incidence rate in a Cambodian hospital and to compare different modalities of SSI surveillance. We performed an active prospective study with post-discharge surveillance. During the hospital stay, trained surveyors collected the CDC criteria to identify SSI by direct examination of the surgical site. After discharge, a card was given to each included patient to be presented to all practitioners examining the surgical site. Among 167 patients, direct examination of the surgical site identified a cumulative incidence rate of 14 infections per 100 patients. An independent review of medical charts presented a sensitivity of 16%. The sensitivity of the purulent drainage criterion to detect SSIs was 83%. After hospital discharge, 87% of the patients provided follow-up data, and nine purulent drainages were reported by a practitioner (cumulative incidence rate: 20%. Overall, the incidence rate was dependent on the surveillance modalities. The review of medical charts to identify SSIs during hospitalization was not effective; the use of a follow-up card with phone calls for post-discharge surveillance was effective. Keywords: Surgical wound infection, Cambodia, Infection control, Developing countries, Follow-up studies, Feasibility studies

  1. Social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia.

    Science.gov (United States)

    Wong, M L; Lubek, I; Dy, B C; Pen, S; Kros, S; Chhit, M

    2003-04-01

    To determine the social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia. Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap for HIV screening. Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91, 95% CI: 1.15 to 3.18) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51, 95% CI: 1.01 to 2.26), after adjustment for age, educational level, marital status, number of sexual encounters per week, and knowledge of AIDS/HIV and sexually transmitted infections. The most frequently reported reason for not using condoms with clients was not being able to persuade them (66.7%), while for non-paying partners, the reason was that they loved them (60.0%). To complement the government's current programme of client education, 100% condom policy and brothel administrative measures, additional strategies to increase condom use among clients and non-paying partners should be directed at (i) the social policy and community levels to address sex workers' economic and cultural barriers to condom use, and (ii) personal level empowerment through developing sex workers' condom negotiation skills.

  2. Parental styles in the intergenerational transmission of trauma stemming from the Khmer Rouge regime in Cambodia.

    Science.gov (United States)

    Field, Nigel P; Muong, Sophear; Sochanvimean, Vannavuth

    2013-10-01

    The impact of parental styles in intergenerational transmission of trauma among mothers who survived the Khmer Rouge regime in Cambodia, in power from 1975 to 1979, and their teenaged children was examined in 2 studies. In Study 1, 46 Cambodian female high school students and their mothers were recruited. Each daughter completed anxiety and depression measures as well as assessment of her mother's role-reversing, overprotective, and rejecting parental styles, whereas the mothers completed measures of their trauma exposure during the Khmer Rouge regime and PTSD symptoms. In support of trauma transmission, the mother's PTSD symptoms were predictive of her daughter's anxiety. Moreover, the mother's role-reversing parental style was shown to mediate the relationship between her own and her daughter's symptoms. In support of their generalizability, the results were replicated in Study 2 in a Cambodian-American refugee sample comparing 15 mental health treatment-seeking mothers and their teenaged children with 17 nontreatment-seeking mother-child pairs. The implications of the findings within the larger literature on intergenerational trauma transmission stemming from genocide are discussed. © 2013 American Orthopsychiatric Association.

  3. Vitamin A supplementation in Cambodia: program coverage and association with greater maternal formal education.

    Science.gov (United States)

    Grover, Davinder S; Pee, Saskia de; Sun, Kai; Raju, V K; Bloem, Martin W; Semba, Richard D

    2008-01-01

    Vitamin A supplementation reduces morbidity, mortality, and blindness among children in developing countries. The objective of this study is to characterize the coverage of the Cambodian national vitamin A program among preschool children and to identify risk factors for not receiving vitamin A supplementation. The study subjects were preschool children and their families who participated in the 2005 Cambodian Demographic and Health Survey (CDHS), a nationally representative survey. Of 1,547 preschool children, aged 12-59 months, 42.8% received a vitamin A capsule within the last six months. There were no significant differences in paternal education, child age, fever within the last 2 weeks, stunting, underweight, or wasting between children who did or did not receive a vitamin A capsule. Maternal education of > or =10 years (Odds Ratio [OR] 2.09, 95% Confidence Interval [CI] 1.02-4.29), 7-9 years (OR 1.46, 95% CI 0.99-2.15), 4-6 years (OR 1.71, 95% CI 1.26-2.32), and 1-3 years (OR 1.50, 95% CI 1.10-2.06) was associated with the child receiving a vitamin A capsule compared to no formal education in multivariate analyses adjusting for other potential confounders. The national vitamin A supplementation program in Cambodia did not reach over one-half of preschool children in 2005. Greater maternal formal education appears to be an important determinant for receipt of a vitamin A capsule by preschool children.

  4. Who Wants to Save the Forest? Characterizing Community-Led Monitoring in Prey Lang, Cambodia

    Science.gov (United States)

    Turreira-García, Nerea; Meilby, Henrik; Brofeldt, Søren; Argyriou, Dimitris; Theilade, Ida

    2018-06-01

    Community monitoring is believed to be successful only where there is sustained funding, legislation for communities to enforce rules, clear tenure rights, and an enabling environment created by the state. Against this backdrop, we present the case of an autonomous grassroots-monitoring network that took the initiative to protect their forest, in a context, where no external incentives and rule enforcement power were provided. The aim was to analyze the socio-demographic and economic backgrounds, motivations and achievements of forest monitors, compared to non-monitors in the same communities. A total of 137 interviews were conducted in four villages bordering Prey Lang forest in Cambodia. We used binary logit models to identify the factors that influenced the likelihood of being a monitor. Results show that there were few (22%, n = 30) active monitors. Active monitors were intrinsically motivated forest-users, and not specifically associated with a particular gender, ethnicity, or residence-time in that area. The most common interventions were with illegal loggers, and the monitors had a general feeling of success in stopping the illegal activities. Most (73%, n = 22) of them had been threatened by higher authorities and loggers. Our results show that despite the lack of power to enforce rules, absence of external funding and land-ownership rights, and enduring threats of violence and conflicts, autonomous community monitoring may take place when community members are sufficiently motivated by the risk of losing their resources.

  5. Microbioligical Hazard Contamination in Fermented Vegetables Sold in Local Markets in Cambodia.

    Science.gov (United States)

    Chrun, Rithy; Hosotani, Yukie; Kawasaki, Susumu; Inatsu, Yasuhiro

    2017-01-01

     Fermented vegetables are common part of Cambodian diet. The food safety status for these foods has not been investigated. This study was conducted to evaluate the microbiological hazards that contaminated fermented vegetables. A total of 68 samples of fermented vegetables were purchased randomly from five wet markets in Phnom Penh. The conventional culture methods for microbiological analysis were used. Coliform bacteria (Escherichia coli, Cronobactersakazakii, and Enterobacter spp.), opportunistic non-Entrobacteriaceae, Enterococcus spp., Staphylococcus spp., and Listeria spp. were found in these fermented foods. The highest contamination rate of Enterococcus spp. was 34% of total fermented vegetable samples, followed by Bacillus spp. coliform bacteria and E. coli (31%, 24% and 10%, respectively). The potential foodborne pathogen, C. sakazakii, was identified in one sample. Fermented mixed vegetables showed higher contamination rate of coliform bacteria (50%) than fermented single-type vegetables (13%). The results showed that fermented vegetables sold in wet market are poor in hygiene. The stage in the processing chain where contamination occurred should be identified and basic sanitary practice should be enforced to improve the food safety of fermented vegetables in Cambodia.

  6. Condom negotiation and use among female sex workers in Phnom Penh, Cambodia.

    Science.gov (United States)

    Bui, Thanh Cong; Markham, Christine M; Tran, Ly T H; Beasley, R Palmer; Ross, Michael W

    2013-02-01

    We examined condom-use negotiation strategies and condom use among 81 female sex workers (FSWs) in Phnom Penh, Cambodia. Percentages of FSWs who did not negotiate condom use or could not describe a negotiation strategy with native clients, foreign clients, and non-paying partners were 15.0, 29.0 and 67.6 %, respectively. The most common negotiation strategy used was "provision of risk information" for native clients (43.8 %) and non-paying partners (26.5 %), and "direct request" for foreign clients (39.5 %). About half could not describe more than one negotiation strategy. Consistent condom use was high with native clients (98.8 %), yet comparatively lower with foreign clients (86.9 %) and non-paying partners (26.5 %). FSWs who did not negotiate or did not know how to negotiate condom use were less likely to report condom use with non-paying regular partners. Future interventions should enhance condom negotiation strategies between FSWs and all partner types.

  7. Using Social Network Analysis to Evaluate Health-Related Adaptation Decision-Making in Cambodia

    Directory of Open Access Journals (Sweden)

    Kathryn J. Bowen

    2014-01-01

    Full Text Available Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or ‘shadow networks’ in the context of climate change adaptation policy and activities. The health governance ‘map’ in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes.

  8. Collaborating for resilience: conflict, collective action, and transformation on Cambodia's Tonle Sap Lake

    Directory of Open Access Journals (Sweden)

    Blake D. Ratner

    2014-09-01

    Full Text Available We report on outcomes and lessons learned from a 15-month initiative in Cambodia's Tonle Sap Lake. Employing the appreciation-influence-control (AIC model of participatory stakeholder engagement, the initiative built shared understanding of the sources of vulnerability in fisheries livelihoods and catalyzed collective action to support resilience in this valuable and productive social-ecological system. Outcomes include the transfer of a large, commercial fishing concession to community access, and resolution of a boundary dispute involving community fishery organizations in neighboring provinces. Motivated by these successes, the main national grassroots network representing fishing communities also modified its internal governance and strategy of engagement to emphasize constructive links with government and the formal NGO sector. The AIC approach, we argue, provides an effective route to enable collective action in ways that strengthen dialogue and collaboration across scales, fostering the conditions for local-level transformations that can contribute to improvement in governance. We conclude with a discussion of the broader implications for resilience practice.

  9. Land Reforms and the Tragedy of the Anticommons—A Case Study from Cambodia

    Directory of Open Access Journals (Sweden)

    Dirk Loehr

    2012-04-01

    Full Text Available Most of the land reforms of recent decades have followed an approach of “formalization and capitalization” of individual land titles (de Soto 2000. However, within the privatization agenda, benefits of unimproved land (such as land rents and value capture are reaped privately by well-organized actors, whereas the costs of valorization (e.g., infrastructure or opportunity costs of land use changes are shifted onto poorly organized groups. Consequences of capitalization and formalization include rent seeking and land grabbing. In developing countries, formal law often transpires to work in favor of the winners of the titling process and is opposed by the customary rights of the losers. This causes a lack of general acknowledgement of formalized law (which is made responsible for deprivation of livelihoods of vulnerable groups and often leads to a clash of formal and customary norms. Countries may fall into a state of de facto anarchy and “de facto open access”. Encroachment and destruction of natural resources may spread. A reframing of development policy is necessary in order to fight these aberrations. Examples and evidence are provided from Cambodia, which has many features in common with other countries in Asia and Sub-Saharan Africa in this respect.

  10. Poverty, economic growth, deprivation, and water: the cases of Cambodia and Vietnam.

    Science.gov (United States)

    Varis, Olli

    2008-05-01

    Poverty reduction decorates all development agendas, but the complexity of the poverty issue is too often hidden behind simplistic indicators and development goals. Here, a closer look is taken at the concepts of "deprivation" and "vulnerability" as outcomes of poverty. Deprivation leads typically to social exclusion and marginalization; such groups are particularly weak in getting themselves out of poverty by "self-help," and economic growth does not trickle down to these people. When looking at the connections between poverty reduction and economic growth, special emphasis should be put on the differences between modern and more traditional sectors: development of the modern sector should not marginalize and exclude those dependent on more traditional livelihoods. Two case studies--The Tonle Sap area, Cambodia, and the Mekong Delta, Vietnam--reveal that investment in education, empowerment of small-scale entrepreneurship and other means of microeconomic environment, along with good governance, infrastructure, and income distribution can ensure that economic growth includes the poorer echelons of society.

  11. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  12. Microbiological effectiveness of locally produced ceramic filters for drinking water treatment in Cambodia.

    Science.gov (United States)

    Brown, Joe; Sobsey, Mark D

    2010-03-01

    Low-cost options for the treatment of drinking water at the household level are being explored by the Cambodian government and non-governmental organizations (NGOs) working in Cambodia, where many lack access to improved drinking water sources and diarrhoeal diseases are the most prevalent cause of death in children under 5 years of age. The ceramic water purifier (CWP), a locally produced, low-cost ceramic filter, is now being implemented by several NGOs, and an estimated 100,000+households in the country now use them for drinking water treatment. Two candidate filters were tested for the reduction of bacterial and viral surrogates for waterborne pathogens using representative Cambodian drinking water sources (rainwater and surface water) spiked with Escherichia coli and bacteriophage MS2. Results indicate that filters were capable of reducing key microbes in the laboratory with mean reductions of E. coli of approximately 99% and mean reduction of bacteriophages of 90-99% over >600 litres throughput. Increased effectiveness was not observed in filters with an AgNO3 amendment. At under US$10 per filter, locally produced ceramic filters may be a promising option for drinking water treatment and safe storage at the household level.

  13. Social network analysis of cattle movement in Kampong Cham, Kampong Speu and Takeo, Cambodia.

    Science.gov (United States)

    Poolkhet, C; Kasemsuwan, S; Seng, S; Keartha, C; Sokmao, C; Shin, M; Kalpravidh, W; Hinrichs, J

    2016-07-01

    The aim of this study is to provide insight the network of cattle movement in Kampong Cham, Kampong Speu and Takeo, Cambodia. A cross-sectional study was carried out from July 2014 to August 2014, using questionnaires. It was implemented with 435 interviewees (24.4%, 24.6% and 51.0% from Kampong Cham, Kampong Speu and Takeo, respectively) using one-step snowball sampling. The findings suggest that the key players in all three provinces are producers who raise their cattle as backyard animals. In all three provinces the key players in spreading disease are probably the middlemen, collectors, brokers or traders. The network of cattle movement is presented as a strong component of varying size in each location. In this network we found three cut-points in both Kampong Cham and Kampong Speu. The network in each province indicates a random pattern of node distribution. The results of our study are useful to relevant authorities and researchers to understand the spread of infectious diseases into different areas. The middlemen, collectors, brokers and traders need to be controlled as first priority in order to reduce the magnitude of the spread of disease. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Sustainable renewable energy projects for intelligent rural electrification in Laos, Cambodia and Vietnam

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz, Brisa; Vetter, Matthias [Fraunhofer Institute for Solar Energy Systems (ISE), Freiburg (Germany); Bourg, Catherine [Fondation Energies pour le Monde (France); Crehay, Romain [Centre Wallon de Recherches Agronomiques (Belgium)

    2010-07-01

    The project ''Renewable Energy Sustainable Programs for Intelligent Rural Electrifrication'' RESIREA has been looking for the creation of conditions that make possible the establishment of Renewable Energy Technologies (RET) markets in targeted provinces to Lao PDR, Cambodia and Vietnam. As a main result of the project, in three different selected provinces (one in each country) have been proposed villages as ''ready to implement''. The ''ready to implement'' villages are specific RET projects resulted from applying developed methodologies. One methodology is a deeply well structured cross-analysis of technical and economic parameters and the results have been integrated in a Geographical Information System GIS. Based on the least-cost methodology, off-grid biomass and photovoltaic PV power supply systems have been designed and asset for the proposed villages. In the case of PV system designs, a detailed study has been carried out by means of simulations tools and extensive field data. The PV system design looks to contribute to an ''easy scale-up'' concept for off-grid power supply systems, especially when rural communities are too diverse. Further expected benefits besides the supply of electricity services are the improvement of the living and health conditions of the populations, the stimulation of local markets for RET and economic activities. (orig.)

  15. Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies.

    Science.gov (United States)

    Lanjouw, S; Macrae, J; Zwi, A B

    1999-09-01

    The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress the worst effects of conflict and to contribute to the consolidation of peace. Such periods of political transition, and associated aid inflows, constitute an opportunity to improve health services in countries whose health indicators have been among the worst in the world and where access to basic health services is significantly diminished by war. This paper analyzes the particular constraints to effective coordination of health sector aid in situations of 'post'-conflict transition. These include: the uncertain legitimacy and competence of state structures; donor choice of implementing channels; and actions by national and international political actors which served to undermine coordination mechanisms in order to further their respective agendas. These obstacles hindered efforts by health professionals to establish an effective coordination regime, for example, through NGO mapping and the establishment of aid coordinating committees at national and provincial levels. These technical measures were unable to address the basic constitutional question of who had the authority to determine the distribution of scarce resources during a period of transition in political authority. The peculiar difficulties of establishing effective coordination mechanisms are important to address if the long-term effectiveness of rehabilitation aid is to be enhanced.

  16. Low risk for transmission of zoonotic Giardia duodenalis from dogs to humans in rural Cambodia

    DEFF Research Database (Denmark)

    Inpankaew, Tawin; Schär, Fabian; Odermatt, Peter

    2014-01-01

    BACKGROUND: A number of epidemiological studies have demonstrated Giardia as prevalent in both humans and dogs worldwide and have postulated the occurrence of anthroponotic, zoonotic and animal-specific cycles of transmission, which may be geographically and regionally unique in its epidemiology.......: Overall, just over 2% of dogs harboured potentially zoonotic assemblages of G. duodenalis in the studied communities and hence pose a minimal zoonotic risk for the transmission of Giardia to humans.......BACKGROUND: A number of epidemiological studies have demonstrated Giardia as prevalent in both humans and dogs worldwide and have postulated the occurrence of anthroponotic, zoonotic and animal-specific cycles of transmission, which may be geographically and regionally unique in its epidemiology....... The aim of this study was to utilise molecular tools to determine the prevalence and compare genotypes of Giardia duodenalis infecting humans and dogs living in a previously identified Giardia-endemic village in rural Cambodia in order to ascertain zoonotic transmission risk. FINDINGS: The prevalence of G...

  17. Antimicrobial Resistance in Invasive Bacterial Infections in Hospitalized Children, Cambodia, 2007-2016.

    Science.gov (United States)

    Fox-Lewis, Andrew; Takata, Junko; Miliya, Thyl; Lubell, Yoel; Soeng, Sona; Sar, Poda; Rith, Kolthida; McKellar, Gregor; Wuthiekanun, Vanaporn; McGonagle, Erin; Stoesser, Nicole; Moore, Catrin E; Parry, Christopher M; Turner, Claudia; Day, Nicholas P J; Cooper, Ben S; Turner, Paul

    2018-05-01

    To determine trends, mortality rates, and costs of antimicrobial resistance in invasive bacterial infections in hospitalized children, we analyzed data from Angkor Hospital for Children, Siem Reap, Cambodia, for 2007-2016. A total of 39,050 cultures yielded 1,341 target pathogens. Resistance rates were high; 82% each of Escherichia coli and Klebsiella pneumoniae isolates were multidrug resistant. Hospital-acquired isolates were more often resistant than community-acquired isolates; resistance trends over time were heterogeneous. K. pneumoniae isolates from neonates were more likely than those from nonneonates to be resistant to ampicillin-gentamicin and third-generation cephalosporins. In patients with community-acquired gram-negative bacteremia, third-generation cephalosporin resistance was associated with increased mortality rates, increased intensive care unit admissions, and 2.26-fold increased healthcare costs among survivors. High antimicrobial resistance in this setting is a threat to human life and the economy. In similar low-resource settings, our methods could be reproduced as a robust surveillance model for antimicrobial resistance.

  18. Evidence for avian H9N2 influenza virus infections among rural villagers in Cambodia.

    Science.gov (United States)

    Blair, Patrick J; Putnam, Shannon D; Krueger, Whitney S; Chum, Channimol; Wierzba, Thomas F; Heil, Gary L; Yasuda, Chadwick Y; Williams, Maya; Kasper, Matthew R; Friary, John A; Capuano, Ana W; Saphonn, Vonthanak; Peiris, Malik; Shao, Hongxia; Perez, Daniel R; Gray, Gregory C

    2013-04-01

    Southeast Asia remains a critical region for the emergence of novel and/or zoonotic influenza, underscoring the importance of extensive sampling in rural areas where early transmission is most likely to occur. In 2008, 800 adult participants from eight sites were enrolled in a prospective population-based study of avian influenza (AI) virus transmission where highly pathogenic avian influenza (HPAI) H5N1 virus had been reported in humans and poultry from 2006 to 2008. From their enrollment sera and questionnaires, we report risk factor findings for serologic evidence of previous infection with 18 AI virus strains. Serologic assays revealed no evidence of previous infection with 13 different low-pathogenic AI viruses or with HPAI avian-like A/Cambodia/R0404050/2007(H5N1). However, 21 participants had elevated antibodies against avian-like A/Hong Kong/1073/1999(H9N2), validated with a monoclonal antibody blocking ELISA assay specific for avian H9. Although cross-reaction from antibodies against human influenza viruses cannot be completely excluded, the study data suggest that a number of participants were previously infected with the avian-like A/Hong Kong/1073/1999(H9N2) virus, likely due to as yet unidentified environmental exposures. Prospective data from this cohort will help us better understand the serology of zoonotic influenza infection in a rural cohort in SE Asia. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. All rights reserved.

  19. Municipal solid waste management in Phnom Penh, capital city of Cambodia.

    Science.gov (United States)

    Seng, Bunrith; Kaneko, Hidehiro; Hirayama, Kimiaki; Katayama-Hirayama, Keiko

    2011-05-01

    This paper presents an overview of municipal solid waste management (MSWM) for both technical and regulatory arrangements in the municipality of Phnom Penh (MPP), Cambodia. Problems with the current MSWM are identified, and challenges and recommendations for future improvement are also given in this paper. MPP is a small city with a total area of approximately 374 km(2) and an urban population of about 1.3 million in 2008. For the last 14 years, average annual municipal solid waste (MSW) generated in MPP has increased rapidly from 0.136 million tons in 1995 to 0.361 million tons in 2008. The gross generation rate of MSW per capita was 0.74 kg day(-1). However, the per capita household waste generation was 0.487 kg day(- 1). At 63.3%, food waste is the predominant portion of generated waste, followed by plastics (15.5%), grass and wood (6.8%), and paper and cardboard (6.4%). The remaining waste, including metals, glass, rubber/leather, textiles, and ceramic/ stone, accounted for less than 3%. Waste recycling through informal sectors is very active; recycled waste accounted for about 9.3% of all waste generated in 2003. Currently, the overall technical arrangement, including storage and discharge, collection and transport, and disposal, is still in poor condition, which leads to environmental and health risks. These problems should be solved by improving legislation, environmental education, solid waste management facilities, and management of the waste scavengers.

  20. Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia

    Science.gov (United States)

    Ly, Sowath; Ouk, Vara; Chanroeurn, Hak; Thavary, Saem; Boroath, Ban; Canestri, Ana; Viretto, Gérald; Delfraissy, Jean-François; Ségéral, Olivier

    2016-01-01

    Background Lopinavir/ritonavir (LPV/r) is widely used in Cambodia with high efficacy but scarce data exist on long-term metabolic toxicity. Methods We carried out a cross-sectional and retrospective study evaluating metabolic disorders and cardiovascular risk in Cambodian patients on LPV/r-based antiretroviral therapy (ART) for > 1 year followed in Calmette Hospital, Phnom Penh. Data collected included cardiovascular risk factors, fasting blood lipids and glucose, and retrospective collection of bioclinical data. We estimated the 10-year risks of coronary heart disease with the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations. We identified patients with LDL above targets defined by the French expert group on HIV and by the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (IDSA-AACTG). Results Of 115 patients enrolled—mean age 40.9 years, 69.2% male, mean time on LPV/r 3.8 years—40 (34.8%) had hypercholesterolemia (> 2.40 g/L), and 69 (60.0%) had low HDL cholesterol (dyslipidemia was high in this cohort of HIV-infected Cambodian patients on LPV/r. Roughly one third had high LDL levels requiring specific intervention. PMID:27579612

  1. SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia

    Directory of Open Access Journals (Sweden)

    Thuong T. Nguyen

    2014-11-01

    Full Text Available Background: The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. However, the paperbased format of the checklist makes administration cumbersome and limits timely analysis and communication of results. Development of e-Tool: In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors’ feedback about usability. Outcomes: The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries.

  2. Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones

    Directory of Open Access Journals (Sweden)

    Kaewkungwal Jaranit

    2011-05-01

    Full Text Available Abstract Background Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging. Methods A survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours. Results The majority of migrants from Myanmar are long-term residents (98% with no plans to move back to Myanmar, understand spoken Thai (77% and can therefore benefit from health messages in Thai, have Thai health insurance (99% and accessed public health services in Thailand (63% for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%. Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%, self-treated (11%, or did not seek treatment for their last illness (27%. Conclusion Most highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of

  3. Access to mental health and psychosocial services in Cambodia by survivors of trafficking and exploitation: a qualitative study.

    Science.gov (United States)

    Aberdein, Charlotte; Zimmerman, Cathy

    2015-01-01

    Emerging evidence indicates the extreme forms of violence and acute and longer-term mental health consequences associated with trafficking and exploitation. However, there has been little research on post-trafficking mental health and psychosocial support services for survivors. This study explored the availability and accessibility of mental health and psychosocial support services in Cambodia for women, men and children trafficked and exploited for sex or labour purposes. Semi-structured interviews were conducted with a purposively selected sample of representatives from seven service organizations providing mental health and psychosocial support services for people who have been trafficked. This qualitative method was selected to gain insights into the service approaches and challenges faced by the small number of post-trafficking service providers in Cambodia. A conceptual framework outlining access dimensions associated with service provision guided the structure of the study. Findings indicate that among the available post-trafficking services, there are few trained mental health specialists, an over-representation of shelter services in urban versus rural areas and limited services for males, people with disabilities, individuals exploited for labour (versus sexual exploitation) and those with more serious mental illnesses. Providers believe that discrimination and stigma related to both mental health and human trafficking hinder trafficked people's willingness to access services, but suggest that awareness-raising may reduce these prejudices. Care in this sector is precarious due to over-reliance on financial support by donors versus government. Recent increases in newly qualified professionals and providers suggest potential improvements in the quality and availability of psychological support for trafficking survivors. Psychological support for the growing number of identified trafficking survivors in Cambodia will depend on improved geographical

  4. A Comprehensive Approach to Motorcycle-Related Head Injury Prevention: Experiences from the Field in Vietnam, Cambodia, and Uganda.

    Science.gov (United States)

    Craft, Greig; Van Bui, Truong; Sidik, Mirjam; Moore, Danielle; Ederer, David J; Parker, Erin M; Ballesteros, Michael F; Sleet, David A

    2017-11-30

    Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; however, both child and adult helmet use are low in many countries where motorcycles are a primary mode of transportation. In response to the need to increase helmet use by all drivers and their passengers, the Global Helmet Vaccine Initiative (GHVI) was established to increase helmet use in three countries where a substantial portion of road users are motorcyclists and where helmet use is low. The GHVI approach includes five strategies to increase helmet use: targeted programs, helmet access, public awareness, institutional policies, and monitoring and evaluation. The application of GHVI to Vietnam, Cambodia, and Uganda resulted in four key lessons learned. First, motorcyclists are more likely to wear helmets when helmet use is mandated and enforced. Second, programs targeted to at-risk motorcyclists, such as child passengers, combined with improved awareness among the broader population, can result in greater public support needed to encourage action by decision-makers. Third, for broad population-level change, using multiple strategies in tandem can be more effective than using a single strategy alone. Lastly, the successful expansion of GHVI into Cambodia and Uganda has been hindered by the lack of helmet accessibility and affordability, a core component contributing to its success in Vietnam. This paper will review the development of the GHVI five-pillar approach in Vietnam, subsequent efforts to implement the model in Cambodia and Uganda, and lessons learned from these applications to protect motorcycle drivers and their adult and child passengers from injury.

