Abstract
Introduction
Globally, malaria affected 249 million people and caused 608,000 deaths across 85 countries in 2022. In Cambodia, malaria has become more focalized and endemic, requiring a tailored approach to identify and interrupt the remaining sources of transmission. The goal of eliminating all malaria species by 2025 has been set. Stung Treng Province accounted for an alarming 534 malaria cases, constituting 39% of the total cases reported in Cambodia. Therefore, this study analyzes malaria case trends and malaria infection by sociodemographic profiles and other characteristics among hard-to-reach populations in Stung Treng Province from 2021 to 2023.
Methods
We analyzed malaria data from Stung Treng Province (2021-2023) extracted from the Malaria Consortium's Project, which targeted mobile, migrant, and vulnerable populations who were at high risk of malaria transmission in the province. The data were analyzed via Stata 17 with descriptive statistics to calculate frequencies and percentages for categorical variables. The chi-square test was used to determine associations between socio-demographics (gender, age, occupation, and resident status), case classification, points of care, activity type, and malaria infection. P values < 0.05 were considered statistically significant.
Results
Among the 552 identified malaria cases, it peaked in 2022 (306 cases) from May to August. Mobile detection (55–74%) surpassed local detection. Most patients were male (1.4%) vs. female (0.5%), with p<0.001. A higher positivity rate was found in children under 5 years of age (1.5%) than in older age groups (p < 0.001), but most of the cases were aged 15–49 years (378 cases). Relapses constituted 62.9% of the cases. Soldiers accounted for half of the cases (50.2%). Mobile Malaria Posts detected 53% of the cases, followed by home detection and outreach/active fever screening/co-traveller activities. Among the 544 Pv/Mix cases, 69 were referred for radical cure; the remaining 475 were not referred because they were ineligible due to low weight.
Conclusion
The analysis of hard-to-reach populations revealed that malaria cases surged in 2022, with most cases relapsing. Children under 5 years of age had the highest positivity rate, but those aged 15-49 years accounted for most malaria cases. Soldiers reported being most at risk of malaria infection. Active fever screening yielded the highest positivity rate. These findings underscore the need for tailored malaria strategies for these populations, especially military personnel in remote areas, emphasizing ITN use, chemoprophylaxis, early detection, and prompt treatment.