July 17, 2007
The number of children admitted to Takeo Provincial Hospital in southeast Cambodia, where Doctors Without Borders/Médecins Sans Frontières (MSF) is helping fight an outbreak of dengue, has slightly decreased. Admissions have fallen from an average 200 patients per week to 125 this week.
Dengue, an infectious disease transmitted by mosquito bites, is endemic in Cambodia, but this year, an outbreak hit the country much earlier than in previous years and hit hard. Official figures show a total of nearly 15,000 cases for July 2007 alone, against 16,600 cases for the entirety of 2006. With the large increase in the number of cases, dengue-related deaths have reached 182 for the month of July to date, compared to 152 fatalities for all of 2006.
Since the onset of the epidemic, MSF has worked closely with the country's ministry of health, sending additional doctors and nurses, and providing medical supplies, such as syringes, rehydration kits, and infusions.
"We've seen an encouraging drop in the number of admissions, but it is too early to say if these results are significant," stresses Philippe Berneau, the MSF head of mission. "Health authorities at the provincial level must step up their prevention campaigns. Still too many children die because they are brought to the hospital too late."
Seven children have died in Takeo, mainly from dengue shock syndrome or dengue hemorrhagic fever, which is the most severe form of the disease. While symptoms of dengue include muscle pains, high fever, nausea and intense joint pains, dengue hemorrhagic fever can cause bleeding and shock and it is particularly lethal in children. There is no specific medicine for dengue, but early diagnosis and treatment can prevent complications and death.
"The central health authorities have just produced information leaflets in Khmer language, but at the provincial level the response has been slow, and the leaflets still have not been distributed here," says Berneau.
The shortage of blood for transfusions, which are needed in case of complications, is also a concern. "We have convinced families to give blood, but it remains difficult to get enough," says Berneau. "There should be campaigns to raise awareness of the importance of donating blood."
MSF has recruited a doctor with intensive experience in dengue to help the hospital provide 24-hour supervision of patients. "The staff felt uneasy about keeping children with complications and would refer them to a Phnom Penh hospital, but finding transportation was often a problem," explains Berneau.
Today, more children can be treated immediately at the Takeo hospital.
MSF teams have assessed four other districts of the province–Bati, Kirivong, Ang Roka, and Prey Kabas–and found stable situations.
The World Health Organization estimates there may be around 50 million cases of dengue infections worldwide each year.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)