  5. Effect of a mobile phone-based intervention on post-abortion contraception: a randomized controlled trial in Cambodia

    Science.gov (United States)

    Ngo, Thoai D; Gold, Judy; Edwards, Phil; Vannak, Uk; Sokhey, Ly; Machiyama, Kazuyo; Slaymaker, Emma; Warnock, Ruby; McCarthy, Ona; Free, Caroline

    2015-01-01

    Abstract Objective To assess the effect of a mobile phone-based intervention (mHealth) on post-abortion contraception use by women in Cambodia. Methods The Mobile Technology for Improved Family Planning (MOTIF) study involved women who sought safe abortion services at four Marie Stopes International clinics in Cambodia. We randomly allocated 249 women to a mobile phone-based intervention, which comprised six automated, interactive voice messages with counsellor phone support, as required, whereas 251 women were allocated to a control group receiving standard care. The primary outcome was the self-reported use of an effective contraceptive method, 4 and 12 months after an abortion. Findings Data on effective contraceptive use were available for 431 (86%) participants at 4 months and 328 (66%) at 12 months. Significantly more women in the intervention than the control group reported effective contraception use at 4 months (64% versus 46%, respectively; relative risk, RR: 1.39; 95% confidence interval, CI: 1.17–1.66) but not at 12 months (50% versus 43%, respectively; RR: 1.16; 95% CI: 0.92–1.47). However, significantly more women in the intervention group reported using a long-acting contraceptive method at both follow-up times. There was no significant difference between the groups in repeat pregnancies or abortions at 4 or 12 months. Conclusion Adding a mobile phone-based intervention to abortion care services in Cambodia had a short-term effect on the overall use of any effective contraception, while the use of long-acting contraceptive methods lasted throughout the study period. PMID:26668436

  6. Drug-resistant tuberculosis in HIV-infected patients in a national referral hospital, Phnom Penh, Cambodia

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    Genevieve Walls

    2015-01-01

    Full Text Available Background and objective: There are no recent data on the prevalence of drug-resistant tuberculosis (DR TB in Cambodia. We aim to describe TB drug resistance amongst adults with pulmonary and extra-pulmonary TB and human immunodeficiency virus (HIV co-infection in a national referral hospital in Phnom Penh, Cambodia. Design: Between 22 November 2007 and 30 November 2009, clinical specimens from HIV-infected patients suspected of having TB underwent routine microscopy, Mycobacterium tuberculosis culture, and drug susceptibility testing. Laboratory and clinical data were collected for patients with positive M. tuberculosis cultures. Results: M. tuberculosis was cultured from 236 HIV-infected patients. Resistance to any first-line TB drug occurred in 34.7% of patients; 8.1% had multidrug resistant tuberculosis (MDR TB. The proportion of MDR TB amongst new patients and previously treated patients was 3.7 and 28.9%, respectively (p<0.001. The diagnosis of MDR TB was made after death in 15.8% of patients; in total 26.3% of patients with MDR TB died. The diagnosis of TB was established by culture of extra-pulmonary specimens in 23.6% of cases. Conclusions: There is significant resistance to first-line TB drugs amongst new and previously treated TB–HIV co-infected patients in Phnom Penh. These data suggest that the prevalence of DR TB in Cambodia may be higher than previously recognised, particularly amongst HIV-infected patients. Additional prevalence studies are needed. This study also illustrates the feasibility and utility of analysis of non-respiratory specimens in the diagnosis of TB, even in low-resource settings, and suggests that extra-pulmonary specimens should be included in TB diagnostic algorithms.

  7. Seroprevalence, genotypic distribution and potential risk factors of hepatitis B and C virus infections among adults in Siem Reap, Cambodia.

    Science.gov (United States)

    Yamada, Hiroko; Fujimoto, Mayumi; Svay, Somana; Lim, Olline; Hok, Sirany; Goto, Noboru; Ohisa, Masayuki; Akita, Tomoyuki; Matsuo, Junko; Do, Son Huy; Katayama, Keiko; Miyakawa, Yuzo; Tanaka, Junko

    2015-04-01

    We investigated hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among adults in Siem Reap, Cambodia, to consider the prevention strategy in cooperation with the Ministry of Health in Cambodia. Serological tests for determining HBV and HCV infections and questionnaires were performed from 2010 to 2012 among the general population in the province of Siem Reap. Multivariate logistic regression analysis was conducted to clarify the factors related to HBV and HCV infections. There were 483 participants, comprising 194 men and 289 women (age range, 18-89 years). The prevalence of hepatitis B surface antigen was not very high at 4.6%, while anti-hepatitis B core (anti-HBc) was high at 38.5%. All HBV DNA samples were classified as genotype C. Anti-HBc showed the trend that the older the age, the higher the positive rate (P = 0.0002). The prevalence of HCV RNA and anti-HCV were 2.3% and 5.8%, respectively. HCV RNA was detected in 39.3% of anti-HCV positive samples and most of them were classified as genotype 6 (54.5%) and 1 (27.3%). Remarkably, in multivariate logistic regression analysis, history of operation and blood transfusion were significantly associated with the positivity for HBV infection and HCV RNA, respectively. Our results showed that operation and blood transfusion were potential risk factors for HBV and HCV infection, respectively, and supposed that horizontal HBV transmission may be frequent in adults in Cambodia. Hence, for reducing HBV and HCV infections, it is necessary to improve the safety of blood and medical treatment. © 2014 The Japan Society of Hepatology.

  8. Forest Disturbances and Regrowth Assessment Using ALOS PALSAR Data from 2007 to 2010 in Vietnam, Cambodia and Lao PDR

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    Stéphane Mermoz

    2016-03-01

    Full Text Available This paper aims to develop a new methodology for monitoring forest disturbances and regrowth using ALOS PALSAR data in tropical regions. In the study, forest disturbances and regrowth were assessed between 2007 and 2010 in Vietnam, Cambodia and Lao People’s Democratic Republic. The deforestation rate in Vietnam has been among the highest in the tropics in the last few decades, and those in Cambodia and Lao are increasing rapidly. L-band ALOS PALSAR mosaic data were used for the detection of forest disturbances and regrowth, because L-band SAR intensities are sensitive to forest aboveground biomass loss. The methodology used here combines SAR data processing, which is particularly suited for change detection, forest detection and forest disturbances and regrowth detection using expectation maximization, which is closely related to fuzzy logic. A reliable training and testing database has been derived using AVNIR-2 and Google Earth images for calibration and validation. Efforts were made to apply masking areas that are likely to show different SAR backscatter temporal behaviors from the forests considered in the study, including mangroves, inundated forests, post-flooding or irrigated croplands and water bodies, as well as sloping areas and urban areas. The resulting forest disturbances and regrowth map (25-m resolution indicates disturbance rates of −1.07% in Vietnam, −1.22% in Cambodia and −0.94% in Lao between 2007 and 2010, with corresponding aboveground biomass losses of 60.7 Tg, 59.2 Tg and 83.8 Tg , respectively. It is expected that the method, relying on free of charge data (ALOS and ALOS2 mosaics, can be applied widely in the tropics.

  9. High prevalence of non-communicable diseases and associated risk factors amongst adults living with HIV in Cambodia.

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    Pheak Chhoun

    Full Text Available With rapid expansion of antiretroviral therapy for HIV, there are rising life expectancies among people living with HIV. As a result, co-morbidity from non-communicable diseases in those living and aging with HIV is increasingly being reported. Published data on this issue have been limited in Cambodia. The aim of this study was to determine the prevalence of diabetes mellitus, hypertension and hypercholesterolemia and associated risk factors in adults living with HIV in Cambodia.This cross-sectional study was conducted in five provinces of Cambodia from May-June 2015. Information was obtained on socio-demographic and clinical characteristics through face-to-face interviews using a structured questionnaire, and anthropometric and biochemical measurements were performed. Diabetes mellitus was diagnosed with fasting blood glucose ≥126 mg/dl, hypertension with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and hypercholesterolemia with fasting blood cholesterol ≥190 mg/dl. Multivariable logistic regression analyses were used to explore risk factors.The study sample included 510 adults living with HIV; 67% were female, with a mean age of 45 (standard deviation = 8 years. Of these, 8.8% had diabetes mellitus, 15.1% had hypertension and 34.7% had hypercholesterolemia. Of the total participants with non-communicable diseases (n = 244, 47.8% had one or more diseases, and 75% were not aware of their diseases prior to the study: new disease was diagnosed in 90% of diabetes mellitus, 44% of hypertension and 90% of hypercholesterolemia. Single disease occurred in 81%, dual disease in 17% and triple disease in 2%. In adjusted analyses, those consuming 1 serving of fruit compare to 2 servings as significantly with diabetes mellitus, those eating 1 serving of fruit compare to 2 servings and using lard for cooking were significantly associated with hypertension, and those being unemployed, having monthly income less than 100

  10. Utilizing three years of epidemiological data from medical missions in Cambodia to shape the mobile medical clinic formulary

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    Jeany Kim Jun

    2017-01-01

    Full Text Available Objective: The purpose of this project was to gather epidemiological data on common diseases and medications dispensed during medical mission trips to Cambodia to shape the mobile medical clinic formulary. Methods: Data for patients seen during week-long mobile medical clinics was collected in Cambodia during Septembers 2012 to 2014. Each patient’s gender, age, weight, blood pressure, glucose, pertinent laboratory values, diagnoses, and medications dispensed were collected. Blood pressure and glucose levels were measured in patients 18 years and above. Data collected onto paper intake forms were transferred onto spreadsheets without patient identifying information and analyzed for aggregate means, common diseases, and most dispensed medications. This project received institutional review board approval. Results: A total of 1,015 patients were seen over three years. Women made up 61.4%, and the mean age was 41.8 years. The most common diagnosis was gastrointestinal disorders (22.9% that included gastroesophageal reflux disease and intestinal parasites. Next, 20.1% of patients had hypertension (BP>140/90, 18.0% had presbyopia, 15.4% had back and joint pain, followed by 8.8% with headache, including migraines. Approximately 8.4% of patients had hyperglycemia (RPG >140 mg/dl. The top five medications dispensed were acetaminophen, omeprazole, multivitamin, ibuprofen, and metformin. For hypertension, amlodipine and lisinopril were dispensed. Conclusion: Cambodia lacks systematic public health collection of epidemiological data for prevalence of diseases. Hence, investigators collected and analyzed information from week-long mobile medical clinics over three years. Proton-pump inhibitors and H. pylori lab tests were recommended for gastrointestinal disorders. Acetaminophen and ibuprofen were recommended for pain. Angiotensin-converting-enzyme inhibitors and dihydropyridine calcium channel blockers were recommended over diuretics since patients were

  11. Ten year experience with antiretroviral treatment in Cambodia: Trends in patient characteristics and treatment outcomes.

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    Phirum Lay

    Full Text Available Although HIV disease stage at ART initiation critically determines ART outcomes, few reports have longitudinally monitored this within Asia. Using prospectively collected data from a large ART program at Sihanouk Hospital Center of Hope in Cambodia, we report on the change in patient characteristics and outcomes over a ten-year period.We conducted a retrospective analysis including all adults (≥ 18 years old starting ART from March 2003-March 2013 in a non-governmental hospital in Phnom Penh, Cambodia. The cumulative incidence of death, lost to follow-up (LTFU, attrition (death or LTFU and first line treatment failure were calculated using Kaplan-Meier methods. Independent risk factors for these outcomes were determined using Cox regression modeling.Over the ten-year period, 3581 patients initiated ART with a median follow-up time of 4.8 years (IQR 2.8-7.2. The median age was 35 years (IQR 30-41, 54% were female. The median CD4 count at ART initiation increased from 22 cells/μL (IQR 4-129 in 2003 to 218 (IQR 57-302 in 2013. Over the 10 year period, a total of 282 (7.9% individuals died and 433 (12.1% were defined LTFU. Program attrition (died or LTFU was 11.1% (95% CI: 10.1%- 12.4% at one year, 16.3% (95% CI: 15.1%-17.6% at three years, 19.8% (95% CI: 18.5%-21.2% at five years and 23.3% (95% CI: 21.6-25.1 at ten years. Male sex and low baseline body mass index (BMI were associated with increased attrition. Factors independently associated with mortality included a low baseline CD4 count, older age, male sex, low baseline BMI and hepatitis B co-infection. Individuals aged above 40 years old had an increased risk of mortality but were less likely to LTFU. There were a total of 137 individuals with first line ART failure starting second line treatment. The probability of first line failure was estimated at 2.8% (95% CI: 2.3%-3.4% at 3 years, 4.6% (95% CI: 3.9%-5.5% at 5 years and 7.8% (95% CI 4.8%-12.5% at ten years of ART. The probability was

  12. Rational drug use in Cambodia: study of three pilot health centers in Kampong Thom Province.

    Science.gov (United States)

    Chareonkul, Chanin; Khun, Va Luong; Boonshuyar, Chaweewon

    2002-06-01

    This study obtained baseline information for the design of a strategy to address irrational prescribing practices in three health centers in Kampong Thom Province, Cambodia. Indicators of rational drug use have been measured and compared with Standard Guidelines. Data were collected from patients' registers and by interviewing patients immediately after patient-prescriber and patient-dispenser encounters. Checklists and pre-designed forms were used to collect data regarding the World Health Organization drug use indicators and some additional indices. Of the 330 prescriptions analyzed, the results showed that the average number of drugs per prescription was 2.35 and that a large proportion of the prescriptions contained two or more drugs that could result in adverse drug interactions. Prescribing by generic names (99.8%) was encouraging. The exposure of patients to antibiotics (66% to 100%) was high, and injection use (2.4%) was often unnecessary. Prescribing from the Essential Drugs List (99.7%) was satisfactory. The average consultation and dispensing times were short and not sufficient for patients to get health information. All the prescribed drugs were supplied, but all were inadequately labeled. Some 55% of patients knew the correct dosage of their drugs. The availability of key essential drugs (86.6%) was below the Standard. The percentages of appropriate prescriptions for treating malaria, diarrhea and acute respiratory infection treatment were 68.3%, 3.3%, and 45%, respectively. Inappropriate prescriptions were mostly due to unsuitable dosages, incorrect drugs, and the improper duration of treatment. The results suggest a need for intervention to curb the irrational use of drugs in prescribing at the three pilot health centers. Continuing education of prescribers and healthcare providers, monitoring, supervision, public education would be beneficial.

  13. Assessment of Flood Disaster Impacts in Cambodia: Implications for Rapid Disaster Response

    Science.gov (United States)

    Ahamed, Aakash; Bolten, John; Doyle, Colin

    2016-04-01

    Disaster monitoring systems can provide near real time estimates of population and infrastructure affected by sudden onset natural hazards. This information is useful to decision makers allocating lifesaving resources following disaster events. Floods are the world's most common and devastating disasters (UN, 2004; Doocy et al., 2013), and are particularly frequent and severe in the developing countries of Southeast Asia (Long and Trong, 2001; Jonkman, 2005; Kahn, 2005; Stromberg, 2007; Kirsch et al., 2012). Climate change, a strong regional monsoon, and widespread hydropower construction contribute to a complex and unpredictable regional hydrodynamic regime. As such, there is a critical need for novel techniques to assess flood impacts to population and infrastructure with haste during and following flood events in order to enable governments and agencies to optimize response efforts following disasters. Here, we build on methods to determine regional flood extent in near real time and develop systems that automatically quantify the socioeconomic impacts of flooding in Cambodia. Software developed on cloud based, distributed processing Geographic Information Systems (GIS) is used to demonstrate spatial and numerical estimates of population, households, roadways, schools, hospitals, airports, agriculture and fish catch affected by severe monsoon flooding occurring in the Cambodian portion of Lower Mekong River Basin in 2011. Results show modest agreement with government and agency estimates. Maps and statistics generated from the system are intended to complement on the ground efforts and bridge information gaps to decision makers. The system is open source, flexible, and can be applied to other disasters (e.g. earthquakes, droughts, landslides) in various geographic regions.

  14. Crisis Team Management in a Scarce Resource Setting: Angkor Hospital for Children in Siem Reap, Cambodia

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    Richard Alynn Henker

    2017-07-01

    Full Text Available IntroductionA crisis team management (CTM simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2, crisis team training (3, and TeamSTEPPs© models (4. The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance.MethodsEach of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5. CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course.ResultsOf the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve (p < 0.05 for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information.ConclusionTeaching of non-technical skills can be effective in a setting with scarce

  15. Crisis Team Management in a Scarce Resource Setting: Angkor Hospital for Children in Siem Reap, Cambodia.

    Science.gov (United States)

    Henker, Richard Alynn; Henker, Hiroko; Eng, Hor; O'Donnell, John; Jirativanont, Tachawan

    2017-01-01

    A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance. Each of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5). CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course. Of the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve ( p  < 0.05) for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information. Teaching of non-technical skills can be effective in a setting with scarce resources in a Southeastern Asian country.

  16. Evidence for avian H9N2 influenza virus infections among rural villagers in Cambodia

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    Patrick J. Blair

    2013-04-01

    Full Text Available Summary: Background: Southeast Asia remains a critical region for the emergence of novel and/or zoonotic influenza, underscoring the importance of extensive sampling in rural areas where early transmission is most likely to occur. Methods: In 2008, 800 adult participants from eight sites were enrolled in a prospective population-based study of avian influenza (AI virus transmission where highly pathogenic avian influenza (HPAI H5N1 virus had been reported in humans and poultry from 2006 to 2008. From their enrollment sera and questionnaires, we report risk factor findings for serologic evidence of previous infection with 18 AI virus strains. Results: Serologic assays revealed no evidence of previous infection with 13 different low-pathogenic AI viruses or with HPAI avian-like A/Cambodia/R0404050/2007(H5N1. However, 21 participants had elevated antibodies against avian-like A/Hong Kong/1073/1999(H9N2, validated with a monoclonal antibody blocking ELISA assay specific for avian H9. Conclusions: Although cross-reaction from antibodies against human influenza viruses cannot be completely excluded, the study data suggest that a number of participants were previously infected with the avian-like A/Hong Kong/1073/1999(H9N2 virus, likely due to as yet unidentified environmental exposures. Prospective data from this cohort will help us better understand the serology of zoonotic influenza infection in a rural cohort in SE Asia. Keywords: Influenza A virus, Avian, Zoonoses, Occupational exposure, Communicable diseases, Emerging, Cohort studies

  17. Entrenched geographical and socioeconomic disparities in child mortality: trends in absolute and relative inequalities in Cambodia.

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    Eliana Jimenez-Soto

    Full Text Available BACKGROUND: Cambodia has made considerable improvements in mortality rates for children under the age of five and neonates. These improvements may, however, mask considerable disparities between subnational populations. In this paper, we examine the extent of the country's child mortality inequalities. METHODS: Mortality rates for children under-five and neonates were directly estimated using the 2000, 2005 and 2010 waves of the Cambodian Demographic Health Survey. Disparities were measured on both absolute and relative scales using rate differences and ratios, and where applicable, slope and relative indices of inequality by levels of rural/urban location, regions and household wealth. FINDINGS: Since 2000, considerable reductions in under-five and to a lesser extent in neonatal mortality rates have been observed. This mortality decline has, however, been accompanied by an increase in relative inequality in both rates of child mortality for geography-related stratifying markers. For absolute inequality amongst regions, most trends are increasing, particularly for neonatal mortality, but are not statistically significant. The only exception to this general pattern is the statistically significant positive trend in absolute inequality for under-five mortality in the Coastal region. For wealth, some evidence for increases in both relative and absolute inequality for neonates is observed. CONCLUSION: Despite considerable gains in reducing under-five and neonatal mortality at a national level, entrenched and increased geographical and wealth-based inequality in mortality, at least on a relative scale, remain. As expected, national progress seems to be associated with the period of political and macroeconomic stability that started in the early 2000s. However, issues of quality of care and potential non-inclusive economic growth might explain remaining disparities, particularly across wealth and geography markers. A focus on further addressing key

  18. Redeeming qualities: exploring factors that affect women’s use of reproductive health vouchers in Cambodia

    Science.gov (United States)

    2013-01-01

    Background One approach to delivering healthcare in developing countries is through voucher programs, where vouchers are distributed to a specific population for free or subsidized health care. Recent evaluations suggest that vouchers have the potential to extend coverage of priority health services to the poor in developing countries. In Cambodia, a reproductive health voucher program was implemented in January 2011. This study aims to explore women’s early experiences accessing health services with their vouchers at accredited clinics. Methods This qualitative exploratory study used focus group methodology to gather information from five groups of older (>25 years) and four groups of younger (18–25 years) women who were eligible for the voucher program in three rural provinces. Focus groups were digitally recorded, transcribed and translated from Khmer into English. Data analysis was an iterative process, which comprised of open coding to find commonalities that reflected categories or themes and axial coding to relate initial themes to each other. Next, a basic framework for analysis was formed by integrating the themes into the framework. Results Two overarching themes were identified in the data: 1) factors that facilitate voucher use and 2) factors that inhibit voucher use. Within each of these themes, three subthemes were identified: 1) pre-existing factors, 2) distribution factors, and 3) redemption factors. Overall, women expressed positive feelings towards the voucher program, while several areas for program improvement were identified including the importance of addressing pre-existing demand-side barriers to using reproductive health services, the need for more comprehensive counselling during voucher distribution, and the persistent cost of unofficial payments expected by midwives after delivery irrespective of voucher use. Conclusions Early information from program beneficiaries can lead to timely and responsive changes that can help to maximize

  19. Vegetation and vascular flora of the Mekong River, Kratie and Steung Treng Provinces, Cambodia

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    James F. Maxwell

    2009-04-01

    Full Text Available A preliminary and detailed botanical survey of the islands in the Mekong River between Kratie and Steung Treng was done. This area includes the most biologically intact and threatened riparian and terrestrial ecosystems along the river in Cambodia. The vegetation includes six riverine zones and four terrestrial facies. Riverine habitats are mostly intact while the terrestrial vegetation ranges from destroyed to degraded. Effective conservation measures are required to stop further habitat destruction and loss of biodiversity. One new species, 23 records for the Cambodian flora, and a total of 690 species were collected. Detailed descriptions of all habitats, a database, and photographs are included. Increased exploitative human settlement in the area has caused drastic environmental changes with extensive deforestation and hunting. The forests are grazed, burned, logged, and often cleared for agricultural use without effective control. Sustainable management and scientifically acceptable development must be implemented before the area is totally ruined. Properly conceived reforestation is urgently required as well as a conservation education project aimed directly at the people living in the area. Unless effective restraints are implemented the area will become biologically destitute and will not be able to provide the natural resources that people require--in short, the area will become uninhabitable. Restoration of degraded or destroyed places will be impossible or far more difficult than conservation and intelligent management of presently endangered places. The potential for profitable eco-tourism should also be considered since tourists will certainly want to visit natural ecosystems on some of the islands. Only if local people are directly involved in eco-tourism and understand the necessity of conservation can this activity be successful. It is strongly recommended that continued botanical research be conducted in the area in order to

  20. Improving the Effectiveness of the Bio-slurry Extension Component of National Biodigester Program in Cambodia

    Energy Technology Data Exchange (ETDEWEB)

    Islam, M. F.

    2009-10-15

    This report deals with the escalating challenge Cambodia faces in its agricultural sector for providing sufficient feeding to an increasing population, while also having improper soil management. Based on field visits, interviews, regular meetings, training workshops, and joint analysis it was revealed that farmers used both organic (bio-slurry) and inorganic fertilisers but were unaware of the balance needed and required doses of fertiliser. Further, it appeared that farmers have limited access to improve crop management practices, specifically to fertiliser management. In a response to the problem, the current weaknesses, and further scope of improvement of present organisational setup of slurry extension component of NBP and subsidy system have been analysed in depth. Extensive recommendations are offered on an organisational setup level (e.g. strengthen the linkage between Provincial Biogas Program Office-PBPO and Cambodian Centre for Study and Development in Agriculture-CEDAC by involving CEDAC in the planning process), subsidy (e.g. provide subsidy to attract farmers for construction of standard compost hut, boundaries and shade), planning (e.g. bottom up planning approach is suggested where a seasonal planning meeting should be organized at province by the project director involving CEDAC provincial coordinator), development of training materials (e.g. a national consultant should be hired for developing a training manual on bio-slurry systems), training (e.g. strengthen user training by increasing its number, frequency, topics), farmers participatory action research (e.g. the participatory approach should be replaced by a demonstration one), monitoring and reporting (e.g. monitoring system should be established as desk and field monitoring)

  1. What Explains Cambodia's Success in Reducing Child Stunting-2000-2014?

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    Giacomo Zanello

    Full Text Available In many developing countries, high levels of child undernutrition persist alongside rapid economic growth. There is considerable interest in the study of countries that have made rapid progress in child nutrition to uncover the driving forces behind these improvements. Cambodia is often cited as a success case having reduced the incidence of child stunting from 51% to 34% over the period 2000 to 2014. To what extent is this success driven by improvements in the underlying determinants of nutrition, such as wealth and education, ("covariate effects" and to what extent by changes in the strengths of association between these determinants and nutrition outcomes ("coefficient effects"? Using determinants derived from the widely-applied UNICEF framework for the analysis of child nutrition and data from four Demographic and Health Surveys datasets, we apply quantile regression based decomposition methods to quantify the covariate and coefficient effect contributions to this improvement in child nutrition. The method used in the study allows the covariate and coefficient effects to vary across the entire distribution of child nutrition outcomes. There are important differences in the drivers of improvements in child nutrition between severely stunted and moderately stunted children and between rural and urban areas. The translation of improvements in household endowments, characteristics and practices into improvements in child nutrition (the coefficient effects may be influenced by macroeconomic shocks or other events such as natural calamities or civil disturbance and may vary substantially over different time periods. Our analysis also highlights the need to explicitly examine the contribution of targeted child health and nutrition interventions to improvements in child nutrition in developing countries.

  2. Groundwater discharge and phosphorus dynamics in a flood-pulse system: Tonle Sap Lake, Cambodia

    Science.gov (United States)

    Burnett, William C.; Wattayakorn, Gullaya; Supcharoen, Ratsirin; Sioudom, Khamfeuane; Kum, Veasna; Chanyotha, Supitcha; Kritsananuwat, Rawiwan

    2017-06-01

    Tonle Sap Lake (Cambodia), a classic example of a "flood pulse" system, is the largest freshwater lake in SE Asia, and is reported to have one of the highest freshwater fish productions anywhere. During the dry season (November-April) the lake drains through a tributary to the Mekong River. The flow in the connecting tributary completely reverses during the wet monsoon (May-October), adding huge volumes of water back to the lake, increasing its area about six fold. The lake is likely phosphorus limited and we hypothesized that groundwater discharge, including recirculated lake water, may represent an important source of P and other nutrients. To address this question, we surveyed hundreds of kilometers of the lake for natural 222Rn (radon), temperature, conductivity, GPS coordinates and water depth. All major inorganic nutrients and phosphorus species were evaluated by systematic sampling throughout the lake. Results showed that there were radon hotspots, all at the boundaries between the permanent lake and the floodplain, indicating likely groundwater inputs. A radon mass balance model indicates that the groundwater flow to Tonle Sap Lake is approximately 10 km3/yr, about 25% as large as the floodwaters entering from the Mekong River during the wet monsoon. Our results suggest that the groundwater-derived dissolved inorganic phosphorus (DIP) contribution to Tonle Sap is more than 30% of the average inflows from all natural sources. Since the productivity of the lake appears to be phosphorus limited, this finding suggests that the role of groundwater is significant for Tonle Sap Lake and perhaps for other flood pulse systems worldwide.

