title: Mekong malaria. II. Update of malaria, multi-drug resistance and economic development in the Mekong region of Southeast Asia.
abstract: 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.
authors.affiliation: Center for National Malaria Control (CNM), Phnom Penh, Cambodia.
authors.forename: Doung
authors.initials: D
authors.lastname: Socheat
authors.forename: Mey Bouth
authors.initials: MB
authors.lastname: Denis
authors.forename: Thierry
authors.initials: T
authors.lastname: Fandeur
authors.forename: Zaixing
authors.initials: Z
authors.lastname: Zhang
authors.forename: Henglin
authors.initials: H
authors.lastname: Yang
authors.forename: Jianwei
authors.initials: J
authors.lastname: Xu
authors.forename: Xingwu
authors.initials: X
authors.lastname: Zhou
authors.forename: Samlane
authors.initials: S
authors.lastname: Phompida
authors.forename: Rattanaxay
authors.initials: R
authors.lastname: Phetsouvanh
authors.forename: Saw
authors.initials: S
authors.lastname: Lwin
authors.forename: Khin
authors.initials: K
authors.lastname: Lin
authors.forename: Than
authors.initials: T
authors.lastname: Win
authors.forename: Soe Win
authors.initials: SW
authors.lastname: Than
authors.forename: Ye
authors.initials: Y
authors.lastname: Htut
authors.forename: Somsak
authors.initials: S
authors.lastname: Prajakwong
authors.forename: Chaiporn
authors.initials: C
authors.lastname: Rojanawatsirivet
authors.forename: Rungrawee
authors.initials: R
authors.lastname: Tipmontree
authors.forename: Saowanit
authors.initials: S
authors.lastname: Vijaykadga
authors.forename: Supawadee
authors.initials: S
authors.lastname: Konchom
authors.forename: Le Dinh
authors.initials: le D
authors.lastname: Cong
authors.forename: Nong Thi
authors.initials: NT
authors.lastname: Thien
authors.forename: Le Khanh
authors.initials: le K
authors.lastname: Thuan
authors.forename: Pascal
authors.initials: P
authors.lastname: Ringwald
authors.forename: Allan
authors.initials: A
authors.lastname: Schapira
authors.forename: Eva
authors.initials: E
authors.lastname: Christophel
authors.forename: Kevin
authors.initials: K
authors.lastname: Palmer
authors.forename: P R
authors.initials: PR
authors.lastname: Arbani
authors.forename: Chusak
authors.initials: C
authors.lastname: Prasittisuk
authors.forename: R
authors.initials: R
authors.lastname: Rastogi
authors.forename: Feliciano
authors.initials: F
authors.lastname: Monti
authors.forename: Carlo
authors.initials: C
authors.lastname: Urbani
authors.forename: Reiko
authors.initials: R
authors.lastname: Tsuyuoka
authors.forename: Stefan
authors.initials: S
authors.lastname: Hoyer
authors.forename: Leonard
authors.initials: L
authors.lastname: Otega
authors.forename: Krongthong
authors.initials: K
authors.lastname: Thimasarn
authors.forename: Sakda
authors.initials: S
authors.lastname: Songcharoen
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Meert
authors.forename: Frederick
authors.initials: F
authors.lastname: Gay
authors.forename: Lawrence
authors.initials: L
authors.lastname: Crissman
authors.lastname: Cho-Min-Naing
authors.forename: Wongsrichanalai
authors.initials: W
authors.lastname: Chansuda
authors.forename: Dowreang
authors.initials: D
authors.lastname: Darasri
authors.forename: Kaemthong
authors.initials: K
authors.lastname: Indaratna
authors.forename: Pratap
authors.initials: P
authors.lastname: Singhasivanon
authors.forename: Sirichai
authors.initials: S
authors.lastname: Chuprapawan
authors.forename: Sornchai
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: Suvanee
authors.initials: S
authors.lastname: Supavej
authors.forename: Chev
authors.initials: C
authors.lastname: Kidson
authors.forename: Visut
authors.initials: V
authors.lastname: Baimai
authors.forename: Surapon
authors.initials: S
authors.lastname: Yimsamran
authors.forename: Kasinee
authors.initials: K
authors.lastname: Buchachart
mesh_terms: 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
chemical_list: D000962:Antimalarials