Small Insect, Big BiteInterview on Malaria with Dr. Benoit Witkowski,Malaria Molecular Epidemiology Unit, Pasteur Institut du Cambodge
After speaking with Dr. Philippe Dussart in our April issue about the exciting development and launching of dengue vaccines in a few countries, Healthwise Digest was thrilled to talk to Dr. Benoit Witkowski, the research assistant at the Malaria molecular Epidemiology Unit of Institut du Paster Cambodge. Dr. Witkowski discussed the impact of malaria in Asian countries, as well as the present Malaria prevalence in the country.
Healthwise Digest (HD): Would you give us an overview of Malaria?
Dr. Benoit Witkowski (Dr. Benoit): Malaria is a name of a blood disease that is very prevalent in tropical areas such as SE Asia, sub-Saharan Africa, and South America. It may affect any people that live in these places and travelers. Malaria is caused by an organism classified as protozoa which are transmitted by mosquitoes. The organism that causes malaria is a parasite, which means it needs a host to survive and develop. There are five different species that can infect a human. Mosquitoes that transmit malaria are Anopheles mosquito. Malaria could be transmitted in time of mosquito blood meal, which occurs for Anopheles at night time.
HD: What are the main issues in malaria control?
Dr. Benoit: It depends on of considered area. For example in Africa, the very high prevalence of malaria in population is the main issue. In Cambodia, the issue for malaria control is mostly antimalarial drug resistance.
HD: What are the possible symptoms one can suffer from when s/he’s infected with Malaria?
Dr. Benoit: The most common symptom is fever. there is also other symptoms, more detectable by biology and responsive medical investigations, such as anemia. Alteration of consciousness and even coma can also be a symptom of malaria and could lead to patient death.
HD: What is the present standing of the disease in Cambodia compared with other countries?
Dr. Benoit: If you compare Cambodia to Africa, which is the main ground for Malaria, the prevalence is very low here. But what is typical in Cambodia and to Southeast Asian countries is the ability of the parasite to resist the treatment. It’s quite common to see patients returning for new treatment because of malaria recurrence because the treatment received beforehand was not efficient enough.
HD: What is the prevalence status of Cambodia today compared to previous years?
Dr. Benoit: There is a decrease of malaria prevalence in Cambodia over years. This is the result of the high involvement of Ministry of Health (MOH) and National Malaria Center (CNM) in reduction of malaria. Next step would be malaria eradication in Cambodia, it is a priority of the government. This will be difficult and it will be important to develop strategies that will enable to circumvent parasite resistance before completely eliminate malaria.
(HD): What basic preventive measures one can use to avoid malaria infection?
Dr. Benoit: The most important measure is to avoid infection by limiting mosquito bites with the use of repellent and nets. Drug prophylaxis and preventive treatments may be use in certain cases such like for pregnant women and travelers. There is still ongoing development of malaria vaccine but it is far from 100% efficacy.
HD: Who are the vulnerable members of the society?
Dr. Benoit: Unlike Africa, where people may experience urban transmission of malaria, here in Cambodia is different because mosquitoes are different and the transmission of malaria in Cambodia is restricted to forest area. People working in forests is thus the main population at risk to the disease. Consequently, malaria in Cambodia is more common in young adults since they represent majority of people working in forest area. Nevertheless, malaria may affect every people and is more severe for nonimmune individuals and pregnant women.
HD: What is the most important thing the public should know about malaria?
Dr. Benoit: It is important to present simple description of how you can get malaria, what are its symptoms and the treatments available. In Cambodia, most people are aware of the disease but it would be highly relevant to make pedagogy for populations at risk for malaria, at a school level, perhaps.