  3. An Efficient Acoustic Density Estimation Method with Human Detectors Applied to Gibbons in Cambodia.

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    Darren Kidney

    Full Text Available Some animal species are hard to see but easy to hear. Standard visual methods for estimating population density for such species are often ineffective or inefficient, but methods based on passive acoustics show more promise. We develop spatially explicit capture-recapture (SECR methods for territorial vocalising species, in which humans act as an acoustic detector array. We use SECR and estimated bearing data from a single-occasion acoustic survey of a gibbon population in northeastern Cambodia to estimate the density of calling groups. The properties of the estimator are assessed using a simulation study, in which a variety of survey designs are also investigated. We then present a new form of the SECR likelihood for multi-occasion data which accounts for the stochastic availability of animals. In the context of gibbon surveys this allows model-based estimation of the proportion of groups that produce territorial vocalisations on a given day, thereby enabling the density of groups, instead of the density of calling groups, to be estimated. We illustrate the performance of this new estimator by simulation. We show that it is possible to estimate density reliably from human acoustic detections of visually cryptic species using SECR methods. For gibbon surveys we also show that incorporating observers' estimates of bearings to detected groups substantially improves estimator performance. Using the new form of the SECR likelihood we demonstrate that estimates of availability, in addition to population density and detection function parameters, can be obtained from multi-occasion data, and that the detection function parameters are not confounded with the availability parameter. This acoustic SECR method provides a means of obtaining reliable density estimates for territorial vocalising species. It is also efficient in terms of data requirements since since it only requires routine survey data. We anticipate that the low-tech field requirements will

  4. Sediment accumulation owing to backwater effect in the lower reach of the Stung Sen River, Cambodia

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    Nagumo, Naoko; Kubo, Sumiko; Sugai, Toshihiko; Egashira, Shinji

    2017-11-01

    We examined channel bars at two sites in the lower reach of the Stung Sen River, which flows into Lake Tonle Sap, Cambodia, to identify sediment transport and accumulation processes during monsoon-related flood events and to investigate how sediment transport capacity changes as a result of enhanced backwater effect of the lake. Channel bars in the lower reach of the Stung Sen River that emerge in the dry season were classified into type A (lateral bars), type B (point bars), type C (concave-bank benches) and type D (diagonal and island bars, or fluvial dunes) based on Nagumo et al.'s previous study. Type B, type C, and type D channel bars were at our study sites of SEN-01 and SEN-02, about 83 and 77 km from the river mouth respectively. Computation of water surface profiles showed that sediment transport capacity of the Stung Sen River decreased abruptly after the peak flow stage because of the backwater effect from Lake Tonle Sap during the decreasing flow stage. Our observations suggest that alternating layers of sand and silt to clay layers accumulate to form type C channel bars, corresponding to changes in sediment transport capacity controlled by backwater effects from Lake Tonle Sap and by changes in flow depths and associated slackwater systems. The accumulation of alternating silt and sand layers of type B channel bars results from lateral sediment transportation that is accelerated with an increase of secondary flow, whereas development of type D channel bars is related to bedload mobility.

  5. Mass anti-malarial administration in western Cambodia: a qualitative study of factors affecting coverage.

    Science.gov (United States)

    Pell, Christopher; Tripura, Rupam; Nguon, Chea; Cheah, Phaikyeong; Davoeung, Chan; Heng, Chhouen; Dara, Lim; Sareth, Ma; Dondorp, Arjen; von Seidlein, Lorenz; Peto, Thomas J

    2017-05-19

    Mass anti-malarial administration has been proposed as a key component of the Plasmodium falciparum malaria elimination strategy in the Greater Mekong sub-Region. Its effectiveness depends on high levels of coverage in the target population. This article explores the factors that influenced mass anti-malarial administration coverage within a clinical trial in Battambang Province, western Cambodia. Qualitative data were collected through semi-structured interviews and focus group discussions with villagers, in-depth interviews with study staff, trial drop-outs and refusers, and observations in the communities. Interviews were audio-recorded, transcribed and translated from Khmer to English for qualitative content analysis using QSR NVivo. Malaria was an important health concern and villagers reported a demand for malaria treatment. This was in spite of a fall in incidence over the previous decade and a lack of familiarity with asymptomatic malaria. Participants generally understood the overall study aim and were familiar with study activities. Comprehension of the study rationale was however limited. After the first mass anti-malarial administration, seasonal health complaints that participants attributed to the anti-malarial as "side effects" contributed to a decrease of coverage in round two. Staff therefore adapted the community engagement approach, bringing to prominence local leaders in village meetings. This contributed to a subsequent increase in coverage. Future mass anti-malarial administration must consider seasonal disease patterns and the importance of local leaders taking prominent roles in community engagement. Further research is needed to investigate coverage in scenarios that more closely resemble implementation i.e. without participation incentives, blood sampling and free healthcare.

  6. Assessing government’s fiscal space for moving towards universal health coverage in Cambodia

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    Kouland Thin

    2017-01-01

    Full Text Available Background In line with the global trend, it becomes clear that the Cambodian government’s policy direction is leaning toward universal health coverage, the agreed target within the newly ratified Sustainable Development Goals. Thus, the health system will need to be further reformed to achieve this target by 2030. To assess if the Cambodian government is able to increase the proportion of health budget out of the total government expenditure, this study will evaluate the government’s fiscal space and propose feasible options where and to what extent new resources can be generated for improving the health system. Design The data used for this analysis were obtained from World Bank online database and a series of Cambodia’s economic updates produced by the World Bank office in Cambodia. We observed the trends over time from 2011 to 2018 to provide insights into the extent to which fiscal space for health can be expanded. Findings By assessing the key fiscal indicators, it is unlikely that the Cambodian government is able to increase the proportion of health budget out of its total budget in the short run. Health budget is increased in absolute terms but not in real terms, which is linked tightly to the predicted 7% economic growth per annum. Conclusion The proportion of health budget from now until 2018 is expected to remain the same, and the revenues raised through pre‐payment mechanisms are still too small to address the pressing issues in the current health system. The Ministry of Health could benefit from putting a much stronger effort on improving efficiency and equity in the distribution of resources, as well as transparency and accountability, to achieve the immediate objectives for universal health coverage.

  7. Using microfinance to facilitate household investment in sanitation in rural Cambodia.

    Science.gov (United States)

    Geissler, Kimberley H; Goldberg, Jeffrey; Leatherman, Sheila

    2016-11-01

    Improved sanitation access is extremely low in rural Cambodia. Non-governmental organizations have helped build local supply side latrine markets to promote household latrine purchase and use, but households cite inability to pay as a key barrier to purchase. To examine the extent to which microfinance can be used to facilitate household investment in sanitation, we applied a two-pronged assessment: (1) to address the gap between interest in and use of microfinance, we conducted a pilot study to assess microfinance demand and feasibility of integration with a sanitation marketing program and (2) using a household survey (n = 935) at latrine sales events in two rural provinces, we assessed attitudes about microfinance and financing for sanitation. We found substantial stated intent to use a microfinance institution (MFI) loan to purchase a latrine (27%). Five percent of current owners used an MFI loan for latrine purchase. Credit officers attended 159 events, with 4761 individuals attending. Actual loan applications were low, with 4% of sales events attendees applying for a loan immediately following the event (mean = 1.7 loans per event). Ongoing coordination was challenging, requiring management commitment from the sanitation marketing program and commitment to social responsibility from the MFI. Given the importance of improving sanitation coverage and concomitant health impacts, linking functional sanitation markets to already operational finance markets has the potential to give individuals and households more financial flexibility. Further product research and better integration of private vendors and financing modalities are necessary to create a scalable microfinance option for sanitation markets. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. First Direct Dating for the Construction and Modification of the Baphuon Temple Mountain in Angkor, Cambodia.

    Science.gov (United States)

    Leroy, Stéphanie; Hendrickson, Mitch; Delqué-Kolic, Emmanuelle; Vega, Enrique; Dillmann, Philippe

    2015-01-01

    Architecture represents key evidence of dynastic practice and change in the archaeological world. Chronologies for many important buildings and sequences, including the iconic temples of medieval Angkor in Cambodia, are based solely on indirect associations from inscriptions and architectural styles. The Baphuon temple, one of the last major buildings in Angkor without textual or scientifically-derived chronological evidence, is crucial both for the context and date of its construction and the period when its western façade was modified into a unique, gigantic Reclining Buddha. Its construction was part of a major dynastic change and florescence of the Hindu-Mahayana Buddhist state and the modification is the key evidence of Theravada Buddhist power after Angkor's decline in the 15th century. Using a newly-developed approach based on AMS radiocarbon dating to directly date four iron crampons integrated into the structure we present the first direct evidence for the history of the Baphuon. Comprehensive study of ferrous elements shows that both construction and modification were critically earlier than expected. The Baphuon can now be considered as the major temple associated with the imperial reformations and territorial consolidation of Suryavarman I (1010-1050 AD) for whom no previous building to legitimize his reign could be identified. The Theravada Buddhist modification is a hundred years prior to the conventional 16th century estimation and is not associated with renewed use of Angkor. Instead it relates to the enigmatic Ayutthayan occupation of Angkor in the 1430s and 40s during a major period of climatic instability. Accurately dating iron with relatively low carbon content is a decisive step to test long-standing assumptions about architectural histories and political processes for states that incorporated iron into buildings (e.g., Ancient Greece, medieval India). Furthermore, this new approach has the potential to revise chronologies related to iron

  9. First Direct Dating for the Construction and Modification of the Baphuon Temple Mountain in Angkor, Cambodia.

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    Stéphanie Leroy

    Full Text Available Architecture represents key evidence of dynastic practice and change in the archaeological world. Chronologies for many important buildings and sequences, including the iconic temples of medieval Angkor in Cambodia, are based solely on indirect associations from inscriptions and architectural styles. The Baphuon temple, one of the last major buildings in Angkor without textual or scientifically-derived chronological evidence, is crucial both for the context and date of its construction and the period when its western façade was modified into a unique, gigantic Reclining Buddha. Its construction was part of a major dynastic change and florescence of the Hindu-Mahayana Buddhist state and the modification is the key evidence of Theravada Buddhist power after Angkor's decline in the 15th century. Using a newly-developed approach based on AMS radiocarbon dating to directly date four iron crampons integrated into the structure we present the first direct evidence for the history of the Baphuon. Comprehensive study of ferrous elements shows that both construction and modification were critically earlier than expected. The Baphuon can now be considered as the major temple associated with the imperial reformations and territorial consolidation of Suryavarman I (1010-1050 AD for whom no previous building to legitimize his reign could be identified. The Theravada Buddhist modification is a hundred years prior to the conventional 16th century estimation and is not associated with renewed use of Angkor. Instead it relates to the enigmatic Ayutthayan occupation of Angkor in the 1430s and 40s during a major period of climatic instability. Accurately dating iron with relatively low carbon content is a decisive step to test long-standing assumptions about architectural histories and political processes for states that incorporated iron into buildings (e.g., Ancient Greece, medieval India. Furthermore, this new approach has the potential to revise chronologies

  10. Estimated Nutritive Value of Low-Price Model Lunch Sets Provided to Garment Workers in Cambodia

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    Jan Makurat

    2017-07-01

    Full Text Available Background: The establishment of staff canteens is expected to improve the nutritional situation of Cambodian garment workers. The objective of this study is to assess the nutritive value of low-price model lunch sets provided at a garment factory in Phnom Penh, Cambodia. Methods: Exemplary lunch sets were served to female workers through a temporary canteen at a garment factory in Phnom Penh. Dish samples were collected repeatedly to examine mean serving sizes of individual ingredients. Food composition tables and NutriSurvey software were used to assess mean amounts and contributions to recommended dietary allowances (RDAs or adequate intake of energy, macronutrients, dietary fiber, vitamin C (VitC, iron, vitamin A (VitA, folate and vitamin B12 (VitB12. Results: On average, lunch sets provided roughly one third of RDA or adequate intake of energy, carbohydrates, fat and dietary fiber. Contribution to RDA of protein was high (46% RDA. The sets contained a high mean share of VitC (159% RDA, VitA (66% RDA, and folate (44% RDA, but were low in VitB12 (29% RDA and iron (20% RDA. Conclusions: Overall, lunches satisfied recommendations of caloric content and macronutrient composition. Sets on average contained a beneficial amount of VitC, VitA and folate. Adjustments are needed for a higher iron content. Alternative iron-rich foods are expected to be better suited, compared to increasing portions of costly meat/fish components. Lunch provision at Cambodian garment factories holds the potential to improve food security of workers, approximately at costs of <1 USD/person/day at large scale. Data on quantitative total dietary intake as well as physical activity among workers are needed to further optimize the concept of staff canteens.

  11. Re-assessment of woodfuel supply and demand relationships in Kampong Thom Province, Cambodia

    International Nuclear Information System (INIS)

    Top, Neth; Ty, Sokhun; Mizoue, Nobuya; Ito, Satoshi; Kai, Shigetaka; Nakao, Toshio

    2006-01-01

    This study re-examined a previously published relationship between supply and demand for woodfuel at different spatial scales within Kampong Thom Province, Cambodia. We considered three different scales: The first was the whole area of the province. The second scale calculated village-scale data in zones of 1, 3, and 5km from each village and then aggregated for all villages of the province. The third scale also calculated data for the three zones at the village-scale, but the data were then aggregated according to three regional groupings based on population density and forest availability. When evaluating woodfuel supply, we excluded biomass increment of trees with diameter larger than 30cm because it was found that local people rarely collect trees larger than 30cm for fuel. On the demand side, dead wood, which was included in the previous assessment, and woodfuel obtained from non-forest sources were excluded to enable comparison of supply and demand that related only to living trees originating from forests. The re-assessment revealed large decreases in both supply and demand at each scale as compared with our previous assessment; supply reduced by 46% and demand by 36% at the whole province scale. However, the ratios of supply to demand at each scale examined were very similar for both assessments. This re-assessment therefore supports our previous findings: there is a deficiency in woodfuel resources in areas of high population density along the main road due to high woodfuel demand and a predominance of agricultural land and regrowth forest in close proximity to villages. This study underscores the usefulness of taking detailed woodfuel consumption patterns into account when assessing the impact of woodfuel demand on forests. For a more accurate assessment on the sustainability of woodfuel resources and utilization, further research is needed to project future woodfuel demand, not only for green wood from forested sources, but also for dead wood and

  12. Poverty, user fees and ability to pay for health care for children with suspected dengue in rural Cambodia

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    Manderson Lenore

    2008-04-01

    Full Text Available Abstract User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from dengue fever among infants and children reflect the difficulties that women continue to face in finding sufficient cash in cases of medical emergency, resulting in delays in diagnosis and treatment. In this article, drawing on in-depth interviews conducted with mothers of children infected with dengue in eastern Cambodia, we illustrate the profound economic consequences for households when a child is ill. The direct costs for health care and medical services, and added indirect costs, deterred poor women from presenting with sick children. Those who eventually sought care often had to finance health spending through out-of-pocket payments and loans, or sold property, goods or labour to meet the costs. Costs were often catastrophic, exacerbating the extreme poverty of those least able to afford it.

  13. [Histology of liver lesions due to Schistosoma mekongi. About six cases with severe portal hypertension operated in Cambodia].

    Science.gov (United States)

    Monchy, D; Dumurgier, C; Heng, T K; Hong, K; Khun, H; Hou, S V; Sok, K E; Huerre, M R

    2006-12-01

    Schistosomiasis mekongi was shown to be endemic, along the Mekong River, in northern Cambodia, affecting many patients with portal hypertension. Surgical procedures were proposed to some patients with digestive haemorrhage history to avoid fatal recurrence. The aim of our study was to evaluate the intensity of the liver fibrosis among these patients. During surgical treatment, liver biopsies were collected, fixed in Bouin or in formalin and processed at the Institut Pasteur of Cambodia. Sections were stained by H&E, Masson's trichrome, PAS, Ziehl-Neelsen's method and Congo Red. A total of six biopsies from patients aged 16-36 were analysed. There was complete disorganization of hepatic architecture with fibrous enlargement of portal tracts and some portal-portal bridging fibrosis, but there was no cirrhosis. In portal areas, there was blood vessel congestion and thrombosis with inflammation. Bile ducts were normal. In the parenchyma, congestion of sinusoidal capillaries was combined with focal mononuclear inflammatory infiltrate. There was no steatosis, no necrosis, no cholestasis, no iron accumulation and no amyloidosis. Numerous eggs of Schistosoma mekongi were observed in five cases, mostly in fibrous areas and more rarely in the parenchyma. Eggs were round or oval, measuring 60 x 40 microns with an acid-fast thin hyaline wall. Some eggs were surrounded by epithelioid and giant cell reaction. In conclusion, our findings illustrated a surprisingly high degree of fibrosis among young adults which contrasts with other schistosomiasis.

  14. Poverty, user fees and ability to pay for health care for children with suspected dengue in rural Cambodia.

    Science.gov (United States)

    Khun, Sokrin; Manderson, Lenore

    2008-04-25

    User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from dengue fever among infants and children reflect the difficulties that women continue to face in finding sufficient cash in cases of medical emergency, resulting in delays in diagnosis and treatment. In this article, drawing on in-depth interviews conducted with mothers of children infected with dengue in eastern Cambodia, we illustrate the profound economic consequences for households when a child is ill. The direct costs for health care and medical services, and added indirect costs, deterred poor women from presenting with sick children. Those who eventually sought care often had to finance health spending through out-of-pocket payments and loans, or sold property, goods or labour to meet the costs. Costs were often catastrophic, exacerbating the extreme poverty of those least able to afford it.

  15. The Economic Burden of Malnutrition in Pregnant Women and Children under 5 Years of Age in Cambodia.

    Science.gov (United States)

    Moench-Pfanner, Regina; Silo, Sok; Laillou, Arnaud; Wieringa, Frank; Hong, Rathamony; Hong, Rathavuth; Poirot, Etienne; Bagriansky, Jack

    2016-05-14

    Malnutrition is locked in a vicious cycle of increased mortality, poor health, impaired cognitive development, slow physical growth, reduced learning capacity, inferior performance, and ultimately lower adult work performance and productivity. The consensus of global scientific evidence indicates that lowering the rates of malnutrition will be an indispensable component of any successful program to raise the quality of human capital and resources. This study used a "consequence model" to apply the coefficient risk-deficit on economic losses, established in the global scientific literature, to Cambodian health, demographic, and economic data to develop a national estimate of the value of economic losses due to malnutrition. The impact of the indicators of malnutrition analyzed represent a burden to the national economy of Cambodia estimated at 266 million USD annually (1.7% of GDP). Stunting is reducing the Cambodian economic output by more than 120 million USD, and iodine deficiency disorders alone by 57 million USD. This economic burden is too high in view of Cambodia's efforts to drive economic development. The government should rapidly expand a range of low-cost effective nutrition interventions to break the current cycle of increased mortality, poor health and ultimately lower work performance, productivity, and earnings.

  16. Mapping potential freshwater services, and their representation within Protected Areas (PAs, under conditions of sparse data. Pilot implementation for Cambodia

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    Leonardo Sáenz

    2016-07-01

    Full Text Available Freshwater is arguably one of Earth’s most threatened natural resources, on which more than 7 billion people depend. Pressures on freshwater resources from infrastructure, resource development, agricultural pollution and deforestation are mounting, particularly in developing countries. To date, conservation responses such as Protected Areas (PAs have not typically targeted freshwater ecosystems and their services, and thus little is known about the effectiveness of these efforts in protecting them. This paper proposes and pilots an innovative freshwater services metrics framework to quantify the representation of potential freshwater services in PAs under conditions of scarce data, with a pilot application for Cambodia. Our results indicate that conservation actions have more effectively represented potential freshwater regulation services than potential freshwater provisioning services, with major rivers remaining generally unprotected. Results from the framework are then used to propose a series of context and region specific management options to improve the conservation of freshwater services in Cambodia. There is an acute need for such management options, as the country’s food security depends largely on important freshwater ecosystems such as the Tonle Sap Lake and the deep water pools systems of the Mekong River. The framework proposed can be applied in other countries or large river basins to explore the degree of representation of freshwater services within PAs systems, under conditions of sparse data.

  17. Determinants of reduced child stunting in Cambodia: analysis of pooled data from three demographic and health surveys.

    Science.gov (United States)

    Ikeda, Nayu; Irie, Yuki; Shibuya, Kenji

    2013-05-01

    To assess how changes in socioeconomic and public health determinants may have contributed to the reduction in stunting prevalence seen among Cambodian children from 2000 to 2010. A nationally representative sample of 10 366 children younger than 5 years was obtained from pooled data of cross-sectional surveys conducted in Cambodia in 2000, 2005, and 2010. The authors used a multivariate hierarchical logistic model to examine the association between the prevalence of childhood stunting over time and certain determinants. They estimated those changes in the prevalence of stunting in 2010 that could have been achieved through further improvements in public health indicators. Child stunting was associated with the child's sex and age, type of birth, maternal height, maternal body mass index, previous birth intervals, number of household members, household wealth index score, access to improved sanitation facilities, presence of diarrhoea, parents' education, maternal tobacco use and mother's birth during the Khmer Rouge famine. The reduction in stunting prevalence during the past decade was attributable to improvements in household wealth, sanitation, parental education, birth spacing and maternal tobacco use. The prevalence of stunting would have been further reduced by scaling up the coverage of improved sanitation facilities, extending birth intervals, and eradicating maternal tobacco use. Child stunting in Cambodia has decreased owing to socioeconomic development and public health improvements. Effective policy interventions for sanitation, birth spacing and maternal tobacco use, as well as equitable economic growth and education, are the keys to further improvement in child nutrition.

  18. The relevance of a coproductive capacity framework to climate change adaptation: investigating the health and water sectors in Cambodia

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    Kathryn J. Bowen

    2015-03-01

    Full Text Available Multiple active partnerships in the health and water sectors in Cambodia exist to address climate change adaptation, operating beyond typical sectoral and organizational divides. Decisions around national adaptation policy are made predominantly by the relevant lead ministry, contrasting with where funding originates from (i.e., major donors, multilaterals, United Nation agencies. Adaptation policy is thus the result of a process of coproduction by state and nonstate actors. The research we present sought to understand the relationships that exist between knowledge- and decision-makers with respect to climate change adaptation in the health and water sectors in Cambodia, and the factors that enabled or constrained these relationships. Forty-four interviews were conducted with representatives of 32 organizations. We found that coproductive relationships were most effective when there were clearly defined roles and responsibilities, coordination of technical and financial resources, and trust. The two key factors of coproductive capacity that enabled and supported these partnerships were scientific resources and governance capability. Ultimately, the roles and responsibilities given to various actors requires commensurate funding and greater consideration of existing relationships and power dynamics. The reliance on international scientific expertise also needs to be challenged so that local research capabilities can be developed and locally relevant, problem-specific information can be provided. The ongoing funding, codevelopment, and sharing of such knowledge would significantly enhance trust and cooperation.

  19. Injections, cocktails and diviners: therapeutic flexibility in the context of malaria elimination and drug resistance in Northeast Cambodia.

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    Charlotte Gryseels

    Full Text Available BACKGROUND: Adherence to effective malaria medication is extremely important in the context of Cambodia's elimination targets and drug resistance containment. Although the public sector health facilities are accessible to the local ethnic minorities of Ratanakiri province (Northeast Cambodia, their illness itineraries often lead them to private pharmacies selling "cocktails" and artemether injections, or to local diviners prescribing animal sacrifices to appease the spirits. METHODS: The research design consisted of a mixed methods study, combining qualitative (in-depth interviews and participant observation and quantitative methods (household and cross-sectional survey. RESULTS: Three broad options for malaria treatment were identified: i the public sector; ii the private sector; iii traditional treatment based on divination and ceremonial sacrifice. Treatment choice was influenced by the availability of treatment and provider, perceived side effects and efficacy of treatments, perceived etiology of symptoms, and patient-health provider encounters. Moreover, treatment paths proved to be highly flexible, changing mostly in relation to the perceived efficacy of a chosen treatment. CONCLUSIONS: Despite good availability of anti-malarial treatment in the public health sector, attendance remained low due to both structural and human behavioral factors. The common use and under-dosage of anti-malaria monotherapy in the private sector (single-dose injections, single-day drug cocktails represents a threat not only for individual case management, but also for the regional plan of drug resistance containment and malaria elimination.

  20. Hydropower, social priorities and the rural–urban development divide: The case of large dams in Cambodia

    International Nuclear Information System (INIS)

    Siciliano, Giuseppina; Urban, Frauke; Kim, Sour; Dara Lonn, Pich

    2015-01-01

    Hydropower investment is a priority in many developing countries, as a means to increase electrification rates and promote national development. However, neglect of dam-affected people's needs, can make them vulnerable to the multifaceted impacts of such projects. Using the case of Cambodia's first large dam, the Kamchay dam, this paper reveals social priorities of affected communities and institutional actors linked to environmental and social implications of large hydropower projects using a preference ranking method. Qualitative research revealed concerns among dam-affected communities which included energy access, livelihood changes, environmental impacts, access to natural resources and compensation. Results also reveal divergence between national and local priorities, which in turn brings about an unequal distribution of costs and benefits of the Kamchay Dam between urban and rural areas. The paper provides recommendations to policy-makers, NGOs and international organizations regarding governance issues, consultation processes and mitigation measures. - Highlights: • We assess social priorities linked to the impacts of a large dam in Cambodia. • We examine differences between local actors in the prioritization of the impacts. • Findings show divergences between national and local priorities of dam construction. • Distribution of cost and benefit is spatially unequal between rural and urban areas.

  1. For the verification of National Biodigester Programme Cambodia. Monitoring period I (24/5/2009 - 31/08/2010)

    Energy Technology Data Exchange (ETDEWEB)

    Buysman, E.

    2011-11-15

    The National Biodigester Programme (NBP) Cambodia has executed a monitoring survey for her Voluntary Gold Standard (VGS) project. The VGS project is located in South-East Cambodia and covers 8 provinces. The monitoring activities are executed according to the monitoring plan in the PDD and the Gold Standard Passport, both document are approved by the DOE. The monitoring period I runs from 24-5-2009 to 31-08-2010. The survey population is 8571 biodigesters built as of 31-08-2010. The survey strategy is a stratified sampling approach, where first 12 districts were randomly selected and 120 households were randomly selected of the survey population in these 12 districts. The survey sample of 120 households is based on a confidence interval of 95% and a sampling error of 10%. The survey sample is twice as high as dictated by the used methodology in the PDD. The main findings of the monitoring survey are: (1) The project has an annual per household project emission of 0.512 tCO2 from physical leakage, incomplete combustion and wood fuel for thermal energy; (2) All the biodigester surveyed were in operation, a figure of 99% is adopted to be on the safe side; (3) The annual per household emission reductions are 4.18 tCO2; (4) The total emission reduction for the monitoring period I are 34,112 tCO2.

  2. eLearning in Higher Education Makes Its Debut in Cambodia: Implications of the Provincial Business Education Project

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    Buenafe R. Abdon

    2007-03-01

    Full Text Available Developing countries face a number of challenges in their efforts to compete successfully in the new global economy. Perhaps the most critical resource needed to achieve these goals is trained human capital. While many developing countries are trying to address this need through traditional means, this may not be the most effective or efficient response. e-Learning has been suggested as an alternative approach that can overcome many of the challenges involved in reaching underserved students. But most educational institutions in developing countries are unfamiliar with e-Learning, have low levels of computer availability, access, familiarity and Internet penetration which leads to skepticism about the feasibility of this approach. In an effort to assess the potential of e-Learning in meeting the needs for developing human capital in Cambodia, this paper reports on the experience and achievements of the Provincial Business Education through the Community Information Centers (CICs project. Key findings are that e-Learning was able to successfully deliver tertiary educational opportunities to underserved provincial students, Cambodian students were able to overcome serious challenges and that female Cambodian students demonstrated superior performance in online classes. These results suggest that e-Learning is an effective alternative for delivering tertiary education in Cambodia.

  3. Effects of logging and recruitment on community phylogenetic structure in 32 permanent forest plots of Kampong Thom, Cambodia.

    Science.gov (United States)

    Toyama, Hironori; Kajisa, Tsuyoshi; Tagane, Shuichiro; Mase, Keiko; Chhang, Phourin; Samreth, Vanna; Ma, Vuthy; Sokh, Heng; Ichihashi, Ryuji; Onoda, Yusuke; Mizoue, Nobuya; Yahara, Tetsukazu

    2015-02-19

    Ecological communities including tropical rainforest are rapidly changing under various disturbances caused by increasing human activities. Recently in Cambodia, illegal logging and clear-felling for agriculture have been increasing. Here, we study the effects of logging, mortality and recruitment of plot trees on phylogenetic community structure in 32 plots in Kampong Thom, Cambodia. Each plot was 0.25 ha; 28 plots were established in primary evergreen forests and four were established in secondary dry deciduous forests. Measurements were made in 1998, 2000, 2004 and 2010, and logging, recruitment and mortality of each tree were recorded. We estimated phylogeny using rbcL and matK gene sequences and quantified phylogenetic α and β diversity. Within communities, logging decreased phylogenetic diversity, and increased overall phylogenetic clustering and terminal phylogenetic evenness. Between communities, logging increased phylogenetic similarity between evergreen and deciduous plots. On the other hand, recruitment had opposite effects both within and between communities. The observed patterns can be explained by environmental homogenization under logging. Logging is biased to particular species and larger diameter at breast height, and forest patrol has been effective in decreasing logging. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  4. High compliance randomized controlled field trial of solar disinfection of drinking water and its impact on childhood diarrhea in rural Cambodia

    CSIR Research Space (South Africa)

    McGuigan, KG

    2011-09-01

    Full Text Available of a 1 year randomized controlled trial investigating the effect of SODIS of drinking water on the incidence of dysentery and nondysentery diarrhea among children of age 6 months to 5 years living in rural communities in Cambodia. They compared 426...

