Mekong malaria. II. Update of malaria, multi-drug resistance and economic development in the Mekong region of Southeast Asia.
In an expansion of the first Mekong Malaria monograph published in 1999, this second monograph updates the malaria database in the countries comprising the Mekong region of Southeast Asia. The update adds another 3 years' information to cover cumulative data from the 6 Mekong countries (Cambodia, China/Yunnan, Lao PDR, Myanmar, Thailand, Viet Nam) for the six-year period 1999-2001. The objective is to generate a more comprehensive regional perspective in what is a global epicenter of drug resistant falciparum malaria, in order to improve malaria control on a regional basis in the context of social and economic change. The further application of geographical information systems (GIS) to the analysis has underscored the overall asymmetry of disease patterns in the region, with increased emphasis on population mobility in disease spread. Of great importance is the continuing expansion of resistance of P. falciparum to antimalarial drugs in common use and the increasing employment of differing drug combinations as a result. The variation in drug policy among the 6 countries still represents a major obstacle to the institution of region-wide restrictions on drug misuse. An important step forward has been the establishment of 36 sentinel sites throughout the 6 countries, with the objective of standardizing the drug monitoring process; while not all sentinel sites are fully operational yet, the initial implementation has already given encouraging results in relation to disease monitoring. Some decreases in malaria mortality have been recorded. The disease patterns delineated by GIS are particularly instructive when focused on inter-country distribution, which is where more local collaborative effort can be made to rationalize resource utilization and policy development. Placing disease data in the context of socio-economic trends within and between countries serves to further identify the needs and the potential for placing emphasis on resource rationalization on a regional basis. Despite the difficulties, the 6-year time frame represented in this monograph gives confidence that the now well established collaboration is becoming a major factor in improving malaria control on a regional basis and hopefully redressing to a substantial degree the key problem of spread of drug resistance regionally and eventually globally.
Socheat
Doung
D
Center for National Malaria Control (CNM), Phnom Penh, Cambodia.
Denis
Mey Bouth
MB
Fandeur
Thierry
T
Zhang
Zaixing
Z
Yang
Henglin
H
Xu
Jianwei
J
Zhou
Xingwu
X
Phompida
Samlane
S
Phetsouvanh
Rattanaxay
R
Lwin
Saw
S
Lin
Khin
K
Win
Than
T
Than
Soe Win
SW
Htut
Ye
Y
Prajakwong
Somsak
S
Rojanawatsirivet
Chaiporn
C
Tipmontree
Rungrawee
R
Vijaykadga
Saowanit
S
Konchom
Supawadee
S
Cong
Le Dinh
le D
Thien
Nong Thi
NT
Thuan
Le Khanh
le K
Ringwald
Pascal
P
Schapira
Allan
A
Christophel
Eva
E
Palmer
Kevin
K
Arbani
P R
PR
Prasittisuk
Chusak
C
Rastogi
R
R
Monti
Feliciano
F
Urbani
Carlo
C
Tsuyuoka
Reiko
R
Hoyer
Stefan
S
Otega
Leonard
L
Thimasarn
Krongthong
K
Songcharoen
Sakda
S
Meert
Jean-Pierre
JP
Gay
Frederick
F
Crissman
Lawrence
L
Cho-Min-Naing
Chansuda
Wongsrichanalai
W
Darasri
Dowreang
D
Indaratna
Kaemthong
K
Singhasivanon
Pratap
P
Chuprapawan
Sirichai
S
Looareesuwan
Sornchai
S
Supavej
Suvanee
S
Kidson
Chev
C
Baimai
Visut
V
Yimsamran
Surapon
S
Buchachart
Kasinee
K
D000818:Animals; D000962:Antimalarials / Q000494:pharmacology*; D002160:Cambodia / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D009033:Culicidae; D018432:Drug Resistance, Multiple; D004777:Environment; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D007303:Insect Vectors; D007812:Laos / Q000453:epidemiology; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control; D002052:Myanmar / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000187:drug effects; D010966:Plasmodium vivax / Q000187:drug effects; D011156:Population Density; D011157:Population Dynamics; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology
D000962:Antimalarials