  5. Colonization of Asian freshwaters by the Mytilidae (Bivalvia): a comparison of Sinomytilus harmandi from the Tonle-Sap River, Phnom Penh, Cambodia, with Limnoperna fortunei

    DEFF Research Database (Denmark)

    Morton, Brian; Dinesen, Grete E.

    2010-01-01

    Sinomytilus harmandi occurs in the lakes and rivers of Indochina, notably in Cambodia, Laos, Thailand and Vietnam and, again notably, the Mekong River and its myriad tributaries. Hitherto, this species and its four junior synonyms have been examined only superficially. Because of an interior shel...

  6. The National Politics of Educational Advocacy in the Context of Global Governance: International Funding and Support for Civil Society Engagement in Cambodia

    Science.gov (United States)

    Edwards, D. Brent, Jr.; Brehm, Willian C.; Storen, Inga

    2018-01-01

    This paper examines the Civil Society Education Fund's (CSEF) impact on the non-governmental organisation education partnership (NEP) in Cambodia. With financial backing from the World Bank and the Fast Track Initiative, the CSEF is an initiative that is managed internationally by the Global Campaign for Education. Its goal is to help national…

  7. Situation Report--Australia, Burundi, Cambodia, Mexico, Montserrat, Nicaragua, Papua & New Guinea, Republic of Vietnam, Sabah, Sarawak, Sierra Leone, Tahiti, Tonga.

    Science.gov (United States)

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in fourteen foreign countries are presented in these situation reports. Countries included are Australia, Burundi, Cambodia, Mexico, Montserrat, Nicaragua, Papua and New Guines, Republic of Vietnam, Sabah, Sarawak, Sierra Leone, Tahiti (French Polynesia), and Tonga. Information is provided under two…

  8. “Learning it the Hard Way”: Social safeguards norms in Chinese-led dam projects in Myanmar, Laos and Cambodia

    NARCIS (Netherlands)

    Kirchherr, Julian|info:eu-repo/dai/nl/411261487; Matthews, Nathanial; Charles, Katrina J.; Walton, Matthew J.

    Chinese dam developers claim to construct at least every second dam worldwide. However, scholarly literature comprehensively investigating the social safeguard norms in these projects is rare. This paper analyses social safeguard norms in Chinese-led dam projects in Myanmar, Laos and Cambodia,

  9. Whose Education Policies in Aid-Receiving Countries? A Critical Discourse Analysis of Quality and Normative Transfer through Cambodia and Laos

    Science.gov (United States)

    McCormick, Alexandra

    2012-01-01

    Critical discourse analysis of policy contexts and documents has been employed in this research to analyze the role of language in promoting normative positions affecting the quality of education in Cambodia and Laos. The article examines the ways institutional normative influences at multiple levels within the Education for All (EFA) program have…

  10. Private sector opportunities and threats to achieving malaria elimination in the Greater Mekong Subregion: results from malaria outlet surveys in Cambodia, the Lao PDR, Myanmar, and Thailand.

    Science.gov (United States)

    Phok, Sochea; Phanalasy, Saysana; Thein, Si Thu; Likhitsup, Asawin

    2017-05-02

    The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current coverage of private sector engagement and support through ACTwatch outlet surveys implemented in 2015 and 2016. Over 76,168 outlets were screened, and approximately 6500 interviews were conducted (Cambodia, N = 1303; the Lao People's Democratic Republic (PDR), N = 724; Myanmar, N = 4395; and Thailand, N = 74). There was diversity in the types of private sector outlets providing malaria treatment across countries, and the extent to which they were authorized to test and treat for malaria differed. Among outlets stocking at least one anti-malarial, public sector availability of the first-line treatment for uncomplicated Plasmodium falciparum or Plasmodium vivax malaria was >75%. In the anti-malarial stocking private sector, first-line treatment availability was variable (Cambodia, 70.9%; the Lao PDR, 40.8%; Myanmar P. falciparum = 42.7%, P. vivax = 19.6%; Thailand P. falciparum = 19.6%, P. vivax = 73.3%), as was availability of second-line treatment (the Lao PDR, 74.9%; Thailand, 39.1%; Myanmar, 19.8%; and Cambodia, 0.7%). Treatment not in the National Treatment Guidelines (NTGs) was most common in Myanmar (35.8%) and Cambodia (34.0%), and was typically stocked by the informal sector. The majority of anti-malarials distributed in Cambodia and Myanmar were first-line P. falciparum or P. vivax treatments (90.3% and 77.1%, respectively), however, 8.8% of the market share in Cambodia was treatment not in the NTGs (namely chloroquine) and 17.6% in Myanmar (namely oral artemisinin monotherapy). In the Lao PDR, approximately 9 in 10 anti-malarials distributed in the private sector were second-line treatments-typically locally manufactured chloroquine. In Cambodia, 90% of anti-malarials were distributed through outlets that had confirmatory testing

  11. Patterns of ecosystem metabolism in the Tonle Sap Lake, Cambodia with links to capture fisheries.

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    Gordon W Holtgrieve

    Full Text Available The Tonle Sap Lake in Cambodia is a dynamic flood-pulsed ecosystem that annually increases its surface area from roughly 2,500 km(2 to over 12,500 km(2 driven by seasonal flooding from the Mekong River. This flooding is thought to structure many of the critical ecological processes, including aquatic primary and secondary productivity. The lake also has a large fishery that supports the livelihoods of nearly 2 million people. We used a state-space oxygen mass balance model and continuous dissolved oxygen measurements from four locations to provide the first estimates of gross primary productivity (GPP and ecosystem respiration (ER for the Tonle Sap. GPP averaged 4.1±2.3 g O2 m(-3 d(-1 with minimal differences among sites. There was a negative correlation between monthly GPP and lake level (r = 0.45 and positive correlation with turbidity (r = 0.65. ER averaged 24.9±20.0 g O2 m(-3 d(-1 but had greater than six-fold variation among sites and minimal seasonal change. Repeated hypoxia was observed at most sampling sites along with persistent net heterotrophy (GPP

  12. Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men in Cambodia.

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    Siyan Yi

    Full Text Available Compared to the general population, men who have sex with men (MSM are at greater risk for HIV and less understood due to their more hidden and stigmatized nature. Moreover, the discrepancy in findings in the literature merits further investigations in MSM populations from different cultures and settings. We therefore conducted this study to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia.This cross-sectional study was conducted in 2014 among 367 MSM randomly selected from Battembang and Siem Reap using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect information on characteristics of respondents, HIV testing history, self-perception of HIV risk, substance use, sexual behaviors, mental disorders, and HIV knowledge. Multivariable logistic regression analysis was performed to identify factors independently associated with inconsistent condom use.On average, 62.3% of respondents reported that they always used condoms over the past three months. The rates varied with types of sexual partners; the proportion of respondents who reported always using condoms was 55.1%, 64.2%, 75.9%, 73.0%, 78.1%, and 70.3%, for sexual partners who were girlfriends, boyfriends, female sex workers, male sex workers, female clients, or male clients, respectively. After adjustment, inconsistent condom use was significantly associated with age of ≥25 (AOR = 1.77, 95% CI = 1.09-2.86, self-rated quality of life as good or very good (AOR = 4.37, 95% CI = 1.79-5.67, self-perception of higher HIV risk compared to the general population (AOR = 2.37, 95% CI = 1.35-4.17, illicit drug use in the past three months (AOR = 5.76, 95% CI = 1.65-10.09, and reported consistent lubricant use when selling anal sex to men in the past three months (AOR = 2.85, 95% CI = 1.07-8.12.We found risky sexual behaviors to be considerably high among MSM in this study, especially among those who used

  13. Hydrogeologic reconnaissance of the Mekong Delta in South Vietnam and Cambodia

    Science.gov (United States)

    Anderson, Henry R.

    1978-01-01

    The present report describes the results of a hydrogeologic reconnaissance in the Mekong Delta region by the writer, a hydrogeologist of the U.S. Geological Survey, while on assignment as an adviser to the Vietnamese Directorate of Water Supply from October 1968 to April 1970 under the auspices of the U.s. Agency for International Development. The delta of the Mekong River, comprising an area of about 70,000 square kilometres in South Vietnam and Cambodia, is an almost featureless plain rising gradually from sea level to about 5 metres above sea level at its apex 300 kilometres inland. Most of the shallow ground water in the Holocene Alluvium of the delta in Vietnam is brackish or saline down to depths of 50 to 100 metres. Moreover, in the Dong Thap Mu?oi (Plain of Reeds) the shallow ground water is alum-bearing. Locally, however, perched bodies of fresh ground water occur in ancient beach and dune ridges and are tapped by shallow dug wells or pits for village and domestic water supply. The Old Alluvium beneath the lower delta contains freshwater in some areas, notably in the Ca Mau Peninsula and adjacent areas, in the viciniy of Bau Xau near Saigon, and in the Tinh Long An area. Elsewhere in the lower delta both the Holocene and Old Alluvium may contain brackish or saline water from the land surface to depths of as much as 568 metres, as for example in Tinh Vinh Binh. Ground water in the outcrop area of Old Alluvium northwest of Saigon is generally fresh and potable, but high iron and low pH are locally troublesome. Although considerable exploratory drilling for ground water down to depths of as much as 568 metres has already been completed, large areas of the delta remain yet to be explored before full development of the ground-water potential can be realized. With careful development and controlled management to avoid saltwater contamination, however, it is estimated that freshwater aquifers could provide approximately 80 percent of existing needs for village

  14. Seasonal Influences on Ground-Surface Water Interactions in an Arsenic-Affected Aquifer in Cambodia

    Science.gov (United States)

    Richards, L. A.; Magnone, D.; Van Dongen, B.; Bryant, C.; Boyce, A.; Ballentine, C. J.; Polya, D. A.

    2015-12-01

    Millions of people in South and Southeast Asia consume drinking water daily which contains dangerous levels of arsenic exceeding health-based recommendations [1]. A key control on arsenic mobilization in aquifers in these areas has been controversially identified as the interaction of 'labile' organic matter contained in surface waters with groundwaters and sediments at depth [2-4], which may trigger the release of arsenic from the solid- to aqueous-phase via reductive dissolution of iron-(hyr)oxide minerals [5]. In a field site in Kandal Province, Cambodia, which is an arsenic-affected area typical to others in the region, there are strong seasonal patterns in groundwater flow direction, which are closely related to monsoonal rains [6] and may contribute to arsenic release in this aquifer. The aim of this study is to explore the implications of the high susceptibility of this aquifer system to seasonal changes on potential ground-surface water interactions. The main objectives are to (i) identify key zones where there are likely ground-surface water interactions, (ii) assess the seasonal impact of such interactions and (iii) quantify the influence of interactions using geochemical parameters (such as As, Fe, NO3, NH4, 14C, 3T/3He, δ18O, δ2H). Identifying the zones, magnitude and seasonal influence of ground-surface water interactions elucidates new information regarding potential locations/pathways of arsenic mobilization and/or transport in affected aquifers and may be important for water management strategies in affected areas. This research is supported by NERC (NE/J023833/1) to DP, BvD and CJB and a NERC PhD studentship (NE/L501591/1) to DM. References: [1] World Health Organization, 2008. [2] Charlet & Polya (2006), Elements, 2, 91-96. [3] Harvey et al. (2002), Science, 298, 1602-1606. [4] Lawson et al. (2013), Env. Sci. Technol. 47, 7085 - 7094. [5] Islam et al. (2004), Nature, 430, 68-71. [6] Benner et al. (2008) Appl. Geochem. 23(11), 3072 - 3087.

  15. Little evidence of subclinical avian influenza virus infections among rural villagers in Cambodia.

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    Gregory C Gray

    Full Text Available In 2008, 800 adults living within rural Kampong Cham Province, Cambodia were enrolled in a prospective cohort study of zoonotic influenza transmission. After enrollment, participants were contacted weekly for 24 months to identify acute influenza-like illnesses (ILI. Follow-up sera were collected at 12 and 24 months. A transmission substudy was also conducted among the family contacts of cohort members reporting ILI who were influenza A positive. Samples were assessed using serological or molecular techniques looking for evidence of infection with human and avian influenza viruses. Over 24 months, 438 ILI investigations among 284 cohort members were conducted. One cohort member was hospitalized with a H5N1 highly pathogenic avian influenza (HPAI virus infection and withdrew from the study. Ninety-seven ILI cases (22.1% were identified as influenza A virus infections by real-time RT-PCR; none yielded evidence for AIV. During the 2 years of follow-up, 21 participants (3.0% had detectable antibody titers (≥ 1:10 against the studied AIVs: 1 against an avian-like A/Migratory duck/Hong Kong/MPS180/2003(H4N6, 3 against an avian-like A/Teal/Hong Kong/w312/97(H6N1, 9 (3 of which had detectible antibody titers at both 12- and 24-month follow-up against an avian-like A/Hong Kong/1073/1999(H9N2, 6 (1 detected at both 12- and 24-month follow-up against an avian-like A/Duck/Memphis/546/74(H11N9, and 2 against an avian-like A/Duck/Alberta/60/76(H12N5. With the exception of the one hospitalized cohort member with H5N1 infection, no other symptomatic avian influenza infections were detected among the cohort. Serological evidence for subclinical infections was sparse with only one subject showing a 4-fold rise in microneutralization titer over time against AvH12N5. In summary, despite conducting this closely monitored cohort study in a region enzootic for H5N1 HPAI, we were unable to detect subclinical avian influenza infections, suggesting either that these

  16. Gender differences in suicidal expressions and their determinants among young people in Cambodia, a post-conflict country.

    Science.gov (United States)

    Jegannathan, Bhoomikumar; Kullgren, Gunnar

    2011-03-21

    Suicide among young people is a global public health problem, but adequate information on determinants of suicidal expression is lacking in middle and low income countries. Young people in transitional economies are vulnerable to psychosocial stressors and suicidal expressions. This study explores the suicidal expressions and their determinants among high school students in Cambodia, with specific focus on gender differences. A sample of 320 young people, consisting of 153 boys and 167 girls between 15-18 years of age, was randomly selected from two high schools in Cambodia. Their self-reported suicidal expressions, mental health problems, life-skills dimensions, and exposure to suicidal behavior in others were measured using the Youth Self-Report (YSR), Life-Skills Development Scale (LSDS)-Adolescent Form, and Attitude Towards Suicide (ATTS) questionnaires. Suicidal plans were reported more often by teenage boys than teenage girls (M=17.3%, F=5.6%, p=0.001), whereas girls reported more attempts (M=0.6%, F=7.8%, p=0.012). Young men scored significantly higher on rule-breaking behavior than young women (p=0.001), whereas young women scored higher on anxious/depression (p=0.000), withdrawn/depression (p=0.002), somatic complaints (p=0.034), social problems (p=0.006), and internalizing syndrome (p=0.000). Young men exposed to suicide had significantly higher scores for internalizing syndrome compared to those unexposed (p=0.001), while young women exposed to suicide scored significantly higher on both internalizing (p=0.001) and externalizing syndromes (p=0.012). Any type of exposure to suicidal expressions increased the risk for own suicidal expressions in both genders (OR=2.04, 95% CI=1.06-3.91); among young women, however, those exposed to suicide among friends and partners were at greater risk for the serious suicidal expressions (OR=2.79, 95% CI=1.00-7.74). Life skills dimension scores inversely correlated with externalizing syndrome in young men (p=0.026) and

  17. Sero-epidemiological evaluation of changes in Plasmodium falciparum and Plasmodium vivax transmission patterns over the rainy season in Cambodia

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    Cook Jackie

    2012-03-01

    Full Text Available Abstract Background In Cambodia, malaria transmission is low and most cases occur in forested areas. Sero-epidemiological techniques can be used to identify both areas of ongoing transmission and high-risk groups to be targeted by control interventions. This study utilizes repeated cross-sectional data to assess the risk of being malaria sero-positive at two consecutive time points during the rainy season and investigates who is most likely to sero-convert over the transmission season. Methods In 2005, two cross-sectional surveys, one in the middle and the other at the end of the malaria transmission season, were carried out in two ecologically distinct regions in Cambodia. Parasitological and serological data were collected in four districts. Antibodies to Plasmodium falciparum Glutamate Rich Protein (GLURP and Plasmodium vivax Merozoite Surface Protein-119 (MSP-119 were detected using Enzyme Linked Immunosorbent Assay (ELISA. The force of infection was estimated using a simple catalytic model fitted using maximum likelihood methods. Risks for sero-converting during the rainy season were analysed using the Classification and Regression Tree (CART method. Results A total of 804 individuals participating in both surveys were analysed. The overall parasite prevalence was low (4.6% and 2.0% for P. falciparum and 7.9% and 6.0% for P. vivax in August and November respectively. P. falciparum force of infection was higher in the eastern region and increased between August and November, whilst P. vivax force of infection was higher in the western region and remained similar in both surveys. In the western region, malaria transmission changed very little across the season (for both species. CART analysis for P. falciparum in the east highlighted age, ethnicity, village of residence and forest work as important predictors for malaria exposure during the rainy season. Adults were more likely to increase their antibody responses to P. falciparum during the

  18. Youth paying for sex: what are the associated factors? Findings from a cross-sectional study in Cambodia.

    Science.gov (United States)

    Dizechi, Soaman; Brody, Carinne; Tuot, Sovannary; Chhea, Chhorvann; Saphonn, Vonthanak; Yung, Kunthearith; Kim, Sanh; Yi, Siyan

    2018-01-08

    At-risk male youth in Cambodia who purchase sex are at greater risk for HIV compared to the general population. Factors associated with paying for sex among youth are poorly studied, both globally and in Cambodia. This study aimed to identify specific factors associated with transactional sex with women among most-at-risk male youth in Cambodia. This cross-sectional questionnaire survey was conducted with 405 sexually active male youth aged 16-24 recruited at 'hotspots' in the capital city of Phnom Penh and seven provinces. We collected data on demographic factors, sexual behaviors, HIV testing and other potential factors. Multivariable logistic regression analysis was used to identify factors associated with transactional sex. In total, this study included 405 male youth with a mean age of 21.3 (SD = 2.2). Of the total respondents, 82.5% (n = 334) have ever paid for sex. After controlling for potential confounding, participants who purchased sex in the last 12 months remained significantly more likely to be older than 18 (AOR = 3.60, 95% CI = 1.26-10.62), reside in an urban area (AOR = 2.29, 95% CI = 1.24-4.20), never have been married (AOR = 9.58, 95% CI = 4.34-21.12), spend less than 2.55 USD per day (AOR = 2.22, 95% CI = 1.12-4.40), and have had more than 4.6 sexual partners in the past year (AOR = 16.73, 95% CI = 4.71-59.36). This study highlights the high proportion of Cambodian male youth who paid for sex and the potential challenges to addressing this issue. While the majority of HIV prevention interventions surrounding sex work are aimed at female sex workers themselves, targeting the demand side of sex work, particularly the local demand, may be an important next step towards a sustainable HIV prevention.

  19. Factors associated with sex work among at-risk female youth in Cambodia: a cross-sectional study.

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    Brody, Carinne; Tuot, Sovannary; Chhea, Chhorvann; Saphonn, Vonthanak; Yi, Siyan

    2016-01-01

    In Cambodia, despite great achievements in reducing the prevalence of HIV in the general population, reducing new HIV infections among young at-risk women remains a challenge. This study was designed to examine the prevalence of risky behaviors of sexually active female youth in Cambodia and to explore risk factors associated with engagement in transactional sex. We surveyed sexually active female youth aged 10-24 enrolled at risk "hotspots" in eight provinces in Cambodia. We collected data on demographic factors, sexual behavior, and factors hypothesized to be associated with transactional sex. Multivariable logistic regression was used to identify associations between demographic and sexual behavior and transactional sex. Of the 280 respondents, the mean age was 21.2, and 48.1% had been paid for sex in the past year. After adjustment, at-risk females who were never have been married (adjusted odds ratio (AOR) 3.40, 95% confidence interval (CI) = 1.65-6.97), have completed less than 6 years of school (AOR 3.26, 95% CI = 1.60-6.66), have 1 or more parents who had died (AOR 4.34, 95% CI = 2.00-9.38), be a heavy alcohol drinker (AOR 3.58, 95% CI = 1.78-7.18), have used a condom with their boyfriend during last sexual encounter (AOR 3.50, 95% CI = 1.68-7.32), and have ever had an HIV test (AOR 3.51, 95% CI = 1.68-7.32) were more likely to engage in sex work. Our findings suggest that prevention strategies for female youth at risk of engagement in sex work should include upstream structural interventions that aim to encourage girls' education and empowerment. In addition, tailored sex education and behavior change messaging about the risks of heavy drinking, condom use with romantic partners, and the importance of frequent HIV testing for at-risk youth and sex workers should be designed and delivered to youth currently engaging in sex work.

  20. How elimination of lymphatic filariasis as a public health problem in the Kingdom of Cambodia was achieved.

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    Khieu, Virak; Or, Vandine; Tep, Chhakda; Odermatt, Peter; Tsuyuoka, Reiko; Char, Meng Chuor; Brady, Molly A; Sidwell, Joshua; Yajima, Aya; Huy, Rekol; Ramaiah, Kapa D; Muth, Sinuon

    2018-02-20

    Endemicity of lymphatic filariasis (LF) in Cambodia was proven in 1956 when microfilariae were detected in mosquitos in the Kratié province. In 2001, an extensive study confirmed the presence of both Brugia malayi and Wuchereria bancrofti microfilariae. In 2003, the Ministry of Health established a national task force to develop policies and strategies for controlling and eliminating neglected tropical diseases (NTDs), with the goal of eliminating LF by 2015. This article summarizes the work accomplished to eliminate LF as a public health problem in Cambodia. The National Program to Eliminate Lymphatic Filariasis made excellent progress in the goal towards elimination due to strong collaboration between ministries, intensive supervision by national staff, and advocacy for mobilization of internal and external resources. Mass drug administration (MDA) with diethylcarbamazine citrate and albendazole was conducted in six implementation units, achieving > 70% epidemiological coverage for five consecutive rounds, from 2005 to 2009. In 2006, in 14 provinces, healthcare workers developed a line list of lymphedema and hydrocele patients, many of whom were > 40 years old and had been affected by LF for many years. The national program also trained healthcare workers and provincial and district staff in morbidity management and disability prevention, and designated health centers to provide care for lymphedema and acute attack. Two reference hospitals were designated to administer hydrocele surgery. Effectiveness of MDA was proven with transmission assessment surveys. These found that less than 1% of school children had antigenemia in 2010, which fell to 0% in both 2013 and 2015. A separate survey in one province in 2015 using Brugia Rapid tests to test for LF antibody found one child positive among 1677 children. The list of chronic LF patients was most recently updated and confirmed in 2011-2012, with 32 lymphoedema patients and 17 hydrocele patients listed. All

  1. Improvement in smallholder farmer knowledge of cattle production, health and biosecurity in Southern Cambodia between 2008 and 2010.

    Science.gov (United States)

    Nampanya, S; Suon, S; Rast, L; Windsor, P A

    2012-04-01

    Farmer knowledge surveys were conducted in 2008 and 2010 in Cambodia to evaluate the impact of a research project studying interventions that can improve cattle production and health, including biosecurity and practices relating to risks of transmission of transboundary diseases. The project hypothesis is that by increasing the value of smallholder-owned large ruminants through nutritional interventions and improved marketing, knowledge-based interventions including risk management for infectious diseases such as foot-and-mouth disease (FMD) can be implemented into a more sustainable pathway for rural development. Between 2008 and 2010, significant improvements in farmer knowledge and attitudes were recorded in three villages in three provinces of southern Cambodia. This was achieved through participatory 'applied field research', 'on the job' training plus 'formal' training programmes. No cases of FMD were recorded during the study period in the 'high-intervention' (HI) villages despite the common occurrence of the disease in a nearby 'low-intervention' and many other villages in the three provinces. Whilst it is likely that protection of these villages from FMD infection was from increasing the herd immunity by vaccination, it could also have been partly because of a decrease in risk behaviours by farmers as a result of their increasing knowledge of biosecurity. The research indicates that smallholder farmers are motivated by nutritional interventions that improve the value of their cattle 'bank' and offer better marketing opportunities. This provides a more receptive environment for introduction of disease risk management for infectious and other production limiting diseases, best implemented for smallholder farmers in Cambodia by intensive training programmes. In lieu of a widespread public awareness programme to deliver mass education of smallholder farmers in disease prevention and biosecurity, livestock development projects in South-East Asia should be

  2. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

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    Sirenda Vong

    Full Text Available BACKGROUND: Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. METHODS AND FINDINGS: Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons. The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5. During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, p<0.001. CONCLUSION: The large-scale active surveillance study for dengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly

  3. Prevalence of and factors associated with utilization of herbal medicines among outpatients in primary health centers in Cambodia.

    Science.gov (United States)

    Pearson, Hattie; Fleming, Tyler; Chhoun, Pheak; Tuot, Sovannary; Brody, Carinne; Yi, Siyan

    2018-04-02

    Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia. A cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers purposively selected from Phnom Penh, Kampong Cham and Siem Reap. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. I-CAM-Q was used to measure TCAM use. A multivariate logistic regression model was constructed to identify factors associated with herbal medicine use. In total, 1602 patients were included in this study, of whom 77.7% were female, and 51.2% were recruited from urban primary health centers with a mean age of 46.5 years (SD = 15.2). Of total, 27.0% reported at least one consultation with a TCAM provider in the past 12 months. The most common modality of TCAM used was herbal medicine (89%). Herbs were obtained at drug or folk stores (36.9%), from herbalists directly (28.5%) or from their own gardens (18.6%). Of herb users, 55.2% reported that herbs were somewhat helpful. After adjustment, herb users were significantly more likely to be female (AOR = 1.42, 95% CI = 1.12-2.67), have completed less schooling (AOR = 0.66, 95% CI = 0.45-0.96), were unemployed or homemakers (AOR = 0.23, 95% CI = 0.13-0.52) and have a gastrointestinal illness (AOR = 0.49, 95% CI = 0.39-0.62). Herbal medicines are broadly used among chronic disease patients in Cambodia. Understanding TCAM use in

  4. Case management of malaria fever in Cambodia: results from national anti-malarial outlet and household surveys

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    Littrell Megan

    2011-10-01

    Full Text Available Abstract Background Continued progress towards global reduction in morbidity and mortality due to malaria requires scale-up of effective case management with artemisinin-combination therapy (ACT. The first case of artemisinin resistance in Plasmodium falciparum was documented in western Cambodia. Spread of artemisinin resistance would threaten recent gains in global malaria control. As such, the anti-malarial market and malaria case management practices in Cambodia have global significance. Methods Nationally-representative household and outlet surveys were conducted in 2009 among areas in Cambodia with malaria risk. An anti-malarial audit was conducted among all public and private outlets with the potential to sell anti-malarials. Indicators on availability, price and relative volumes sold/distributed were calculated across types of anti-malarials and outlets. The household survey collected information about management of recent "malaria fevers." Case management in the public versus private sector, and anti-malarial treatment based on malaria diagnostic testing were examined. Results Most public outlets (85% and nearly half of private pharmacies, clinics and drug stores stock ACT. Oral artemisinin monotherapy was found in pharmacies/clinics (9%, drug stores (14%, mobile providers (4% and grocery stores (2%. Among total anti-malarial volumes sold/distributed nationally, 6% are artemisinin monotherapies and 72% are ACT. Only 45% of people with recent "malaria fever" reportedly receive a diagnostic test, and the most common treatment acquired is a drug cocktail containing no identifiable anti-malarial. A self-reported positive diagnostic test, particularly when received in the public sector, improves likelihood of receiving anti-malarial treatment. Nonetheless, anti-malarial treatment of reportedly positive cases is low among people who seek treatment exclusively in the public (61% and private (42% sectors. Conclusions While data on the anti

  5. Gender differences in suicidal expressions and their determinants among young people in Cambodia, a post-conflict country*

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    Kullgren Gunnar

    2011-03-01

    Full Text Available Abstract Background Suicide among young people is a global public health problem, but adequate information on determinants of suicidal expression is lacking in middle and low income countries. Young people in transitional economies are vulnerable to psychosocial stressors and suicidal expressions. This study explores the suicidal expressions and their determinants among high school students in Cambodia, with specific focus on gender differences. Methods A sample of 320 young people, consisting of 153 boys and 167 girls between 15-18 years of age, was randomly selected from two high schools in Cambodia. Their self-reported suicidal expressions, mental health problems, life-skills dimensions, and exposure to suicidal behavior in others were measured using the Youth Self-Report (YSR, Life-Skills Development Scale (LSDS-Adolescent Form, and Attitude Towards Suicide (ATTS questionnaires. Results Suicidal plans were reported more often by teenage boys than teenage girls (M = 17.3%, F = 5.6%, p = 0.001, whereas girls reported more attempts (M = 0.6%, F = 7.8%, p = 0.012. Young men scored significantly higher on rule-breaking behavior than young women (p = 0.001, whereas young women scored higher on anxious/depression (p = 0.000, withdrawn/depression (p = 0.002, somatic complaints (p = 0.034, social problems (p = 0.006, and internalizing syndrome (p = 0.000. Young men exposed to suicide had significantly higher scores for internalizing syndrome compared to those unexposed (p = 0.001, while young women exposed to suicide scored significantly higher on both internalizing (p = 0.001 and externalizing syndromes (p = 0.012. Any type of exposure to suicidal expressions increased the risk for own suicidal expressions in both genders (OR = 2.04, 95% CI = 1.06-3.91; among young women, however, those exposed to suicide among friends and partners were at greater risk for the serious suicidal expressions (OR = 2.79, 95% CI = 1.00-7.74. Life skills dimension scores

  6. Malaria and the mobile and migrant population in Cambodia: a population movement framework to inform strategies for malaria control and elimination.

    Science.gov (United States)

    Guyant, Philippe; Canavati, Sara E; Chea, Nguon; Ly, Po; Whittaker, Maxine Anne; Roca-Feltrer, Arantxa; Yeung, Shunmay

    2015-06-20

    The relationships between human population movement (HPM) and health are a concern at global level. In the case of malaria, those links are crucial in relation to the spread of drug resistant parasites and to the elimination of malaria in the Greater Mekong sub-Region (GMS) and beyond. The mobile and migrant populations (MMP) who are involved in forest related activities are both at high risk of being infected with malaria and at risk of receiving late and sub-standard treatment due to poor access to health services. In Cambodia, in 2012, the National Malaria Control Programme (NMCP) identified, as a key objective, the development of a specific strategy for MMPs in order to address these challenges. A population movement framework (PMF) for malaria was developed and operationalized in order to contribute to this strategy. A review of the published and unpublished literature was conducted. Based on a synthesis of the results, information was presented and discussed with experienced researchers and programme managers in the Cambodian NMCP and led to the development and refinement of a PMF for malaria. The framework was "tested" for face and content validity with national experts through a workshop approach. In the literature, HPM has been described using various spatial and temporal dimensions both in the context of the spread of anti-malarial drug resistance, and in the context of malaria elimination and previous classifications have categorized MMPs in Cambodia and the GMS through using a number of different criteria. Building on these previous models, the PMF was developed and then refined and populated with in-depth information relevant to Cambodia collected from social science research and field experiences in Cambodia. The framework comprises of the PMF itself, MMP activity profiles and a Malaria Risk Index which is a summation of three related indices: a vulnerability index, an exposure index and an access index which allow a qualitative ranking of malaria

  7. Pesticide use and self-reported symptoms of acute pesticide poisoning among aquatic farmers in Phnom Penh, Cambodia

    DEFF Research Database (Denmark)

    Jensen, Hanne Klith; Konradsen, Flemming; Jørs, Erik

    2011-01-01

    Organophosphates and carbamates (OPs/CMs) are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers...... in Boeung Cheung Ek (BCE) Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88%) had experienced symptoms of acute pesticide poisoning, and this was significantly...... associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02-1.28). The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22-0.91). These findings suggest that improving safe pesticide...

  8. How do young people in Cambodia perceive the impact of societal attitudes, media and religion on suicidal behaviour?

    Science.gov (United States)

    Jegannathan, Bhoomikumar; Kullgren, Gunnar; Dahlblom, Kjerstin

    2016-03-01

    Young people in low and middle income countries (LMICs) in societal transitions with rapidly changing norms face an increased risk of suicide. This study explores how young people in Cambodia understand the impact on suicidal behaviour from societal attitudes, media and religion. Focus group discussions were held with school students from a suburban area. Thematic analysis was used to interpret the data. Participants perceived the prevailing suicide-stigmatizing societal attitudes, the double-edged media and suicide-ambiguity in Buddhist religion as challenging. Globalization was recognized as contradicting with traditional Cambodian norms and values. Suicide prevention programmes should take into consideration the complex picture of suicide that young people are exposed to. © The Author(s) 2015.

  9. Faecal and protozoan parasite contamination of water spinach (Ipomoea aquatica) cultivated in urban wastewater in Phnom Penh, Cambodia

    DEFF Research Database (Denmark)

    Anh, Vuong Tuan; Tram, Nguyen Thuy; Klank, Lise Tønner

    2007-01-01

    Objective To identify the level of contamination with thermotolerant coliforms (ThC), intestinal helminth eggs and protozoan parasites in water spinach (Ipomoea aquatica) cultivated in a wastewater-fed lake in Phnom Penh, Cambodia. Methods The investigation was carried out from July 2004 to May...... into a stream. Water spinach samples were harvested at each of the three locations with and without wastewater contact according to the normal practices of farmers, and analysed for ThC, protozoan parasites (Giardia, Cryptosporidium and Cyclospora), and helminth eggs (Ascaris lumbricoides, Trichuris trichura...... and hookworm) using standard methods. Wastewater samples were also collected at each of the three locations and analysed for ThC and helminth eggs. Results High concentrations of ThC (approximately 10(5)-10(7)/g) were found in water spinach samples. ThC mean counts did not differ significantly, neither between...

  10. Commentary (Analysis of Decisions on Interim Release at the Extraordinary Chambers in the Courts of Cambodia (ECCC))

    DEFF Research Database (Denmark)

    Appazov, Artur

    2015-01-01

    As of today, the decision-making organs of the ECCC have issued a number of decisions on applications of suspects and accused persons for provisional release. One only one such application has been successful so far. This situation is regarded as acceptable in other international criminal...... jurisdictions for the reasons of unavailability of reliable enforcement mechanisms. This is said to justify the pre-trial detention to be de facto the rule rather than exception. However, specific conditions of the Extraordinary Chambers in the Courts of Cambodia (ECCC) warrant a differing appraisal....... The commentary examines a tendency of the decision-makers of the ECCC uncritically to accept arguments in the submissions of the Co-Prosecutors to the effect that the continuous provisional detention is in each case the necessary measure in accordance with the law of the ECCC. At that, the quality of judicial...

  11. Impact of Multi-Micronutrient-Fortified Rice on Micronutrient Status, Health, and Cognitive Performance in Schoolchildren in Cambodia

    DEFF Research Database (Denmark)

    Khov, Kuong

    ferritin concentrations nutritional status of school-age children as well as the reasons of iron deficiency. Food fortification...... with multiple micronutrients has the potential to improve micronutrient status, growth and cognitive performance, and reduce morbidity incidence in developing countries. In Cambodia, rice is a staple food, and therefore fortified rice with multiple micronutrients could be a promising strategy to reduce...... the prevalence of micronutrient deficiencies. However, few studies have investigated the impact of fortified rice on micronutrient status, health and cognitive development in school-age children. Therefore, the aim of this PhD study is to evaluate the impact of fortified rice on nutritional status, health...

  12. Border Malaria Associated with Multidrug Resistance on Thailand-Myanmar and Thailand-Cambodia Borders: Transmission Dynamic, Vulnerability, and Surveillance

    Science.gov (United States)

    Bhumiratana, Adisak; Intarapuk, Apiradee; Sorosjinda-Nunthawarasilp, Prapa; Maneekan, Pannamas; Koyadun, Surachart

    2013-01-01

    This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread of Plasmodium falciparum and Plasmodium vivax multidrug resistance (MDR) malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world's most MDR falciparum and vivax malaria on these chaotic borders. PMID:23865048

  13. Border Malaria Associated with Multidrug Resistance on Thailand-Myanmar and Thailand-Cambodia Borders: Transmission Dynamic, Vulnerability, and Surveillance

    Directory of Open Access Journals (Sweden)

    Adisak Bhumiratana

    2013-01-01

    Full Text Available This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread of Plasmodium falciparum and Plasmodium vivax multidrug resistance (MDR malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world’s most MDR falciparum and vivax malaria on these chaotic borders.

  14. From subjects to relations: Bioethics and the articulation of postcolonial politics in the Cambodia Pre-Exposure Prophylaxis trial.

    Science.gov (United States)

    Grant, Jenna M

    2016-04-01

    Controversies about global clinical trials, particularly HIV trials, tend to be framed in terms of ethics. In this article, I explore debates about ethics in the Cambodia Pre-Exposure Prophylaxis trial, which was designed to test the safety and efficacy of tenofovir as a prevention for HIV infection. Bringing together studies of public participation in science with studies of bioethics, I show how activists around the Cambodian Pre-Exposure Prophylaxis trial circulated and provoked debates about standards of research ethics, as opposed to research methodology. This postcolonial bioethics was configured through the circulation of and debate about ethics guidelines, and historically and culturally specific relations of vulnerability and responsibility between foreigners and Cambodians and between Cambodian leaders and Cambodian subjects. I argue that this shift in the object of ethical concern, from the experimental human subject to the relation between subjects and researchers, illustrates how a postcolonial field of articulation reformulates classical bioethics.

  15. The Influence of English Communication Ability on Income in Tourist Industry Frontline Employees of Siem Reap, Cambodia

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    Jeffrey Stewart Morrow

    2017-06-01

    Full Text Available Siem Reap, Cambodia’s tourism growth has been remarkable. Since most tourists are native English speakers, tourist industry (TI employees need high levels of English communication ability (ECA to handle tasks effectively, but data in Cambodia has been difficult to find. To fill this gap, the author wanted to collect employees’ general and English education information during interviews in six TI related businesses, to assess their ECA, and to statistically examine interactions of English variables with income. The author created an English assessment test loosely based on the Common European Framework of Reference for Languages (CEFR. Statistical analysis found direct positive influence from English ability on income. Findings also showed that employees who have advanced levels of English ability earn USD200 per month, double the salary of garment workers. This type of research can be used profitably over the Internet in many research situations.

  16. Integration of population census and water point mapping data-A case study of Cambodia, Liberia and Tanzania.

    Science.gov (United States)

    Yu, Weiyu; Wardrop, Nicola A; Bain, Robert; Wright, Jim A

    2017-07-01

    Sustainable Development Goal (SDG) 6 has expanded the Millennium Development Goals' focus from improved drinking-water to safely managed water services. This expanded focus to include issues such as water quality requires richer monitoring data and potentially integration of datasets from different sources. Relevant data sets include water point mapping (WPM), the survey of boreholes, wells and other water points, census and household survey data. This study examined inconsistencies between population census and WPM datasets for Cambodia, Liberia and Tanzania, and identified potential barriers to integrating the two datasets to meet monitoring needs. Literatures on numbers of people served per water point were used to convert WPM data to population served by water source type per area and compared with census reports. For Cambodia and Tanzania, discrepancies with census data suggested incomplete WPM coverage. In Liberia, where the data sets were consistent, WPM-derived data on functionality, quantity and quality of drinking water were further combined with census area statistics to generate an enhanced drinking-water access measure for protected wells and springs. The process revealed barriers to integrating census and WPM data, including exclusion of water points not used for drinking by households, matching of census and WPM source types; temporal mismatches between data sources; data quality issues such as missing or implausible data values, and underlying assumptions about population served by different water point technologies. However, integration of these two data sets could be used to identify and rectify gaps in WPM coverage. If WPM databases become more complete and the above barriers are addressed, it could also be used to develop more realistic measures of household drinking-water access for monitoring. Copyright © 2017 Elsevier GmbH. All rights reserved.

  17. Dengue knowledge, attitudes and practices and their impact on community-based vector control in rural Cambodia.

    Science.gov (United States)

    Kumaran, Emmanuelle; Doum, Dyna; Keo, Vanney; Sokha, Ly; Sam, BunLeng; Chan, Vibol; Alexander, Neal; Bradley, John; Liverani, Marco; Prasetyo, Didot Budi; Rachmat, Agus; Lopes, Sergio; Hii, Jeffrey; Rithea, Leang; Shafique, Muhammad; Hustedt, John

    2018-02-01

    Globally there are an estimated 390 million dengue infections per year, of which 96 million are clinically apparent. In Cambodia, estimates suggest as many as 185,850 cases annually. The World Health Organization global strategy for dengue prevention aims to reduce mortality rates by 50% and morbidity by 25% by 2020. The adoption of integrated vector management approach using community-based methods tailored to the local context is one of the recommended strategies to achieve these objectives. Understanding local knowledge, attitudes and practices is therefore essential to designing suitable strategies to fit each local context. A Knowledge, Attitudes and Practices survey in 600 randomly chosen households was administered in 30 villages in Kampong Cham which is one of the most populated provinces of Cambodia. KAP surveys were administered to a sub-sample of households where an entomology survey was conducted (1200 households), during which Aedes larval/pupae and adult female Aedes mosquito densities were recorded. Participants had high levels of knowledge regarding the transmission of dengue, Aedes breeding, and biting prevention methods; the majority of participants believed they were at risk and that dengue transmission is preventable. However, self-reported vector control practices did not match observed practices recorded in our surveys. No correlation was found between knowledge and observed practices either. An education campaign regarding dengue prevention in this setting with high knowledge levels is unlikely to have any significant effect on practices unless it is incorporated in a more comprehensive strategy for behavioural change, such a COMBI method, which includes behavioural models as well as communication and marketing theory and practice. ISRCTN85307778.

  18. Determination of total arsenic in soil and arsenic-resistant bacteria from selected ground water in Kandal Province, Cambodia

    International Nuclear Information System (INIS)

    Hamzah, A.; Wong, K.K.; Hasan, F.N.; Mustafa, S.; Khoo, K.S.; Sarmani, S.B.

    2013-01-01

    Cambodia has geological environments conducive to generation of high-arsenic groundwater and people are at high risk of chronic arsenic exposure. The aims of this study are to investigate the concentration of total arsenic and to isolate and identify arsenic-resistant bacteria from selected locations in Kandal Province, Cambodia. The INAA technique was used to measure the concentration of total arsenic in soils. The arsenic concentrations in soils were above permissible 5 mg/kg, ranging from 5.34 to 27.81 mg/kg. Bacteria resistant to arsenic from two arsenic-contaminated wells in Preak Russey were isolated by enrichment method in nutrient broth (NB). Colonies isolated from NB was then grown on minimal salt media (MSM) added with arsenic at increasing concentrations of 10, 20, 30, 50, 100 and 250 ppm. Two isolates that can tolerate 750 ppm of arsenic were identified as Enterobacter agglomerans and Acinetobacter lwoffii based on a series of biochemical, physiological and morphological analysis. Optimum growth of both isolates ranged from pH 6.6 to 7.0 and 30-35 deg C. E. agglomerans and A. lwoffii were able to remove 66.4 and 64.1 % of arsenic, respectively at the initial concentration of 750 ppm, within 72 h of incubation. Using energy dispersive X-ray technique, the percentage of arsenic absorbed by E. agglomerans and A. lwoffii was 0.09 and 0.15 %, respectively. This study suggested that arsenic-resistant E. agglomerans and A. lwoffii removed arsenic from media due to their ability to absorb arsenic. (author)

  19. Dengue knowledge, attitudes and practices and their impact on community-based vector control in rural Cambodia

    Science.gov (United States)

    Doum, Dyna; Keo, Vanney; Sokha, Ly; Sam, BunLeng; Chan, Vibol; Alexander, Neal; Bradley, John; Liverani, Marco; Prasetyo, Didot Budi; Rachmat, Agus; Lopes, Sergio; Hii, Jeffrey; Rithea, Leang; Shafique, Muhammad; Hustedt, John

    2018-01-01

    Background Globally there are an estimated 390 million dengue infections per year, of which 96 million are clinically apparent. In Cambodia, estimates suggest as many as 185,850 cases annually. The World Health Organization global strategy for dengue prevention aims to reduce mortality rates by 50% and morbidity by 25% by 2020. The adoption of integrated vector management approach using community-based methods tailored to the local context is one of the recommended strategies to achieve these objectives. Understanding local knowledge, attitudes and practices is therefore essential to designing suitable strategies to fit each local context. Methods and findings A Knowledge, Attitudes and Practices survey in 600 randomly chosen households was administered in 30 villages in Kampong Cham which is one of the most populated provinces of Cambodia. KAP surveys were administered to a sub-sample of households where an entomology survey was conducted (1200 households), during which Aedes larval/pupae and adult female Aedes mosquito densities were recorded. Participants had high levels of knowledge regarding the transmission of dengue, Aedes breeding, and biting prevention methods; the majority of participants believed they were at risk and that dengue transmission is preventable. However, self-reported vector control practices did not match observed practices recorded in our surveys. No correlation was found between knowledge and observed practices either. Conclusion An education campaign regarding dengue prevention in this setting with high knowledge levels is unlikely to have any significant effect on practices unless it is incorporated in a more comprehensive strategy for behavioural change, such a COMBI method, which includes behavioural models as well as communication and marketing theory and practice. Trial registration ISRCTN85307778. PMID:29451879

  20. Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia.

    Science.gov (United States)

    Bell, Carolyn A; Ilomäki, Jenni; Pichenda, Koeut; Duncan, Gregory J; Saini, Bandana

    2015-04-01

    Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their closest public sector clinic for diagnosis and treatment. The study objective was to investigate factors associated with referral of TB symptomatic clients from pharmacies to public sector clinics in Phnom Penh, Cambodia. Face-to-face structured interviews were conducted with staff from a stratified random sample of 180 private pharmacies in Phnom Penh in 2012. Trained interviewers were Khmer speakers. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with self-reported referral during the previous 3 months. Fifty (29.6%) pharmacies reported that they had referred 125 clients (range 1-10) to public sector clinics during the previous 3 months. In total, 164 (96.5%) pharmacies reported that they always referred all TB symptomatic clients to DOTS (directly observed treatment, short course) clinics. More than 6-year participation in the programme (OR 5.23, 95% CI 1.93-14.18) and willingness to always continue referring (OR 12.24, 95% CI 11.61-93.10) were associated with referral of one or more clients in the previous 3 months. Referral to the client's closest clinic was negatively associated with referral (OR 0.45, 95% CI 0.23-0.99). Pharmacies' ongoing commitment to the Referral Programme was strongly associated with referral. Increased advocacy among the high number of non-referring pharmacies may improve programme performance. Factors negatively associated with referral may need investigation. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  1. A survey of visual impairment and blindness in children attending four schools for the blind in Cambodia.

    Science.gov (United States)

    Sia, David I T; Muecke, James; Hammerton, Michael; Ngy, Meng; Kong, Aimee; Morse, Anna; Holmes, Martin; Piseth, Horm; Hamilton, Carolyn; Selva, Dinesh

    2010-08-01

    To identify the causes of blindness and severe visual impairment (BL/SVI) in children attending four schools for the blind in Cambodia and to provide spectacles, low vision aids, orientation and mobility training and ophthalmic treatment. Children schools for the blind in Cambodia. Causes of visual impairment and blindness were determined and categorized using World Health Organization methods. Of the 95 children examined, 54.7% were blind (BL) and 10.5% were severely visually impaired (SVI). The major anatomical site of BL/SVI was the lens in 27.4%, cornea in 25.8%, retina in 21% and whole globe in 17.7%. The major underlying etiologies of BL/SVI were hereditary factors (mainly cataract and retinal dystrophies) in 45.2%, undetermined/unknown (mainly microphthalmia and anterior segment dysgenesis) in 38.7% and childhood factors in 11.3%. Avoidable causes of BL/SVI accounted for 50% of the cases; 12.9% of the total were preventable with measles being the commonest cause (8.1% of the total); 37.1% were treatable with cataracts and glaucoma being the commonest causes (22.6% and 4.8% respectively). More than 35% of children required an optical device and 27.4% had potential for visual improvement with intervention. Half of the BL/SVI causes were potentially avoidable. The data support the need for increased coverage of measles immunization. There is also a need to develop specialized pediatric ophthalmic services for the management of surgically remediable conditions, to provide optometric, low vision and orientation and mobility services. Genetic risk counseling services also may be considered.

  2. How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

    Science.gov (United States)

    Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

    2018-03-01

    Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of

  3. From reaching every district to reaching every community: analysis and response to the challenge of equity in immunization in Cambodia

    Science.gov (United States)

    Chan Soeung, Sann; Grundy, John; Duncan, Richard; Thor, Rasoka; Bilous, Julian B

    2013-01-01

    Background An international review of the Cambodian Expanded Programme on Immunization (EPI) in 2010 and other data show that despite immunization coverage increases and vaccine preventable diseases incidence reductions, inequities in access to immunization services exist. Utilizing immunization and health systems literature, analysis of global health databases and the EPI review findings, this paper examines the characteristics of immunization access and outcome inequities, and describes proposed longer-term strategic and operational responses to these problems. Findings The national programme has evolved from earlier central and provincial level planning to strengthening routine immunization coverage through the District level ‘Reaching Every District Strategy’. However, despite remarkable improvements, the review found over 20% of children surveyed were not fully immunized, primarily from communities where inequities of both access and impact persist. These inequities relate mainly to socio-economic exposures including wealth and education level, population mobility and ethnicity. To address these problems, a shift in strategic and operational response is proposed that will include (a) a re-focus of planning on facility level to detect disadvantaged communities, (b) establishment of monitoring systems to provide detailed information on community access and utilization, (c) development of communication strategies and health networks that enable providers to adjust service delivery according to the needs of vulnerable populations, and (d) securing financial, management and political commitment for ‘reaching every community’. Conclusions For Cambodia to achieve its immunization equity objectives and disease reduction goals, a shift of emphasis to health centre and community is needed. This approach will maximize the benefits of new vaccine introduction in the coming ‘Decade of Vaccines’, plus potentially extend the reach of other life-saving maternal

  4. Where You Live Matters: Localising Environmental Impacts on Health, Nutrition and Poverty in Cambodia Using Small Area Estimation Techniques

    Science.gov (United States)

    Nilsen, K.; van Soesbergen, A.; Matthews, Z.

    2016-12-01

    Socioeconomic development depends on local environments. However, the scientific evidence quantifying the impact of environmental factors on health, nutrition and poverty at subnational levels is limited. This is because socioeconomic indicators are derived from sample surveys representative only at aggregate levels compared to environmental variables mostly available in high-resolution grids. Cambodia was selected because of its commitment to development in the context of a rapidly deteriorating environment. Having made considerable progress since 2005, access to health services is limited, a quarter of the population is still poor and 40% rural children are malnourished. Cambodia is also facing considerable environmental challenges including high deforestation rates, land degradation and natural hazards. Addressing existing gaps in the knowledge of environmental impacts on health and livelihoods, this study applies small area estimation (SAE) to quantify health, nutritional and poverty outcomes in the context of local environments. SAE produces reliable subnational estimates of socioeconomic outcomes available only from sample surveys by combining them with information from auxiliary sources (census). A model is used to explain common trades across areas and a random effect structure is applied to explain the observed extra heterogeneity. SAE models predicting health, nutrition and poverty outcomes excluding and including contextual environmental variables on natural hazards vulnerability, forest cover, climate, and agricultural production are compared. Results are mapped at regional and district levels to spatially assess the impacts of environmental variation on the outcomes. Inter and intra-regional inequalities are also estimated to examine the efficacy of health/socioeconomic policy targeting based on geographic location. Preliminary results suggest that localised environmental factors have considerable impacts on the indicators estimated and should

  5. Artificial deepening of seasonal waterholes in eastern Cambodia: impact on water retention and use by large ungulates and waterbirds

    Directory of Open Access Journals (Sweden)

    Thomas N.E. Gray

    2015-05-01

    Full Text Available Natural seasonal waterholes (trapeang in Khmer are an important feature of the deciduous dipterocarp forests of eastern Cambodia and are utilised by a number of globally threatened species of large ungulates and waterbirds. However at the end of the dry-season (April only a small proportion of waterholes retain water. In 2011, we artificially deepened six waterholes in the core area of Mondulkiri Protected Forest, eastern Cambodia, removing 3m3 to 24m3 of earth (mean 16.5m3 from each.  Surveys prior to deepening demonstrated that only one of these waterholes, and 10% of all waterholes surveyed in the study area (n=50, held water at the end of the dry-season.  Following modification five of the six deepened waterholes (83% held water at the end of the subsequent dry-season. From four camera traps over 448 trap-nights, 23 species including two globally threatened large ungulates, Banteng Bos javanicus and Eld’s Deer Rucervus eldii, and two Critically Endangered Ibises (Giant Thaumatibis gigantea and White-shouldered Ibis Pseudibis davisoni, were photographed foraging and drinking at the deepened waterholes between March and June 2012.  Our results suggest that artificial deepening of natural waterholes does not cause damage, and makes these waterholes suitable for use throughout the dry-season.  In the face of changing climate it is suggested that management plans should have a programme for the survey and determination of the status of waterholes every year and improve the use of water resources by artificial deepening. 

  6. Beliefs and practices during pregnancy, post-partum and in the first days of an infant's life in rural Cambodia.

    Science.gov (United States)

    Turner, Claudia; Pol, Sreymom; Suon, Kamsan; Neou, Leakhena; Day, Nicholas P J; Parker, Michael; Kingori, Patricia

    2017-04-12

    The aim of this study was to record the beliefs, practices during pregnancy, post-partum and in the first few days of an infant's life, held by a cross section of the community in rural Cambodia to determine beneficial community interventions to improve early neonatal health. Qualitative study design with data generated from semi structured interviews (SSI) and focus group discussions (FGD). Data were analysed by thematic content analysis, with an a priori coding structure developed using available relevant literature. Further reading of the transcripts permitted additional coding to be performed in vivo. This study was conducted in two locations, firstly the Angkor Hospital for Children and secondarily in five villages in Sotnikum, Siem Reap Province, Cambodia. A total of 20 participants underwent a SSIs (15 in hospital and five in the community) and six (three in hospital and three in the community; a total of 58 participants) FGDs were conducted. Harmful practices that occurred in the past (for example: discarding colostrum and putting mud on the umbilical stump) were not described as being practiced. Village elders did not enforce traditional views. Parents could describe signs of illness and felt responsible to seek care for their child even if other family members disagreed, however participants were unaware of the signs or danger of neonatal jaundice. Cost of transportation was the major barrier to healthcare that was identified. In the population examined, traditional practices in late pregnancy and the post-partum period were no longer commonly performed. However, jaundice, a potentially serious neonatal condition, was not recognised. Community neonatal interventions should be tailored to the populations existing practice and knowledge.

  7. Village malaria worker performance key to the elimination of artemisinin-resistant malaria: a Western Cambodia health system assessment.

    Science.gov (United States)

    Canavati, Sara E; Lawpoolsri, Saranath; Quintero, Cesia E; Nguon, Chea; Ly, Po; Pukrittayakamee, Sasithon; Sintasath, David; Singhasivanon, Pratap; Peeters Grietens, Koen; Whittaker, Maxine Anne

    2016-05-20

    Village malaria workers (VMWs) and mobile malaria workers (MMWs) are a critical component of Cambodia's national strategy to eliminate Plasmodium falciparum malaria by 2025. Since 2004, VMWs have been providing malaria diagnosis through the use of rapid diagnostic tests and free-of-charge artemisinin-based combination therapy in villages more than 5 km away from the closest health facility. They have also played a key role in the delivery of behaviour change communication interventions to this target population. This study aimed to assess the job performance of VMWs/MMWs, and identify challenges they face, which may impede elimination efforts. A mixed-methods assessment was conducted in five provinces of western Cambodia. One hundred and eighty five VMW/MMW participants were surveyed using a structured questionnaire. Qualitative data was gathered through a total of 60 focus group discussions and 65 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. Overall, VMWs/MMWs met or exceeded the expected performance levels (80 %). Nevertheless, some performance gaps were identified. Misconceptions regarding malaria transmission and prevention were found among workers. The recommended approach for malaria treatment, directly-observed treatment (DOT), had low implementation rates. Stock-outs, difficulties in reaching out to migrant and mobile populations, insufficient means of transportation and dwindling worker satisfaction also affected job performance. VMW/MMW job performance must be increased from 80 to 100 % in order to achieve elimination. In order to do this, it is recommended for the national malaria programme to eliminate worker malaria knowledge gaps. Barriers to DOT implementation and health system failures also need to be addressed. The VMW programme should be expanded on several fronts in order to tackle remaining performance gaps. Findings from this evaluation are useful to inform the planning of future

  8. How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia

    OpenAIRE

    Witter, Sophie; Wurie, Haja; Chandiwana, Pamela; Namakula, Justine; So, Sovannarith; Alonso-Garbayo, Alvaro; Ssengooba, Freddie; Raven, Joanna

    2017-01-01

    This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied – Uganda, Sierra Leone, Zimbabwe, and Cambodia – which were at different distances from conflict and crisis, as well as each having a unique conflict story. During the research process, the Ebola epidemic broke out in West Africa. Zimbabwe has continued to face a profound economic crisis. Within our research on health worker incentives, we captu...

  9. An Assessment of the Knowledge and Demand of Young Residents regarding the Ecological Services of Urban Green Spaces in Phnom Penh, Cambodia

    OpenAIRE

    Yat Yen; Zhanqi Wang; Yumin Shi; Bunly Soeung

    2016-01-01

    The fast and steady economic growth and social changes in recent years in Cambodia have brought rapid expansion and restructuring to its cities. These phenomena have brought numerous challenges including threats to urban green spaces (UGS’s). This study addresses problems of UGS’s by investigating the knowledge and perceptions of young residents of Phnom Penh (YRPPs) toward UGS’s in relation to the following: (1) basic knowledge of YRPPs on ecological services (KES) of UGS’s; (2) perceptions ...

  10. Correlations between Maternal, Breast Milk, and Infant Vitamin B12 Concentrations among Mother–Infant Dyads in Vancouver, Canada and Prey Veng, Cambodia: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Philip Chebaya

    2017-03-01

    Full Text Available Vitamin B12 plays an essential role in fetal and infant development. In regions where animal source food consumption is low and perinatal supplementation is uncommon, infants are at risk of vitamin B12 deficiency. In this secondary analysis, we measured total vitamin B12 concentrations in maternal and infant serum/plasma and breast milk among two samples of mother–infant dyads in Canada (assessed at 8 weeks post-partum and in Cambodia (assessed between 3–27 weeks post-partum. Canadian mothers (n = 124 consumed a daily vitamin B12-containing multiple micronutrient supplement throughout pregnancy and lactation; Cambodian mothers (n = 69 were unsupplemented. The maternal, milk, and infant total vitamin B12 concentrations (as geometric means (95% CI in pmol/L were as follows: in Canada, 698 (648,747, 452 (400, 504, and 506 (459, 552; in Cambodia, 620 (552, 687, 317 (256, 378, and 357 (312, 402. The majority of participants were vitamin B12 sufficient (serum/plasma total B12 > 221 pmol/L: 99% and 97% of mothers and 94% and 84% of infants in Canada and Cambodia, respectively. Among the Canadians, maternal, milk, and infant vitamin B12 were all correlated (p < 0.05; only maternal and infant vitamin B12 were correlated among the Cambodians (p < 0.001.

  11. Large-Scale Land Concessions, Migration, and Land Use: The Paradox of Industrial Estates in the Red River Delta of Vietnam and Rubber Plantations of Northeast Cambodia

    Directory of Open Access Journals (Sweden)

    Jefferson Fox

    2018-06-01

    Full Text Available This study investigated the implications of large-scale land concessions in the Red River Delta, Vietnam, and Northeast Cambodia with regard to urban and agricultural frontiers, agrarian transitions, migration, and places from which the migrant workers originated. Field interviews conducted near large-scale land concessions for industrial estates in the Red River Delta and rubber plantations in Northeast Cambodia suggest that these radically different concessions are paradoxically leading to similar reconfigurations of livelihoods, labor patterns, and landscapes despite basic differences in these forms of land use. Both the Red River Delta and Northeast Cambodia are frontier environments undergoing extensive agrarian change with migration to work in the large-scale land concessions leading to a shortage of farm labor that anticipates changes in farming practices and farm livelihoods. These population movements will lead to further land-use changes as governments invest in the infrastructure and services needed to support increased population density in the receiving areas. In addition, labor migrations associated with these investments affect land-use practices both at the site of the concession and the places from where the migrants originate.

  12. Gamma-rays attenuation of zircons from Cambodia and South Africa at different energies: A new technique for identifying the origin of gemstone

    International Nuclear Information System (INIS)

    Limkitjaroenporn, P.; Kaewkhao, J.

    2014-01-01

    In this work, the gamma-rays interaction properties of zircons from Cambodia and South Africa have been studied. The densities of Cambodian and South African’s zircons are 4.6716±0.0040 g/cm 3 and 4.5505±0.0018 g/cm 3 , respectively. The mass attenuation coefficient and the effective atomic number of gemstones were measured with the gamma-ray in energies range 223–662 keV using the Compton scattering technique. The mass attenuation coefficients of both zircons decreased with the increasing of gamma-rays energies. The different mass attenuation coefficients between the two zircons observed at gamma-ray energies below 400 keV are attributed to the differences in the photoelectric interaction. The effective atomic number of zircons was decreased with the increasing of gamma-ray energies and showed totally different values between the Cambodia and South Africa sources. The origins of the two zircons could be successfully identified by the method based on gamma-rays interaction with matter with advantage of being a non-destructive testing. - Highlights: • Gamma-rays interaction of zircons from Cambodia and South Africa studied. • Measured energy is during 223–662 keV. • Different μ m between the two zircons observed at gamma-ray energies below 400 keV. • The origins the two zircons could be successfully identified

  13. Quantitative assessment of a spatial multicriteria model for highly pathogenic avian influenza H5N1 in Thailand, and application in Cambodia

    Science.gov (United States)

    Paul, Mathilde C.; Goutard, Flavie L.; Roulleau, Floriane; Holl, Davun; Thanapongtharm, Weerapong; Roger, François L.; Tran, Annelise

    2016-01-01

    The Highly Pathogenic Avian Influenza H5N1 (HPAI) virus is now considered endemic in several Asian countries. In Cambodia, the virus has been circulating in the poultry population since 2004, with a dramatic effect on farmers’ livelihoods and public health. In Thailand, surveillance and control are still important to prevent any new H5N1 incursion. Risk mapping can contribute effectively to disease surveillance and control systems, but is a very challenging task in the absence of reliable disease data. In this work, we used spatial multicriteria decision analysis (MCDA) to produce risk maps for HPAI H5N1 in poultry. We aimed to i) evaluate the performance of the MCDA approach to predict areas suitable for H5N1 based on a dataset from Thailand, comparing the predictive capacities of two sources of a priori knowledge (literature and experts), and ii) apply the best method to produce a risk map for H5N1 in poultry in Cambodia. Our results showed that the expert-based model had a very high predictive capacity in Thailand (AUC = 0.97). Applied in Cambodia, MCDA mapping made it possible to identify hotspots suitable for HPAI H5N1 in the Tonlé Sap watershed, around the cities of Battambang and Kampong Cham, and along the Vietnamese border. PMID:27489997

  14. Can health systems be enhanced for optimal health services through disease-specific programs? Results of field studies in Viet Nam and Cambodia.

    Science.gov (United States)

    Egami, Y; Fujita, N; Akashi, H; Matsumoto, Y; Ohara, H; Takeuchi, M

    2012-02-01

    Developing better health systems is the key to delivering optimal health services, although more evidence of effective strategies to do so is needed. Field surveys were conducted in Viet Nam and Cambodia to identify best practices in addressing health system bottlenecks to scale up disease control programs. The two countries were compared over time using a framework for analysis developed by the authors. In Viet Nam, a health system was in place for decades at the central to municipal levels, although it was fragile until the 1990s, when the government started taking measures. In Cambodia, the previous health system had been destroyed during previous internal conflict. In the post-conflict period, the health system was rebuilt with support for programs followed by centralization of health services. In different settings, different measures were taken to deal with similar bottlenecks. In Cambodia, vertical programs were dominant, so the government sought to centralize drug management to deal with shortages of essential drugs, while Viet Nam sought to mobilize resources to ensure drug distribution at all levels. This study shows there is no single successful approach to health systems, and a systemic approach needs to be taken because elimination of one bottleneck may reveal another. Efforts to enhance disease-specific programs may not always contribute to overall enhancement of the health system, and the best possible approach may not be the same in different countries. Further study is needed to explore common issues and principles for effective strategies to enhance health systems in different contexts.

  15. AIDS-related stigma and mental disorders among people living with HIV: a cross-sectional study in Cambodia.

    Directory of Open Access Journals (Sweden)

    Siyan Yi

    Full Text Available AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV. We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12 was used to measure mental disorders. Multivariate logistic regression analysis was conducted.The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4. After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4 remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4-2.6, higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2-2.3, and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1-2.2.AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.

  16. Socially-marketed rapid diagnostic tests and ACT in the private sector: ten years of experience in Cambodia

    Directory of Open Access Journals (Sweden)

    Allen Henrietta

    2011-08-01

    Full Text Available Abstract Whilst some populations have recently experienced dramatic declines in malaria, the majority of those most at risk of Plasmodium falciparum malaria still lack access to effective treatment with artemisinin combination therapy (ACT and others are already facing parasites resistant to artemisinins. In this context, there is a crucial need to improve both access to and targeting of ACT through greater availability of good quality ACT and parasitological diagnosis. This is an issue of increasing urgency notably in the private commercial sector, which, in many countries, plays an important role in the provision of malaria treatment. The Affordable Medicines Facility for malaria (AMFm is a recent initiative that aims to increase the provision of affordable ACT in public, private and NGO sectors through a manufacturer-level subsidy. However, to date, there is little documented experience in the programmatic implementation of subsidized ACT in the private sector. Cambodia is in the unique position of having more than 10 years of experience not only in implementing subsidized ACT, but also rapid diagnostic tests (RDT as part of a nationwide social marketing programme. The programme includes behaviour change communication and the training of private providers as well as the sale and distribution of Malarine, the recommended ACT, and Malacheck, the RDT. This paper describes and evaluates this experience by drawing on the results of household and provider surveys conducted since the start of the programme. The available evidence suggests that providers' and consumers' awareness of Malarine increased rapidly, but that of Malacheck much less so. In addition, improvements in ACT and RDT availability and uptake were relatively slow, particularly in more remote areas. The lack of standardization in the survey methods and the gaps in the data highlight the importance of establishing a clear system for monitoring and evaluation for similar initiatives

  17. Field assessment of a novel spatial repellent for malaria control: a feasibility and acceptability study in Mondulkiri, Cambodia.

    Science.gov (United States)

    Liverani, Marco; Charlwood, Jacques Derek; Lawford, Harriet; Yeung, Shunmay

    2017-10-13

    Large-scale use of insecticide-treated nets and indoor residual spraying have contributed to a significant decrease in malaria transmission worldwide. Further reduction and progress towards elimination, however, require complementary control measures which can address the remaining gaps in protection from mosquito bites. Following the development of novel pyrethroids with high knockdown effects on malaria vectors, programmatic use of spatial repellents has been suggested as one potential strategy to fill the gaps. This report explores social and contextual factors that may influence the relevance, uptake and sustainable use of a spatial repellent in two remote villages in Mondulkiri province, Cambodia, with endemic malaria transmission. The repellent consisted of polyethylene emanators, held in an open plastic frame and impregnated with 10% metofluthrin. In a baseline survey, 90.9% of households in Ou Chra (n = 30/33) and 96.6% in Pu Cha (n = 57/59) were interviewed. Behavioural data were collected for all household occupants (n = 448). In both villages, there were times and places in which people remained exposed to mosquito bites. Prior to the installation of the repellent, 50.6 and 59.5% of respondents noted that bites occurred "very often" inside the house and in the outdoor area surrounding the house, respectively. Indoor biting was reported to occur more frequently in the evening, followed by at night, while outdoor biting occurred more frequently in the early morning. In a follow-up survey, spatial repellents were well received in both villages, although 63.2% of respondents would not replace bed nets with repellents. Most participants (96.6%) were willing to use the product again; the mean willingness to pay was US$ 0.3 per unit. A preference for local procurement methods emerged. Widespread use of spatial repellents would not fill all protective gaps, but, if their entomological efficacy can be ascertained, outdoor application has the potential to

  18. Determining barriers to creating an enabling environment in Cambodia: results from a baseline study with key populations and police.

    Science.gov (United States)

    Schneiders, Mira L; Weissman, Amy

    2016-01-01

    Cambodian law enforcement's limited acceptance of harm reduction has hindered HIV program effectiveness. With funding from the Australian Department of Foreign Affairs and Trade, FHI 360 supported the Ministry of Interior to implement the Police Community Partnership Initiative (PCPI) in Cambodia's capital Phnom Penh. To guide this, FHI 360 conducted a baseline study examining police and key populations' attitudes and practices towards one another, including fear and occurrence of arrest. Between December 2012 and January 2013, a cross-sectional survey of 199 police post officers, 199 people who use drugs (PWUD) including people who inject drugs (PWID), 199 men who have sex with men (MSM), 200 transgender women (TGW) and 200 female entertainment workers (FEW) was conducted in five Phnom Penh districts. Eligible participants were ≥18 years, members of a key population from selected hotspots or police officers, deputy chiefs or chiefs. Key populations' median age was 25 years (IQR: 22-30); 40% had completed only primary school. Police were male (99.5%), with median age 43 years (IQR: 30 to 47), and 45 and 25% high school and university completion rates, respectively. Key populations feared arrest for carrying needles and syringes (67%), condoms (23%) and 19% felt afraid to access health services. Close to 75% of police reported body searching and 58% arresting key populations in the past six months for using drugs (64%), selling or distributing drugs (36%) or being violent (13%). Self-reported arrests (23% PWUD, 6% MSM, 6% TGW, 12% FEW; ppolice believed arrest was an appropriate solution to reduce HIV and drug use and reported selling sex (88%) and carrying needles and syringes (55%) as valid reasons for arrest. Key populations' fear of accessing harm reduction and health services and police's negative attitudes and practices towards key populations present major barriers to HIV prevention efforts in Cambodia. To create an enabling environment and ensure police are

  19. Re-imagining malaria: heterogeneity of human and mosquito behaviour in relation to residual malaria transmission in Cambodia.

    Science.gov (United States)

    Gryseels, Charlotte; Durnez, Lies; Gerrets, René; Uk, Sambunny; Suon, Sokha; Set, Srun; Phoeuk, Pisen; Sluydts, Vincent; Heng, Somony; Sochantha, Tho; Coosemans, Marc; Peeters Grietens, Koen

    2015-04-24

    In certain regions in Southeast Asia, where malaria is reduced to forested regions populated by ethnic minorities dependent on slash-and-burn agriculture, malaria vector populations have developed a propensity to feed early and outdoors, limiting the effectiveness of long-lasting insecticide-treated nets (LLIN) and indoor residual spraying (IRS). The interplay between heterogeneous human, as well as mosquito behaviour, radically challenges malaria control in such residual transmission contexts. This study examines human behavioural patterns in relation to the vector behaviour. The anthropological research used a sequential mixed-methods study design in which quantitative survey research methods were used to complement findings from qualitative ethnographic research. The qualitative research existed of in-depth interviews and participant observation. For the entomological research, indoor and outdoor human landing collections were performed. All research was conducted in selected villages in Ratanakiri province, Cambodia. Variability in human behaviour resulted in variable exposure to outdoor and early biting vectors: (i) indigenous people were found to commute between farms in the forest, where malaria exposure is higher, and village homes; (ii) the indoor/outdoor biting distinction was less clear in forest housing often completely or partly open to the outside; (iii) reported sleeping times varied according to the context of economic activities, impacting on the proportion of infections that could be accounted for by early or nighttime biting; (iv) protection by LLINs may not be as high as self-reported survey data indicate, as observations showed around 40% (non-treated) market net use while (v) unprotected evening resting and deep forest activities impacted further on the suboptimal use of LLINs. The heterogeneity of human behaviour and the variation of vector densities and biting behaviours may lead to a considerable proportion of exposure occurring during

  20. Applications of GIS and Other Geophysical Research Skills to Development and Experiential Education in Baray District, Cambodia

    Science.gov (United States)

    Zunino, A. J., III

    2017-12-01

    The presented assemblage of data and maps was collected and created from May 20th to 25th, 2017 on Hong Kong's Independent Schools Foundation (ISF) Academy's trip to the district of Baray, Cambodia, where students participated in an experiential learning program (ELP) in the rural village of Dharmrai Slaap. The focus of this data and mapping is to display development trends both static within Dharmrai Slaap as well as over time as ISF continues to serve the village. Ultimately the hope is that these resources will help all involved to better understand the needs of the community. The primary takeaways from this project with relation to topics of a geophysical nature are the application of scientific research techniques to the issue of development, the teaching of these applications to high school students within an experiential learning context, and ultimately the application of geophysical topics beyond the science classroom. Within 5 short days in Cambodia students: Gained a brief, hands-on introduction to ArcGIS via the design of the project's basemap. Applied quantitative research techniques to social science via the conducting of household interviews. Conducted spatial data collection in the field via the use of handheld GPS devices. Gained hands-on experience with soil coring and water sampling equipment collecting data in the field. Sociological and scientific attributes gathered by students in the field were then assigned spatial data based on coordinates recorded and ported into ArcGIS. Based on the information gathered a selection of maps could then be prepared to reflect trends and needs within the community. This record of spatial data ties into the service component of the experiential learning program, as over the years as this GIS project continues students will be able to see the community's upward trend toward development as a reflection of their service. It is through this application of geophysical research skills and approaches that the topic of

  1. Genetic markers associated with dihydroartemisinin–piperaquine failure in Plasmodium falciparum malaria in Cambodia: a genotype-phenotype association study

    Science.gov (United States)

    Amato, Roberto; Lim, Pharath; Miotto, Olivo; Amaratunga, Chanaki; Dek, Dalin; Pearson, Richard D.; Almagro-Garcia, Jacob; Neal, Aaron T.; Sreng, Sokunthea; Suon, Seila; Drury, Eleanor; Jyothi, Dushyanth; Stalker, Jim; Kwiatkowski, Dominic P.; Fairhurst, Rick M.

    2017-01-01

    Summary Background As the prevalence of artemisinin-resistant Plasmodium falciparum malaria increases in the Greater Mekong Subregion (GMS), emerging resistance to partner drugs in artemisinin combination therapies (ACTs) seriously threatens global efforts to treat and eliminate this disease. Molecular markers for ACT failure are urgently needed to monitor the spread of partner drug resistance, and to recommend alternative treatments in Southeast Asia and beyond. Methods We performed a genome-wide association study (GWAS) of 297 P. falciparum isolates from Cambodia to investigate the relationship of 11,630 exonic single-nucleotide polymorphisms (SNPs) and 43 copy number variations (CNVs) with in-vitro piperaquine 50% inhibitory concentrations (IC50s), and tested whether these genetic variants are markers of dihydroartemisinin-piperaquine failures. We then performed a survival analysis of 133 patients to determine whether candidate molecular markers predicted parasite recrudescence following dihydroartemisinin-piperaquine treatment. Findings Piperaquine IC50s increased significantly from 2011 to 2013 in 3 Cambodian provinces. Genome-wide analysis of SNPs identified a chromosome 13 region that associates with elevated piperaquine IC50s. A nonsynonymous SNP (encoding a Glu415Gly substitution) in this region, within a gene encoding an exonuclease, associates with parasite recrudescence following dihydroartemisinin-piperaquine treatment. Genome-wide analysis of CNVs revealed that a single copy of the mdr1 gene on chromosome 5 and a novel amplification of the plasmepsin II and plasmepsin III genes on chromosome 14 also associate with elevated piperaquine IC50s. After adjusting for covariates, both exo-E415G and plasmepsin II-III markers significantly associate with decreased treatment efficacy (0.38 and 0.41 survival rates, respectively). Interpretation The exo-E415G SNP and plasmepsin II-III amplification are markers of piperaquine resistance and dihydroartemisinin

  2. How understanding and application of drug-related legal instruments affects harm reduction interventions in Cambodia: a qualitative study.

    Science.gov (United States)

    Tuot, Sovannary; Ngin, Chanrith; Pal, Khuondyla; Sou, Sochenda; Sawez, Ghazal; Morgan, Phylicia; Srey, Mony; Chan, Tola; Chhoun, Pheak; Golichenko, Olga; Choub, Sok Chamreun; Yi, Siyan

    2017-06-19

    Harm reduction interventions in Cambodia face numerous obstacles because of conflicting understanding and interests and inconsistencies in the implementation by law enforcement officials. This study aims to examine how understanding and application of Drug Control Law (DCL) and Village/Commune Safety Policy (VCSP) affects harm reduction interventions in Cambodia from the standpoints of law enforcement officials, people who inject drugs and people who use drugs (PWID/PWUD), as well as other key stakeholders. This qualitative study was conducted in the capital city of Phnom Penh in 2015. We held five focus group discussions (FGDs) with groups of PWID/PWUD, police officers, Sangkat/commune officers, and local non-governmental organization (NGO) field staff. We also conducted ten key informant interviews (KIIs) with representatives from government agencies, donor agencies, and NGOs. FGDs and KIIs with Cambodian participants were transcribed in Khmer and translated into English. KIIs with foreign participants were transcribed in English. Transcripts were read and re-read to identify emerging themes, which were reviewed and refined to develop common and divergent patterns. There was a huge gap between what the DCL and VCSP say and how law enforcement officers and PWID/PWUD understood them. The gap was also evident in how law enforcement officers implemented the DCL and VCSP. Harm reduction services, including health- and non-health-related interventions, were limited and challenged by unsupportive attitudes, misinterpretation of the DCL and VCSP, and the lack of full engagement with NGOs in the development of these instruments. The needs of PWID/PWUD in accessing health care services were not met due to misconduct of authorities while practicing the DCL and VCSP. Further, the misconduct and enforcement of the law and policy lead to increased social discrimination and physical abuses against PWID/PWUD. There is a lack of common understanding of the drug-related law and

  3. Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia.

    Science.gov (United States)

    Yi, Siyan; Ngin, Chanrith; Pal, Khuondyla; Khol, Vohith; Tuot, Sovannary; Sau, Sokunmealiny; Chhoun, Pheak; Mburu, Gitau; Choub, Sok Chamreun; Chhim, Kolab; Ly, Penhsun

    2017-07-17

    Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia. In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15-17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a high- or low level of preparedness for transition. Bivariate and multivariate analyses were conducted. Of 223 adolescents, 55.2% were male, and their mean age was 15.8 years. Overall, 53.3% had a high level of preparedness for transition. As part of the transition protocol, 2.7% had completed a transfer form, 24.7% had a transition case manager, 29.6% had been counselled about the transition, and 19.7% had visited an adult ART clinic. In multivariate analysis, a higher level of preparedness for transition was independently associated with older age (AOR 2.44, 95% CI 1.34-4.46; p = 0.004), family having received social support for their health (AOR 5.32, 95% CI 1.97-14.36; p = 0.001), knowing the kind of treatment they received (ART) (AOR 12.67, 95% CI 2.91-15.19; p = 0.001), trust in friends or family for HIV treatment (AOR 7.82, 95% CI 1.13-8.89; p = 0.008), receiving counseling on transition (AOR 3.17, 95% CI 1.15-8.76; p = 0.03), having a 'Case Manager' identified to support them during the preparation process for transition (AOR 3.89, 95% CI 1.08-13.96; p = 0.04), and satisfaction with preparation process for transition in general (AOR 0.35, 95% CI 0.03-0.87; p = 0.01). A range of individual, social and health system and services factors may determine successful

  4. HIV treatment cascade among female entertainment and sex workers in Cambodia: impact of amphetamine use and an HIV prevention program.

    Science.gov (United States)

    Muth, Sokunny; Len, Aynar; Evans, Jennifer L; Phou, Maly; Chhit, Sophal; Neak, Yuthea; Ngak, Song; Stein, Ellen S; Carrico, Adam W; Maher, Lisa; Page, Kimberly

    2017-09-05

    HIV prevalence remains high in Cambodia among female entertainment and sex workers (FESW), and amphetamine-type stimulant (ATS) use significantly increases risk of infection. A successful continuum of care (CoC) is key to effective clinical care and prevention. This study aimed to describe the HIV CoC in HIV-positive FESW. We examined CoC outcomes among HIV-positive FESW participating in the Cambodia Integrated HIV and Drug Prevention Implementation (CIPI) study, being implemented in ten provinces. CIPI is a trial aimed at reducing ATS use concomitant with the SMARTgirl HIV prevention program. From 2013 to 2016, 1198 FESW ≥ 18 years old who reported multiple sex partners and/or transactional sex were recruited. We identified 88 HIV-positive women at baseline. We described linkage to care as 12-month retention and viral suppression (HIV-positive women was 32 years [interquartile range (IQR) 28, 35]; 50% were working in entertainment venues and 50% as freelance sex workers; 70% reported SMARTgirl membership. In the past 3 months, women reported a median of 15 sex partners, 38% reported unprotected sex, and 55% reported using ATS. Overall, 88% were receiving HIV care, 83% were on antiretroviral therapy, 39% were retained in care at 12 months, and 23% were virally suppressed. SMARTgirl membership was independently associated with fourfold greater odds of 12-month retention in care (AOR = 4.16, 95% CI 1.38, 12.56). Those at high risk for an ATS use disorder had 91% lower odds of 12-month retention in care (AOR = 0.09, 95% CI 0.01, 0.72). Viral suppression was independently associated with SMARTgirl membership, older age, reporting of STI symptoms, worse symptoms of psychological distress, and greater numbers of sex partners. This is the first study to characterize the HIV CoC in Cambodian FESW. While most women were successfully linked to HIV care, retention and viral suppression were low. Tailored programs like SMARTgirl, targeting the broader population of

  5. A multi-level spatial analysis of clinical malaria and subclinical Plasmodium infections in Pailin Province, Cambodia

    Directory of Open Access Journals (Sweden)

    Daniel M. Parker

    2017-11-01

    Full Text Available Background: The malaria burden is decreasing throughout the Greater Mekong Subregion, however transmission persists in some areas. Human movement, subclinical infections and complicated transmission patterns contribute to the persistence of malaria. This research describes the micro-geographical epidemiology of both clinical malaria and subclinical Plasmodium infections in three villages in Western Cambodia. Methods: Three villages in Western Cambodia were selected for the study based on high reported Plasmodium falciparum incidence. A census was conducted at the beginning of the study, including demographic information and travel history. The total population was 1766. Cross-sectional surveys were conducted every three months from June 2013 to June 2014. Plasmodium infections were detected using an ultra-sensitive, high-volume, quantitative polymerase chain reaction (uPCR technique. Clinical episodes were recorded by village health workers. The geographic coordinates (latitude and longitude were collected for all houses and all participants were linked to their respective houses using a demographic surveillance system. Written informed consent was obtained from all participants. Results: Most clinical episodes and subclinical infections occurred within a single study village. Clinical Plasmodium vivax episodes clustered spatially in each village but only lasted for a month. In one study village subclinical infections clustered in geographic proximity to clusters of clinical episodes. The largest risk factor for clinical P. falciparum episodes was living in a house where another clinical P. falciparum episode occurred (model adjusted odds ratio (AOR: 6.9; CI: 2.3–19. 8. Subclinical infections of both P. vivax and P. falciparum were associated with clinical episodes of the same species (AOR: 5.8; CI: 1.5–19.7 for P. falciparum and AOR: 14.6; CI: 8.6–25.2 for P. vivax and self-reported overnight visits to forested areas (AOR = 3.8; CI: 1.8

  6. FY1998 survey report on the site surveys on regional situations in improvement in energy consumption (Cambodia and Bangladesh); 1998 nendo energy shohi koritsuka nado chiiki josei genchi chosa hokokusho (Cambodia, Bangladesh) chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    In order to promote technical cooperation of Japan with Asia in the energy aspect, site surveys were carried out on improvement in energy consumption efficiency. Electric power supply in Cambodia is made mostly from EDC, whose power generation amount in 1997 was 310 million kwh, while the power sold was 230 million kwh, with 26.1% of the total generation amount, or 80 million kwh being wasted as the loss. Existing power generation facilities are old and small in scale, made by the former Soviet Union making the repair difficult. The loss is enormous because of aging in power distribution facilities, overload operation, and power stealing. The efficiency is extremely poor, whereas improvement in efficiency of the existing facilities is indispensable to cope with the anticipated increase in the demand. In Bangladesh, 90% of the power is generated by using natural gas produced in the eastern part of the country. Many power plants are experiencing decreased efficiency due to the facility aging and insufficient and improper maintenance. The power transmission and distribution departments have had a large loss in power, which has become one of the most important issues. The loss exceeds 30%. The government is trying to achieve efficiency improvement in the electric power business through introducing the principle of competition by establishing new private companies. However, this approach is facing severe objection from the governmental and public labor unions, making the future development opaque. (NEDO)

  7. Agricultural residue gasification for low-cost, low-carbon decentralized power: An empirical case study in Cambodia

    International Nuclear Information System (INIS)

    Field, John L.; Tanger, Paul; Shackley, Simon J.; Haefele, Stephan M.

    2016-01-01

    Highlights: • Four operating small-scale distributed gasification power systems were observed. • System carbon and energy balance, profitability, and GHG performance were assessed. • Best systems mitigated >1 MgCO_2eq (Mg feedstock)"−"1 and recouped costs within a year. • Wide variability in performance across systems; some likely un-profitable. - Abstract: Small-scale distributed gasification can provide energy access for low-carbon sustainable development, though current understanding of the economic and environmental performance of the technology relies mostly on assumption-heavy modeling studies. Here we report a detailed empirical assessment and uncertainty estimation for four real-world gasification power systems operating at rice mills in rural Cambodia. System inputs and outputs were characterized while operating in both diesel and dual-fuel modes and synthesized into a model of carbon and energy balance, economic performance, and greenhouse gas mitigation. Our results confirm that the best-performing systems reduce diesel fuel use by up to 83%, mitigating greenhouse gas emissions and recouping the initial system capital investment within one year. However, we observe a significant performance disparity across the systems observed leading to a wide range of economic outcomes. We also highlight related critical sustainability challenges around the management of byproducts that should be addressed before more widespread implementation of the technology.

  8. Incorporating Canopy Cover for Airborne-Derived Assessments of Forest Biomass in the Tropical Forests of Cambodia.

    Science.gov (United States)

    Singh, Minerva; Evans, Damian; Coomes, David A; Friess, Daniel A; Suy Tan, Boun; Samean Nin, Chan

    2016-01-01

    This research examines the role of canopy cover in influencing above ground biomass (AGB) dynamics of an open canopied forest and evaluates the efficacy of individual-based and plot-scale height metrics in predicting AGB variation in the tropical forests of Angkor Thom, Cambodia. The AGB was modeled by including canopy cover from aerial imagery alongside with the two different canopy vertical height metrics derived from LiDAR; the plot average of maximum tree height (Max_CH) of individual trees, and the top of the canopy height (TCH). Two different statistical approaches, log-log ordinary least squares (OLS) and support vector regression (SVR), were used to model AGB variation in the study area. Ten different AGB models were developed using different combinations of airborne predictor variables. It was discovered that the inclusion of canopy cover estimates considerably improved the performance of AGB models for our study area. The most robust model was log-log OLS model comprising of canopy cover only (r = 0.87; RMSE = 42.8 Mg/ha). Other models that approximated field AGB closely included both Max_CH and canopy cover (r = 0.86, RMSE = 44.2 Mg/ha for SVR; and, r = 0.84, RMSE = 47.7 Mg/ha for log-log OLS). Hence, canopy cover should be included when modeling the AGB of open-canopied tropical forests.

  9. A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy.

    Science.gov (United States)

    Seponski, Desiree M; Lewis, Denise C; Megginson, Maegan C

    2014-01-01

    Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

  10. Investigation of smallholder farmer biosecurity and implications for sustainable foot-and-mouth disease control in Cambodia.

    Science.gov (United States)

    Young, J R; Suon, S; Olmo, L; Bun, C; Hok, C; Ashley, K; Bush, R D; Windsor, P A

    2017-12-01

    In Cambodia, the majority of the population is rural and reliant on subsistence agriculture, with cattle raised by smallholder farmers using traditional practices, resulting in low productivity and vulnerability to foot-and-mouth disease (FMD). As FMD causes deleterious impacts on rural livelihoods, known FMD risk factors were reviewed, using knowledge, attitudes and practice (KAP) surveys of smallholders (n = 240) from four regions. The study aimed to understand current biosecurity threats to smallholder livelihoods and investigate the hypothesis that smallholder farmers practising FMD risk management should be associated with higher incomes from cattle. Descriptive data were examined to demonstrate trends in KAP and a multivariable linear regression model developed to identify cattle income predictors. Results showed that baseline mean knowledge scores were low at 28.4% across all regions and basic biosecurity practices, including quarantine of new cattle, isolation of sick cattle and FMD vaccination, were lacking. As farmers purchase and sell cattle from and to various administration levels (including export), there is high risk of FMD transmission into and from smallholder communities. The final multivariable linear regression model identified significant explanatory parameters for annual cattle income, including region, number of calves born, forage plot size (ha), vaccination of cattle and the number of cattle purchased (F pr. livestock development programmes implement a systems approach to enhance farmer KAP in biosecurity, nutrition, reproduction and marketing of cattle. © 2017 Blackwell Verlag GmbH.

  11. Using high-resolution in situ radon measurements to determine groundwater discharge at a remote location: Tonle Sap Lake, Cambodia

    International Nuclear Information System (INIS)

    Burnett, W.C.; Chanyotha, S.

    2013-01-01

    Tonle Sap Lake (Cambodia) is the largest freshwater lake in SE Asia, and is reported to have one of the highest freshwater fish productions anywhere. During the dry season (November-April) the lake drains through a tributary to the Mekong River. The flow in the connecting tributary completely reverses during the wet monsoon (May-October), adding huge volumes of water back to the lake, increasing its area about fourfold. We hypothesize that nutrients are at least partially delivered via groundwater discharge, especially during the draining portion of the annual flood cycle. We surveyed over 200 km in the northern section of the lake using a customized system that measures natural 222 Rn (radon), temperature, conductivity, GPS coordinates and water depth while underway. Results showed that there were portions of the lake with significant enrichments in radon, indicating likely groundwater inputs. These same areas were generally characterized by lower electrical conductivities. Samples collected from nearby wells also showed a general inverse relationship between radon and conductivity. Our data suggest that groundwater pathways are important, accounting for roughly 10-20 % of the freshwater flow of the Tonle Sap tributary (connection to the Mekong River), the largest single source of fresh water to the lake. Nutrient inputs from these inputs, because of higher concentrations in groundwater, will be correspondingly higher. (author)

  12. South-East Asian Fortified Stone Walls: Angkor Thom (Cambodia, Ho Citadel (Vietnam and Ratu Boko (Indonesia

    Directory of Open Access Journals (Sweden)

    Víctor Lluís Pérez Garcia

    2017-02-01

    Full Text Available This article aims to analyze three significant examples of defensive walls from South-East Asia made of solid stone blocks (both rock as well as stone-like laterite and provided with different but equivalent functions –a fortified imperial capital-city (Angkor Thom, in Cambodia, a fortified royal citadel (Ho Citadel, in the North of Vietnam and a royal palace with a partly fortified appearance (Ratu Boko, in Java Island, Indonesia–, focusing on their constructive and technical characteristics and establishing parallels between them and their closest counterparts, from China and India. We will see how their design and structure can be closely related to the fortifications of neighbouring empires, as places of origin of their strong cultural influences and, at the same time, we will try to identify the local particularities. We will pay special attention to the form of the fortified enceintes, considering the long tradition of the quadrangular plan in the walls of royal capitals, inspired in the ideal model of Chinese and Indian cities. Our research also make us think that the walls of Ratu Boko, despite their functions as symbolic limits or for retaining the soil, could also have had a defensive purpose, no matter if secondary, or at least they could be used to provide protection to the complex in case of external menace.

  13. Electrical resistivity tomography determines the spatial distribution of clay layer thickness and aquifer vulnerability, Kandal Province, Cambodia

    Science.gov (United States)

    Uhlemann, Sebastian; Kuras, Oliver; Richards, Laura A.; Naden, Emma; Polya, David A.

    2017-10-01

    Despite being rich in water resources, many areas of South East Asia face difficulties in securing clean water supply. This is particularly problematic in regions with a rapidly growing population. In this study, the spatial variability of the thickness of a clay layer, controlling surface - groundwater interactions that affect aquifer vulnerability, was investigated using electrical resistivity tomography (ERT). Data were acquired along two transects, showing significant differences in the imaged resistivities. Borehole samples were analyzed regarding particle density and composition, and linked to their resistivity. The obtained relationships were used to translate the field electrical resistivities into lithologies. Those revealed considerable variations in the thickness of the clay layer, ranging from 0 m up to 25 m. Geochemical data, highlighting zones of increased ingress of surface water into the groundwater, confirmed areas of discontinuities in the clay layer, which act as preferential flow paths. The results may guide urban planning of the Phnom Penh city expansion, in order to supply the growing population with safe water. The presented approach of using geophysics to estimate groundwater availability, accessibility, and vulnerability is not only applicable to Kandal Province, Cambodia, but also to many other areas of fast urbanization in South East Asia and beyond.

  14. Assessing mixed trace elements in groundwater and their health risk of residents living in the Mekong River basin of Cambodia

    International Nuclear Information System (INIS)

    Phan, Kongkea; Phan, Samrach; Huoy, Laingshun; Suy, Bunseang; Wong, Ming Hung; Hashim, Jamal Hisham; Mohamed Yasin, Mohamed Salleh; Aljunid, Syed Mohamed; Sthiannopkao, Suthipong; Kim, Kyoung-Woong

    2013-01-01

    We investigated the potential contamination of trace elements in shallow Cambodian groundwater. Groundwater and hair samples were collected from three provinces in the Mekong River basin of Cambodia and analyzed by ICP-MS. Groundwater from Kandal (n = 46) and Kraite (n = 12) were enriched in As, Mn, Ba and Fe whereas none of tube wells in Kampong Cham (n = 18) had trace elements higher than Cambodian permissible limits. Risk computations indicated that 98.7% and 12.4% of residents in the study areas of Kandal (n = 297) and Kratie (n = 89) were at risk of non-carcinogenic effects from exposure to multiple elements, yet none were at risk in Kampong Cham (n = 184). Arsenic contributed 99.5%, 60.3% and 84.2% of the aggregate risk in Kandal, Kratie and Kampong Cham, respectively. Sustainable and appropriate treatment technologies must therefore be implemented in order for Cambodian groundwater to be used as potable water. -- Highlights: •We investigated the potential contamination of trace elements in Cambodian groundwater. •Residents of Kandal (98.7%) and Kratie (12.4%) were at risk of non-carcinogenic effects. •Significant positive correlation between As, Mn and Ba in groundwater and hair were found. -- Risk assessment indicated that 98.7% of residents in Kandal and 12.4% of Kratie study areas were at risk of non-carcinogenic effects of multiple elements in groundwater

  15. The Economic Burden of Malnutrition in Pregnant Women and Children under 5 Years of Age in Cambodia

    Science.gov (United States)

    Moench-Pfanner, Regina; Silo, Sok; Laillou, Arnaud; Wieringa, Frank; Hong, Rathamony; Hong, Rathavuth; Poirot, Etienne; Bagriansky, Jack

    2016-01-01

    Malnutrition is locked in a vicious cycle of increased mortality, poor health, impaired cognitive development, slow physical growth, reduced learning capacity, inferior performance, and ultimately lower adult work performance and productivity. The consensus of global scientific evidence indicates that lowering the rates of malnutrition will be an indispensable component of any successful program to raise the quality of human capital and resources. This study used a “consequence model” to apply the coefficient risk-deficit on economic losses, established in the global scientific literature, to Cambodian health, demographic, and economic data to develop a national estimate of the value of economic losses due to malnutrition. The impact of the indicators of malnutrition analyzed represent a burden to the national economy of Cambodia estimated at 266 million USD annually (1.7% of GDP). Stunting is reducing the Cambodian economic output by more than 120 million USD, and iodine deficiency disorders alone by 57 million USD. This economic burden is too high in view of Cambodia’s efforts to drive economic development. The government should rapidly expand a range of low-cost effective nutrition interventions to break the current cycle of increased mortality, poor health and ultimately lower work performance, productivity, and earnings. PMID:27187462

  16. Pesticide Use and Self-Reported Symptoms of Acute Pesticide Poisoning among Aquatic Farmers in Phnom Penh, Cambodia

    Directory of Open Access Journals (Sweden)

    Hanne Klith Jensen

    2011-01-01

    Full Text Available Organophosphates and carbamates (OPs/CMs are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers in Boeung Cheung Ek (BCE Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88% had experienced symptoms of acute pesticide poisoning, and this was significantly associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02–1.28. The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22–0.91. These findings suggest that improving safe pesticide management practices among the farmers and enforcing the effective banning of the most toxic pesticides will considerably reduce the number of acute pesticide poisoning episodes.

  17. Local drinking water filters reduce diarrheal disease in Cambodia: a randomized, controlled trial of the ceramic water purifier.

    Science.gov (United States)

    Brown, Joe; Sobsey, Mark D; Loomis, Dana

    2008-09-01

    A randomized, controlled intervention trial of two household-scale drinking water filters was conducted in a rural village in Cambodia. After collecting four weeks of baseline data on household water quality, diarrheal disease, and other data related to water use and handling practices, households were randomly assigned to one of three groups of 60 households: those receiving a ceramic water purifier (CWP), those receiving a second filter employing an iron-rich ceramic (CWP-Fe), and a control group receiving no intervention. Households were followed for 18 weeks post-baseline with biweekly follow-up. Households using either filter reported significantly less diarrheal disease during the study compared with a control group of households without filters as indicated by longitudinal prevalence ratios CWP: 0.51 (95% confidence interval [CI]: 0.41-0.63); CWP-Fe: 0.58 (95% CI: 0.47-0.71), an effect that was observed in all age groups and both sexes after controlling for clustering within households and within individuals over time.

  18. [How practical guidelines can be applied in poor countries? Example of the introduction of a bronchoscopy unit in Cambodia].

    Science.gov (United States)

    Couraud, S; Chan, S; Avrillon, V; Horn, K; Try, S; Gérinière, L; Perrot, É; Guichon, C; Souquet, P-J; Ny, C

    2013-10-01

    According to UN, Cambodia is one of the poorest countries in the World. Respiratory diseases are current public health priorities. In this context, a new bronchoscopy unit (BSU) was created in the respiratory medicine department of Preah Kossamak hospital (PKH) thanks to a tight cooperation between a French and a Cambodian team. Aim of this study was to describe conditions of introduction of this equipment. Two guidelines for practice are available. They are respectively edited by the French and British societies of pulmonology. These guidelines were reviewed and compared to the conditions in which BS was introduced in PKH. Each item from guidelines was combined to a categorical value: "applied", "adapted" or "not applied". In 2009, 54 bronchoscopies were performed in PKH, mainly for suspicion of infectious or tumour disease. In total, 52% and 46% of the French and British guideline items respectively were followed in this Cambodian unit. Patient safety items are those highly followed. By contrast "staff safety" items were those weakly applied. Implementation of EBS in developing countries seems feasible in good conditions of quality and safety for patients. However, some recommendations cannot be applied due to local conditions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Investors, Managers, Brokers, and Culture Workers: How the "New" Chinese are Changing the Meaning of Chineseness in Cambodia

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    Pál Nyíri

    2012-09-01

    Full Text Available China has become the largest source of capital in Cambodia. Managers of state enterprises that construct hydropower plants and roads—as well as private investors and managers in mining, agricultural land concessions, and garment manufacturing—wield increasing influence and are beginning to shape labor practices. In this situation, mainland Chinese migrants are no longer seen by the Sino-Khmer as the marginal and suspect outsiders that they were twenty years ago. Rather, for both the increasingly entrenched Sino-Khmer elite and the struggling Sino-Khmer middle classes, they are a source of business opportunities or jobs. The Sino-Khmer have emerged as middlemen both between Chinese capital and the neopatrimonial Cambodian state and between Chinese managers and Khmer labor. This role is predicated upon a display of Chineseness whose form and content is itself rapidly changing under the influence of an increasing number of teachers and journalists who come from the mainland to run Cambodia’s Chinese-language press and schools. This paper will attempt to makes sense of the facets of this change.

  20. The Economic Burden of Malnutrition in Pregnant Women and Children under 5 Years of Age in Cambodia

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    Regina Moench-Pfanner

    2016-05-01

    Full Text Available Malnutrition is locked in a vicious cycle of increased mortality, poor health, impaired cognitive development, slow physical growth, reduced learning capacity, inferior performance, and ultimately lower adult work performance and productivity. The consensus of global scientific evidence indicates that lowering the rates of malnutrition will be an indispensable component of any successful program to raise the quality of human capital and resources. This study used a “consequence model” to apply the coefficient risk-deficit on economic losses, established in the global scientific literature, to Cambodian health, demographic, and economic data to develop a national estimate of the value of economic losses due to malnutrition. The impact of the indicators of malnutrition analyzed represent a burden to the national economy of Cambodia estimated at 266 million USD annually (1.7% of GDP. Stunting is reducing the Cambodian economic output by more than 120 million USD, and iodine deficiency disorders alone by 57 million USD. This economic burden is too high in view of Cambodia’s efforts to drive economic development. The government should rapidly expand a range of low-cost effective nutrition interventions to break the current cycle of increased mortality, poor health and ultimately lower work performance, productivity, and earnings.

  1. Introduction of ELISA techniques for the Diagnosis and epidemiology of foot-and-mouth disease in Cambodia

    International Nuclear Information System (INIS)

    Sothoeun, S.

    2000-01-01

    Foot-and-mouth disease (FMD) is endemic in the Kingdom of Cambodia and causes major problems to farmers as well as losses in overall terms to the national economy. Losses are due to treatment of sick animal, impact on rice cultivation through the loss of ploughing capabilities, death of animals and finally, through effects on animal trade. The disease affects cattle, buffalo and pig throughout the year. In 1998, 22 cattle actually died whilst 35,000 showed clinical signs of FMD. 1,400 buffaloes and 102 pigs also showed signs of FMD. Virus sero-types Asia I and O were identified from cattle and virus sero-type O was found from infected pig. Tested epithelium and vesicle fluid samples from sick animals for antigen type has shown that 78% were FMD sero-type O among cattle and pigs and 21% FMD sero-type Asia I from cattle. Titration of sera from vaccinated animal against FMD after second vaccination has shown high levels of immunity. All sera tested were positive at a dilution of 1:125 for sero-types O, Asia I and A. (author)

  2. Effects of the spatial repellent metofluthrin on landing rates of outdoor biting anophelines in Cambodia, Southeast Asia.

    Science.gov (United States)

    Charlwood, J D; Nenhep, S; Protopopoff, N; Sovannaroth, S; Morgan, J C; Hemingway, J

    2016-06-01

    The emergence of artemisinin-resistant malaria in Southeast Asia is a major problem. The fact that many people become infected with malaria when they are outside has prompted the development of 'spatial' rather than topical repellents. The respective effects of one or four slow-release emanators of metofluthrin, a pyrethroid, were tested in Pailin, Pursat and Koh Kong, Cambodia. Numbers of mosquitoes counted in outdoor landing catches when one or four emanators were suspended close to the collector were compared with control collections. In Pailin, the effects of emanators on catches in Furvela tent traps and Centers for Disease Control (CDC) light traps suspended underneath houses were also investigated. Rate ratios were used to determine differences. A total of 29 255 mosquitoes were collected over 2934 h of landing collections, 87 nights of tent trapping and 81 nights of light trap capture. In Pailin, landing rates were reduced by 48% by a single emanator and by 67% by four emanators (P metofluthrin collections (P > 0.05). These findings suggest that although the product can produce a significant effect, it requires further improvement. © 2016 The Royal Entomological Society.

  3. Isolation and identification of mold and yeast in medombae, a rice wine starter culture from Kompong Cham Province, Cambodia

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    Chay, C.,

    2017-07-01

    Full Text Available Medombae is a dried starter culture used for traditional rice wine processing in Cambodia. However, studies on the role of mold and yeast present and their efficacy for rice wine fermentation are still limited. Cultural and morphological tests revealed that the isolated representative mold strains were isolated based on the method of identification used as Mucor spp and Rhizopus oryzae. On the other hand, the biochemical properties of the first yeast isolate using the Vitek 2 identification system and YST Card identification suggests its identity as Candida tropicalis. The second yeast strain examined for its morphological and cultural characteristic using agar slide technique, and its protein profile which was compared to the reference and sample protein masses using Biomerieux Vitek MS (MALD-TOF showed the presence of Saccharomyces cerevisiae. The biochemical characteristics and cellular characteristics of the third yeast isolate as described by Lodder (1970 and Kreger-Van Rij (1984 confirmed its identity as Saccharomycopsis spp. The DNA test of identification of the isolates should be conducted to further confirm the identity of the isolates.

  4. Prevalence and antimicrobial resistance in Salmonella enterica isolated from broiler chickens, pigs and meat products in Thailand-Cambodia border provinces.

    Science.gov (United States)

    Trongjit, Suthathip; Angkititrakul, Sunpetch; Tuttle, R Emerson; Poungseree, Jiratchaya; Padungtod, Pawin; Chuanchuen, Rungtip

    2017-01-01

    This study aimed to examine the prevalence and antimicrobial resistance (AMR) of Salmonella isolates from broiler chickens, pigs and their associated meat products in the Thailand-Cambodia border provinces. A total of 941 samples were collected from pigs and broiler chickens at slaughter houses and from carcasses at local fresh markets in Sa Kaeo, Thailand (n = 554) and Banteay Meanchey, Cambodia (n = 387) in 2014 and 2015. From these samples, 345 Salmonella isolates were collected from Sa Keao (n = 145; 23%) and Banteay Meanchey (n = 200; 47%) and assayed for antimicrobial susceptibility, class 1 integrons and extended-spectrum β-lactamase (ESBL) genes. Serovars Typhimurium (29%) and Rissen (29%) were the most common serotypes found in Thai and Cambodian isolates, respectively. Multidrug resistance was detected in 34% and 52% of isolates from Sa Keao and Banteay Meanchey, respectively. The majority of the Thai isolates were resistant to ampicillin (72.4%), whereas most Cambodian isolates were resistant to sulfamethoxazole (71%). Eleven isolates from Sa Keao and 44 from Banteay Meanchey carried class 1 integrons comprising resistance gene cassettes. The most common gene cassette array was dfrA12-aadA2 (61.1%). Six isolates were ESBL producers. The β-lactamase genes found included bla TEM-1 , bla CTX-M-55 and bla CMY-2 . Some of these class 1 integrons and ESBL genes were located on conjugative plasmid. In conclusion, multidrug-resistant Salmonella are common in pigs, chickens and their products in the Thailand-Cambodia border provinces. Our findings indicate that class 1 integrons play a role in spread of AMR in the strains in this study. © 2017 The Societies and John Wiley & Sons Australia, Ltd.

  5. Adherence to PI-based 2nd-line regimens in Cambodia is not simply a question of individual behaviour: the ANRS 12276 2PICAM study.

    Science.gov (United States)

    Sagaon-Teyssier, Luis; Mmadi Mrenda, Bakridine; Khol, Vohith; Ferradini, Laurent; Mam, Sovatha; Ngin, Sopheak; Mora, Marion; Maradan, Gwenaëlle; Vun Mean, Chhi; Ségéral, Olivier; Nerrienet, Eric; Saphonn, Vonthanak; Spire, Bruno

    2017-11-01

    To investigate whether adherence to antiretroviral treatment (ART) can be explained not only by individual factors but also by health care facilities' characteristics, among a sample of people living with HIV (PLWH) treated with PI-based regimens in Cambodia. The ANRS 12276 2PICAM cross-sectional survey was conducted between February 2013 and April 2014 among PLWH followed up in 13 health care facilities. The 1316 patients in this analysis corresponded to 90% of the total number of adult patients treated with 2nd-line PI-based regimens in Cambodia in the study period. A variable indicating whether patients were non-adherent (=1) or completely adherent (=0) was constructed. Health care facilities and individual characteristics were included in a two-level logistic model to investigate their influence on patients' adherence to ART. A total of 17% of participants did not adhere to ART. Patients in health care facilities outside the capital Phnom Penh were six times more likely to be non-adherent than those treated in health care facilities in the capital (OR: 6.15, 95% CI [1.47, 25.79]). Providing psychosocial care (provided by psychologist counsellors and/or full-time coaches) was found to be a structural facilitator of adherence, as the probability of non-adherence fell by 38.5% per each additional psychological worker present in health care facilities (OR: 0.62, 95% CI [0.43, 0.89]). Financial constraints were the main individual factor preventing adherence. Our results suggest that inefficiencies in health care delivery are detrimental to PLWH health and to the exceptional progress currently being made by Cambodia in response to HIV. Policy makers should focus on increasing the number of psychosocial workers, especially in areas outside the capital. © 2017 John Wiley & Sons Ltd.

  6. HIV prevalence and factors associated with HIV infection among transgender women in Cambodia: results from a national Integrated Biological and Behavioral Survey.

    Science.gov (United States)

    Chhim, Srean; Ngin, Chanrith; Chhoun, Pheak; Tuot, Sovannary; Ly, Cheaty; Mun, Phalkun; Pal, Khondyla; Macom, John; Dousset, Jean-Philippe; Mburu, Gitau; Yi, Siyan

    2017-08-11

    To examine factors associated with HIV infection among transgender women in Cambodia. Cross-sectional study. HIV high-burden sites including the capital city and 12 provinces. This study included 1375 sexually active transgender women with a mean age of 25.9 years (SD 7.1), recruited by using respondent-driven sampling for structured questionnaire interviews and rapid finger-prick HIV testing. HIV infection detected by using Determine antibody test. HIV prevalence among this population was 5.9%. After adjustment for other covariates, participants living in urban areas were twice as likely to be HIV infected as those living in rural areas. Participants with primary education were 1.7 times as likely to be infected compared with those with high school education. HIV infection increased with age; compared with those aged 18-24 years, the odds of being HIV infected were twice as high among transgender women aged 25-34 years and 2.8 times higher among those aged ≥35 years. Self-injection of gender affirming hormones was associated with a fourfold increase in the odds of HIV infection. A history of genital sores over the previous 12 months increased the odds of HIV infection by threefold. Transgender women with stronger feminine identity, dressing as a woman all the time, were twice as likely to be HIV infected compared with those who did not dress as a woman all the time. Having never used online services developed for transgender women in the past six months was also associated with higher odds of being HIV infected. Transgender women in Cambodia are at high risk of HIV. To achieve the goal of eliminating HIV in Cambodia, effective combination prevention strategies addressing the above risk factors among transgender women should be strengthened. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Cost of dengue and other febrile illnesses to households in rural Cambodia: a prospective community-based case-control study

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    Margolis Harold S

    2009-05-01

    Full Text Available Abstract Background The average annual reported dengue incidence in Cambodia is 3.3/1,000 among children Methods In 2006, active fever surveillance was conducted among a cohort of 6,694 children aged ≤ 15 years in 16 villages in Kampong Cham province, Cambodia. Subsequently, a case-control study was performed by individually assigning one non-dengue febrile control from the cohort to each laboratory-confirmed dengue case. Parents of cases and controls were interviewed using a standardized questionnaire to determine household-level, illness-related expenditures for medical and non-medical costs, and estimated income loss (see Additional file 1. The household socio-economic status was determined and its possible association with health seeking behaviour and the ability to pay for the costs of a febrile illness. Additional File 1 2006 cost study survey questionnaire, Cambodia. the questionnaire represents the data collection instrument that was developed and used during the present study. Click here for file Results Between September and November 2006, a total of 60 household heads were interviewed: 30 with dengue-positive and 30 with dengue-negative febrile children. Mean total dengue-related costs did not differ from those of other febrile illnesses (31.5 vs. 27.2 US$, p = 0.44. Hospitalization almost tripled the costs of dengue (from 14.3 to 40.1 US$ and doubled the costs of other febrile illnesses (from 17.0 to 36.2 US$. To finance the cost of a febrile illness, 67% of households incurred an average debt of 23.5 US$ and higher debt was associated with hospitalization compared to outpatient treatment (US$ 23.1 vs. US$ 4.5, p Conclusion In Cambodia, dengue and other febrile illnesses pose a financial burden to households. A possible reason for a lower rate of hospitalization among children from poor households could be the burden of higher illness-related costs and debts.

  8. Hydrographic survey of Chaktomuk, the confluence of the Mekong, Tonlé Sap, and Bassac Rivers near Phnom Penh, Cambodia, 2012

    Science.gov (United States)

    Dietsch, Benjamin J.; Densmore, Brenda K.; Wilson, Richard C.

    2014-01-01

    The U.S. Geological Survey, in cooperation with the U.S. Department of State, Mekong River Commission, Phnom Penh Autonomous Port, and the Cambodian Ministry of Water Resources and Meteorology, completed a hydrographic survey of Chaktomuk, which is the confluence of the Mekong, Tonlé Sap (also spelled Tônlé Sab), and Bassac Rivers near Phnom Penh, Cambodia. The hydrographic survey used a high-resolution multibeam echosounder mapping system to map the riverbed during April 21–May 2, 2012.

  9. Comparison of novel and standard diagnostic tools for the detection of Schistosoma mekongi infection in Lao People's Democratic Republic and Cambodia.

    Science.gov (United States)

    Vonghachack, Youthanavanh; Sayasone, Somphou; Khieu, Virak; Bergquist, Robert; van Dam, Govert J; Hoekstra, Pytsje T; Corstjens, Paul L A M; Nickel, Beatrice; Marti, Hanspeter; Utzinger, Jürg; Muth, Sinuon; Odermatt, Peter

    2017-08-10

    Given the restricted distribution of Schistosoma mekongi in one province in Lao People's Democratic Republic (Lao PDR) and two provinces in Cambodia, together with progress of the national control programmes aimed at reducing morbidity and infection prevalence, the elimination of schistosomiasis mekongi seems feasible. However, sensitive diagnostic tools will be required to determine whether elimination has been achieved. We compared several standard and novel diagnostic tools in S. mekongi-endemic areas. The prevalence and infection intensity of S. mekongi were evaluated in 377 study participants from four villages in the endemic areas in Lao PDR and Cambodia using Kato-Katz stool examination, antibody detection based on an enzyme-linked immunosorbent assay (ELISA) and schistosome circulating antigen detection by lateral-flow tests. Two highly sensitive test systems for the detection of cathodic and anodic circulating antigens (CCA, CAA) in urine and serum were utilized. Stool microscopy revealed an overall prevalence of S. mekongi of 6.4% (one case in Cambodia and 23 cases in Lao PDR), while that of Opisthorchis viverrini, hookworm, Trichuris trichiura, Ascaris lumbricoides and Taenia spp. were 50.4%, 28.1%, 3.5%, 0.3% and 1.9%, respectively. In the urine samples, the tests for CCA and CAA detected S. mekongi infections in 21.0% and 38.7% of the study participants, respectively. In the serum samples, the CAA assay revealed a prevalence of 32.4%, while a combination of the CAA assay in serum and in urine revealed a prevalence of 43.2%. There was a difference between the two study locations with a higher prevalence reached in the samples from Lao PDR. The CCA, CAA and ELISA results showed substantially higher prevalence estimates for S. mekongi compared to Kato-Katz thick smears. Active schistosomiasis mekongi in Lao PDR and Cambodia might thus have been considerably underestimated previously. Hence, sustained control efforts are still needed to break transmission

  10. Poultry movement networks in Cambodia: implications for surveillance and control of highly pathogenic avian influenza (HPAI/H5N1).

    Science.gov (United States)

    Van Kerkhove, Maria D; Vong, Sirenda; Guitian, Javier; Holl, Davun; Mangtani, Punam; San, Sorn; Ghani, Azra C

    2009-10-23

    Movement of poultry through markets is potentially important in the circulation and spread of highly pathogenic avian influenza. However little is understood about poultry market chains in Cambodia. We conducted a cross-sectional survey of 715 rural villagers, 123 rural, peri-urban and urban market sellers and 139 middlemen from six provinces and Phnom Penh, to evaluate live poultry movement and trading practices. Direct trade links with Thailand and Vietnam were identified via middlemen and market sellers. Most poultry movement occurs via middlemen into Phnom Penh making live bird wet markets in Phnom Penh a potential hub for the spread of H5N1 and ideal for surveillance and control.

  11. Trends in unprotected intercourse among heterosexual men before and after brothel ban in Siem Reap, Cambodia: a serial cross-sectional study (2003-2012).

    Science.gov (United States)

    Wong, Mee Lian; Teo, Alvin Kuo Jing; Tai, Bee Choo; Ng, Alwyn Mao Tong; Lim, Raymond Boon Tar; Tham, Dede Kam Tyng; Kaur, Nashwinder; Tan, Rayner Kay Jin; Kros, Sarath; Touch, Savun; Chhit, Maryan; Lubek, Ian

    2018-03-27

    Following Cambodia's implementation of the 100% condom use program with enforcement of condom use and STI treatment services for sex workers in 2001, sexually transmitted infection and HIV declined markedly. In 2008, Cambodia implemented a law to ban brothel-based sex work. We reported trends in unprotected vaginal intercourse with sex workers among heterosexual men buying sex before (2003-2008) and after (2009-2012) the brothel ban in Cambodia. We also determined the association of brothel ban with these men's reports of unprotected intercourse with sex workers. In this serial cross-sectional study, we collected yearly behavioural data on random cross-sectional samples of heterosexual men buying sex who attended the only government health centre in Siem Reap for voluntary confidential counselling and testing (VCCT) between 2003 and 2012. We used multivariable Poisson regression analysis on the 10-year data of 976 men to obtain the adjusted prevalence ratio (aPR) of unprotected intercourse in the last 6 months by brothel closure. Men buying sex from non-brothel-based sex workers increased almost 3-fold from 17% in 2007-2008 before brothel closure to 55% in 2011-2012 after brothel closure (p < 0.001). Unprotected intercourse with sex workers in the last week increased significantly from 37% (2003-2004) before brothel closure to 65% (2011-2012) after brothel closure. This increase corresponded closely with the increase in self-reported unprotected intercourse from 35% to 61% by the sex workers (n = 1805) attending the same clinic for VCCT. Brothel closure was associated with an increased risk (aPR: 1.65; 95% CI: 1.40-1.94) of unprotected intercourse with sex workers. HIV prevalence in the heterosexual men declined significantly from 26% in 2003-2004 to 4.8% in 2007-2008 and 0 case in 2009-2010 before increasing to 5.6% in 2011-2012. Our findings suggest that the brothel ban had led to an increase in unprotected intercourse with all sex workers for men buying

  12. Spatio-temporal Characteristics of Land Use Land Cover Change Driven by Large Scale Land Transactions in Cambodia

    Science.gov (United States)

    Ghosh, A.; Smith, J. C.; Hijmans, R. J.

    2017-12-01

    Since mid-1990s, the Cambodian government granted nearly 300 `Economic Land Concessions' (ELCs), occupying approximately 2.3 million ha to foreign and domestic organizations (primarily agribusinesses). The majority of Cambodian ELC deals have been issued in areas of both relatively low population density and low agricultural productivity, dominated by smallholder production. These regions often contain highly biodiverse areas, thereby increasing the ecological cost associated with land clearing for extractive purposes. These large-scale land transactions have also resulted in substantial and rapid changes in land-use patterns and agriculture practices by smallholder farmers. In this study, we investigated the spatio-temporal characteristics of land use change associated with large-scale land transactions across Cambodia using multi-temporal multi-reolution remote sensing data. We identified major regions of deforestation during the last two decades using Landsat archive, global forest change data (2000-2014) and georeferenced database of ELC deals. We then mapped the deforestation and land clearing within ELC boundaries as well as areas bordering or near ELCs to quantify the impact of ELCs on local communities. Using time-series from MODIS Vegetation Indices products for the study period, we also estimated the time period over which any particular ELC deal initiated its proposed activity. We found evidence of similar patterns of land use change outside the boundaries of ELC deals which may be associated with i) illegal land encroachments by ELCs and/or ii) new agricultural practices adopted by local farmers near ELC boundaries. We also detected significant time gaps between ELC deal granting dates and initiation of land clearing for ELC purposes. Interestingly, we also found that not all designated areas for ELCs were put into effect indicating the possible proliferation of speculative land deals. This study demonstrates the potential of remote sensing techniques

  13. Women's views and experiences of a mobile phone-based intervention to support post-abortion contraception in Cambodia.

    Science.gov (United States)

    Smith, Chris; Ly, Sokhey; Uk, Vannak; Warnock, Ruby; Free, Caroline

    2017-06-12

    The MObile Technology for Improved Family Planning (MOTIF) trial assessed a mobile phone-based intervention comprising voice messages and counsellor support to increase post-abortion contraception at four Marie Stopes International clinics in Cambodia. The aim of this process evaluation was to assess women's views and experiences of receiving the MOTIF intervention, gain insights into the mechanism of action of the intervention and seek recommendations for improvements. We conducted a qualitative study comprising15 semi-structured interviews with women who had received the intervention and undertook a simple thematic analysis. We identified themes relating to communication via mobile phone, supporting contraception use, broader post-abortion care, interaction with family and friends and suggestions for improvement. The majority of women were positive about the mobile phone-based intervention to support contraception use and reported it to be a convenient way to ask questions or get advice without going to a health centre, although a few women found the voice messages intrusive. The intervention supported contraception use by provision of information, encouragement, reminders to return to clinic, reassurance and advice for problems and had a positive effect on contraceptive uptake and continuation. Women reported a sense of being cared for and received support for additional physical and emotional issues. Most women thought that the duration of the intervention and frequency of messages were acceptable. The majority of women were positive about the mobile phone-based intervention which provided support for contraception use as well as additional physical and emotional issues. The study provides some insights into how the intervention might have worked and considers how the intervention could be improved.

  14. Impact of payments for environmental services and protected areas on local livelihoods and forest conservation in northern Cambodia.

    Science.gov (United States)

    Clements, Tom; Milner-Gulland, E J

    2015-02-01

    The potential impacts of payments for environmental services (PES) and protected areas (PAs) on environmental outcomes and local livelihoods in developing countries are contentious and have been widely debated. The available evidence is sparse, with few rigorous evaluations of the environmental and social impacts of PAs and particularly of PES. We measured the impacts on forests and human well-being of three different PES programs instituted within two PAs in northern Cambodia, using a panel of intervention villages and matched controls. Both PES and PAs delivered additional environmental outcomes relative to the counterfactual: reducing deforestation rates significantly relative to controls. PAs increased security of access to land and forest resources for local households, benefiting forest resource users but restricting households' ability to expand and diversify their agriculture. The impacts of PES on household well-being were related to the magnitude of the payments provided. The two higher paying market-linked PES programs had significant positive impacts, whereas a lower paying program that targeted biodiversity protection had no detectable effect on livelihoods, despite its positive environmental outcomes. Households that signed up for the higher paying PES programs, however, typically needed more capital assets; hence, they were less poor and more food secure than other villagers. Therefore, whereas the impacts of PAs on household well-being were limited overall and varied between livelihood strategies, the PES programs had significant positive impacts on livelihoods for those that could afford to participate. Our results are consistent with theories that PES, when designed appropriately, can be a powerful new tool for delivering conservation goals whilst benefiting local people. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  15. Sociocultural Influences on the Transmission of HIV From Husbands to Wives in Cambodia: The Male Point of View

    Science.gov (United States)

    Yang, Youngran; Thai, Sopheak

    2017-01-01

    The purpose of the study was to explore, within cultural and societal contexts, the factors of spousal HIV transmission as described by the experiences of HIV-positive Cambodian men. Using qualitative research methods, the researchers collected data from in-depth interviews with 15 HIV-positive Cambodian men of seroconcordant couples recruited from an HIV/AIDS clinic in Phnom Penh. Using a model of HIV transmission from husbands to wives, the questions were designed to elicit the men’s perspectives on the topics of promiscuity, masculinity, condom use in marriage, the image of the ideal Cambodian woman, and attitudes toward sex and marriage. Directed content analysis was used to analyze the interview data. The main results were as follows: (a) men involved with sex workers perceived this as a natural behavior and a necessary part of being an approved member in a male peer group, (b) married men never used condoms during sex with their wives prior to their HIV diagnosis, (c) men perceived a good wife as one who is diligent and loyal to her husband, and (4) men’s attitudes toward sex and marriage (e.g., sex perceived as a part of life pleasure) differed from those of their wives. Promoting honest spousal communication about sexuality, maintaining men’s marital fidelity, and increasing women’s comfort in the use of sexual techniques are suggested as strategies for reducing HIV transmission within marriage in Cambodia. Future interventions should focus on reshaping men’s behaviors and changing cultural norms to protect them and their spouses from HIV infection. PMID:28128012

  16. "Know your audience": A hospital community engagement programme in a non-profit paediatric hospital in Cambodia.

    Directory of Open Access Journals (Sweden)

    Sreymom Pol

    Full Text Available The purpose of this evaluation is to explore the impact of the new hospital community engagement programme (comprised of a Young Persons Advisory Group and a Science Café on community members and other stakeholders, with regard to their attitudes, skills and degree of engagement in a paediatric hospital in Cambodia.Data collection included feedback questionnaires and reflections produced after each YPAG and Science Café event. Further questionnaires and reflective interviews were conducted to gather the views of key stakeholders. Data were analysed by thematic content analysis and numerical data were expressed using descriptive statistics.The vast majority of participants expressed their enjoyment and satisfaction of the hospital community engagement programme. Delivering the programme in the right manner for the target audiences, by prioritising their needs was key to this. Participants valued the programmes in terms of the knowledge delivered around good health practices, the skills developed such as confidence and responsibility for their health, and the provision of opportunities to voice their opinions. All stakeholders recognised the importance of the programme in improving the quality of the healthcare service provided at the hospital.In order to have a successful hospital community engagement programme, understanding the target audience is essential. The engagement programme must be delivered in the right way to meet the needs of community members, including right communication, right setting, right people and right timing. This will ultimately result in a meaningful programme that is able to empower community members, potentially resulting in lasting change in healthcare practices. In conclusion, the gap between hospitals and the community could narrow, allowing everyone to interact and learn from each other.

  17. Sociocultural Influences on the Transmission of HIV From Husbands to Wives in Cambodia: The Male Point of View.

    Science.gov (United States)

    Yang, Youngran; Thai, Sopheak

    2017-07-01

    The purpose of the study was to explore, within cultural and societal contexts, the factors of spousal HIV transmission as described by the experiences of HIV-positive Cambodian men. Using qualitative research methods, the researchers collected data from in-depth interviews with 15 HIV-positive Cambodian men of seroconcordant couples recruited from an HIV/AIDS clinic in Phnom Penh. Using a model of HIV transmission from husbands to wives, the questions were designed to elicit the men's perspectives on the topics of promiscuity, masculinity, condom use in marriage, the image of the ideal Cambodian woman, and attitudes toward sex and marriage. Directed content analysis was used to analyze the interview data. The main results were as follows: (a) men involved with sex workers perceived this as a natural behavior and a necessary part of being an approved member in a male peer group, (b) married men never used condoms during sex with their wives prior to their HIV diagnosis, (c) men perceived a good wife as one who is diligent and loyal to her husband, and (4) men's attitudes toward sex and marriage (e.g., sex perceived as a part of life pleasure) differed from those of their wives. Promoting honest spousal communication about sexuality, maintaining men's marital fidelity, and increasing women's comfort in the use of sexual techniques are suggested as strategies for reducing HIV transmission within marriage in Cambodia. Future interventions should focus on reshaping men's behaviors and changing cultural norms to protect them and their spouses from HIV infection.

  18. Urban and peri-urban family-based pig-keeping in Cambodia: Characteristics, management and perceived benefits and constraints.

    Directory of Open Access Journals (Sweden)

    Gunilla Ström

    Full Text Available Keeping pigs in urban and peri-urban areas may not only provide many benefits for the urban households, but may also be challenging and a potential health hazard. The aim of this cross-sectional study was to describe household characteristics and to evaluate perceived benefits and constraints among pig-keepers in the urban and peri-urban areas of Phnom Penh, Cambodia. The study included 204 households and a structured questionnaire was used to interview the household member responsible for taking care of the pigs. Descriptive analyses showed that most households kept between 5 and 15 pigs and that all households kept their pigs in confinement. About 97% of the households owned the pigs themselves and the pigs were generally managed by female household members (43%. Pigs were mainly kept for commercial purposes and more than 60% of the households stated that income from pig-keeping was the main or one of the main sources of revenue for the household. More than 82% reported that they had experienced disease outbreaks among their pigs during the past three years and disease outbreaks were more commonly reported in households with lower socio-economic position (P = 0.025. Disease outbreaks were considered one of the main constraints, along with expensive feed and low payment prices for the slaughter pigs, but few households considered sanitary or other public health issues problematic. Thus, pig-keeping makes an important contribution to the livelihoods of urban and peri-urban households, but many households face external constraints on their production, such as diseases and low revenues, which may have a negative impact on their livelihoods.

  19. Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia

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    Ly Po

    2010-04-01

    Full Text Available Abstract Background Malaria continues to be a major public health problem in remote forested areas in Cambodia. As a national strategy to strengthen community-based malaria control, the Cambodian government has been running the Village Malaria Worker (VMW project since 2001. This study sought to examine the nature and quality of the VMWs' services. Methods Data collection was carried out in February and March 2008 through interviews with one of the two VMWs who takes the lead in malaria control activities in each of the 315 VMW villages (n = 251. The questionnaire addressed 1 the sociodemographic characteristics of VMWs, 2 service quality, 3 actions for malaria prevention and vector control, and 4 knowledge of malaria epidemiology and vector ecology. Results VMWs were effective in conducting diagnosis with Rapid Diagnostic Tests (RDTs and prescribing anti-malarials to those who had positive RDT results, skills that they had acquired through their training programmes. However, most other services, such as active detection, explanations about compliance, and follow-up of patients, were carried out by only a small proportion of VMWs. The variety of actions that VMWs took for malaria prevention and vector control was small (average action index score 12.8/23, and their knowledge was very limited with less than 20% of the VMWs giving correct answers to six out of seven questions on malaria epidemiology and vector ecology. Knowledge of vector breeding places and malaria transmission were significant determinants of both the quality of VMWs' services and the variety of their actions for malaria prevention and vector control. Conclusions VMWs' services focused primarily on diagnosis and treatment. Their focus needs to be broadened to cover other aspects of malaria control in order to further strengthen community-based malaria control. VMWs' actions and knowledge also need substantial improvement. Strengthening training programmes can help achieve better

  20. Potential Use of School Absenteeism Record for Disease Surveillance in Developing Countries, Case Study in Rural Cambodia

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    Cheng, Calvin K. Y.; Channarith, Hing; Cowling, Benjamin J.

    2013-01-01

    Background Disease surveillance allows prospective monitoring of patterns in disease incidence in the general community, specific institutions (e.g. hospitals, elderly care homes), and other important population subgroups. Surveillance activities are now routinely conducted in many developed countries and in certain easy-to-reach areas of the developing ones. However due to limited health resources, population in rural area that consisted of the most the vulnerable groups are not under surveillance. Cheaper alternative ways for disease surveillance were needed in resource-limited settings. Methods and Findings In this study, a syndromic surveillance system using disease specific absenteeism rates was established in 47 pre-schools with 1,417 students 3–6 y of age in a rural area of Kampot province, Cambodia. School absenteeism data were collected via short message service. Data collected between 1st January and 31st December 2012 was used for system evaluation for future potential use in larger scale. The system appeared to be feasible and acceptable in the rural study setting. Moderate correlation was found between rates of school absenteeism due to illness and the reference data on rates of attendance at health centers in persons absenteeism data is pre-existing, easily accessible and requires minimum time and resources after initial development, and our results suggest that this system may be able to provide complementary data for disease surveillance, especially in resource limited settings where there is very little information on illnesses in the community and traditional surveillance systems are difficult to implement. An important next step is to validate the syndromic data with other forms of surveillance including laboratory data. PMID:24155907

  1. Sex with sweethearts: Exploring factors associated with inconsistent condom use among unmarried female entertainment workers in Cambodia.

    Science.gov (United States)

    Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Ngin, Chanrith; Chhim, Kolab; Brody, Carinne

    2017-01-05

    Despite the success in promoting condom use in commercial relationships, condom use with regular, noncommercial partners remains low among key populations in Cambodia. This study explores factors associated inconsistent condom use with sweethearts among unmarried sexually active female entertainment workers (FEWs). In 2014, the probability proportional to size sampling method was used to randomly select 204 FEWs from entertainment venues in Phnom Penh and Siem Reap for face-to-face interviews. Multivariate logistic regression analysis was conducted to examine independent determinants of inconsistent condom use. Of total, 31.4% of the respondents reported consistent condom use with sweethearts in the past three months. After adjustment, respondents who reported inconsistent condom use with sweethearts remained significantly less likely to report having received any form of sexual and reproductive health education (AOR = 0.49, 95% CI = 0.22-0.99), but more likely to report having been tested for HIV in the past six months (AOR = 2.19, 95% CI = 1.03-4.65). They were significantly more likely to report having used higher amount of alcohol in the past three months (AOR = 1.29, 95% CI = 1.01-1.99) and currently using a contraceptive method other than condoms such as pills (AOR = 4.46, 95% CI = 1.34-10.52) or other methods (AOR = 9.75, 95% CI = 2.07-9.86). The rate of consistent condom use in romantic relationships among unmarried FEWs in this study is considerably low. The importance of consistent condom use with regular, non-commercial partners should be emphasized in the education sessions and materials, particularly for FEWs who use non-barrier contraceptive methods.

  2. Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics.

    Science.gov (United States)

    Ly, Sovann; Arashiro, Takeshi; Ieng, Vanra; Tsuyuoka, Reiko; Parry, Amy; Horwood, Paul; Heng, Seng; Hamid, Sarah; Vandemaele, Katelijn; Chin, Savuth; Sar, Borann; Arima, Yuzo

    2017-01-01

    To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. Using Cambodia's influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two. With these parameters, four threshold levels (seasonal, moderate, high and alert) were established and transmission intensity was categorized based on a World Health Organization alignment method. Parameters were compared against their respective thresholds. Distinct seasonality was observed using the two parameters that incorporated laboratory data. Thresholds established using the composite parameter, combining syndromic and laboratory data, had the least number of false alarms in declaring season onset and were most useful in monitoring intensity. Unlike in temperate regions, the syndromic parameter was less useful in monitoring influenza activity or for setting thresholds. Influenza thresholds based on appropriate parameters have the potential to provide timely triggers for public health measures in a tropical country where monitoring and assessing influenza activity has been challenging. Based on these findings, the Ministry of Health plans to raise general awareness regarding influenza among the medical community and the general public. Our findings have important implications for countries in the tropics/subtropics and in resource-limited settings, and categorized transmission intensity can be used to assess severity of potential pandemic influenza as well as seasonal influenza.

  3. Evaluation of an influenza-like illness case definition in the diagnosis of influenza among patients with acute febrile illness in Cambodia.

    Science.gov (United States)

    Kasper, Matthew R; Wierzba, Thomas F; Sovann, Ly; Blair, Patrick J; Putnam, Shannon D

    2010-11-07

    Influenza-like illness (ILI) is often defined as fever (>38.0°C) with cough or sore throat. In this study, we tested the sensitivity, specificity, and positive and negative predictive values of this case definition in a Cambodia patient population. Passive clinic-based surveillance was established at nine healthcare centers to identify the causes of acute undifferentiated fever in patients aged two years and older seeking treatment. Fever was defined as tympanic membrane temperature >38°C lasting more than 24 hours and less than 10 days. Influenza virus infections were identified by polymerase chain reaction. From July 2008 to December 2008, 2,639 patients were enrolled. From 884 (33%) patients positive for influenza, 652 presented with ILI and 232 acute fever patients presented without ILI. Analysis by age group identified no significant differences between influenza positive patients from the two groups. Positive predictive values (PPVs) varied during the course of the influenza season and among age groups. The ILI case definition can be used to identify a significant percentage of patients with influenza infection during the influenza season in Cambodia, assisting healthcare providers in its diagnosis and treatment. However, testing samples based on the criteria of fever alone increased our case detection by 34%.

  4. High prevalence of unhealthy alcohol use and comparison of self-reported alcohol consumption to phosphatidylethanol among women engaged in sex work and their male clients in Cambodia.

    Science.gov (United States)

    Couture, Marie-Claude; Page, Kimberly; Sansothy, Neth; Stein, Ellen; Vun, Mean Chhi; Hahn, Judith A

    2016-08-01

    In Cambodia, most of the female sex workers (FSW) work in venues where unhealthy alcohol use is ubiquitous and potentially contributing to the HIV epidemic. However, no accurate data exists. We compare self-reported unhealthy alcohol consumption to a biomarker of alcohol intake in Cambodian FSW and male clients, and determine factors associated with unhealthy alcohol use. A cross-sectional study was conducted among FSW (n=100) and male clients (n=100) in entertainment and sex work venues in Cambodia. Self-reported unhealthy alcohol use (AUDIT-C) was compared to phosphatidylethanol (PEth) positive (≥50ng/ml), a biomarker of alcohol intake. Sociodemographics data was collected. Correlates of self-reported unhealthy alcohol use and PEth positive were determined. The prevalence of PEth positive in FSW was 60.0%. Self-reported unhealthy alcohol consumption was reported by 85.0% of the women. Almost all women (95.0%) testing PEth positive also reported unhealthy alcohol use. Prevalence of unhealthy alcohol consumption (self-report and PEth positive) was higher in FSW working in entertainment establishments compared to other sex work venues (psex work settings. Self-reported unhealthy alcohol use is well reported by FSW, but less by male clients. These findings highlight the urgency of using accurate measures of unhealthy alcohol consumption and integrating this health issue into HIV prevention interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Factors affecting the acceptability and consumption of Corn Soya Blend Plus as a prenatal dietary supplement among pregnant women in rural Cambodia.

    Science.gov (United States)

    Janmohamed, Amynah; Karakochuk, Crystal D; Boungnasiri, Somchit; Whitfield, Kyly C; Chapman, Gwen E; Janssen, Patricia; McLean, Judy; Green, Timothy J

    2016-07-01

    Undernutrition is prevalent among pregnant women in Cambodia. The provision of fortified dietary supplements is one strategy to help pregnant women meet their nutritional needs. Corn Soya Blend Plus (CSBP) is a widely used prenatal dietary supplement in areas with high rates of undernutrition and food insecurity. However, little is known about its acceptability during pregnancy. The present study aimed to identify factors that affected the acceptability and consumption of CSBP supplements among pregnant women. Women completed a structured interview designed to provide information on facilitators of and barriers to utilization. In addition, six focus groups were conducted with a subset of women (n 70) to further explore attitudes, perceptions and experiences related to CSBP use. Two districts in Kampong Chhnang Province, Cambodia. Pregnant women (n 288) participating in a cluster-randomized trial of CSBP. The acceptability of CSBP was influenced by sensory attributes, family support, peer influences, and attitudes related to diet, nutritional status and weight gain in pregnancy. Attaining adequate nutrition was considered less important than other concerns during pregnancy, particularly anxiety related to the costs of delivery and postpartum care. Acceptance was lower among new mothers due to fears of weight gain. Health benefits were common reasons for continued use and minor side-effects, such as nausea, were not major barriers to consumption. CSBP was generally well accepted in this population. However, organoleptic factors and perceptions regarding nutrition and weight gain in pregnancy, particularly for first-time mothers, were barriers to increasing acceptance among Cambodian women.

  6. Considering the Practical Rationality of Experimental Operation in Developing Countries: Reality and Challenges under a Rigid Community Forestry System in Cambodia

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    Takayuki Kurashima

    2015-09-01

    Full Text Available Influential stakeholders have highlighted many constraints inherent in conventional scientific forest management plans for community forestry (CF and presented simpler alternatives. Nevertheless, some developing countries continue to use rigid, complex and high-cost plans and regulations. This article considers two issues: (1 why heavily-regulated or rigid CF systems were originally introduced and why they continue to be used in developing countries despite critiques and counterproposals; and (2 under what circumstances will such CF systems face an impasse, and what can be done to resolve the situation. Using Cambodia as a case study, we examine the development of a rigid CF system, review negative factors influencing the upland forested area, clarify the unfavorable situations arising from these factors and discuss likely problems associated with the CF management system. International organizations played a key role in the introduction and maintenance of rigid, complex and high-cost CF systems in Cambodia. Conflicts and crises arise when the administration prosecutes local farmers for illegal cultivation or deprives communities of CF management rights because of the expansion of commercial crop cultivation and the lack of adequate community management in response to unprecedented changes. A likely practical solution to the probable impasse is the development and funding of a functional network of CF management committees, rather than the adoption of an entirely new, alternative system.