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Priority health concerns

Photograph by: Masaru Goto Represented by: AsiaWorks Photography - Bangkok Tel: (66-2) 255 6850 Email: awp@loxinfo.co.th

Two daughters look at their mother who is dying from HIV/AIDS, Cambodia. Photo by World Bank, taken in 2002. Licensed under CC BY-NC-ND 2.0.

Two common features mark Cambodia’s major health concerns:

  • Some health figures are among the worst in the world – the 26 cases of avian flu in Cambodia in 2013 were the highest for any country, for example.1
  • There has been significant progress made in many areas such as malaria, tuberculosis and maternal health. The country has achieved some of its Millenium Development Goals, and in 2015 was declared free of measles.

Among priority health concerns are:

  • Maternal and child health
  • Tuberculosis
  • Malaria
  • HIV/AIDS
  • Avian flu.

Other widespread health problems include malnutrition, diarrhea diseases, acute respiratory infection and dengue fever.

Maternal and child health

Cambodia’s maternal mortality ratio (women who die from complications in pregnancy or childbirth) is high at 170 for each 100,000 births,2 but it has dropped by 86% in the last 15 years.3 Deaths among children have also also dropped, although they remain comparatively high, and the prevalence of underweight newborns is high compared to many countries.

Significant improvements include:

  • 89% of pregnant women had health professionals deliver their babies in 2014, up from 71% in 20104
  • 83% of babies were delivered at a health facility in 2014, up from 54% in 20105
  • 81.2% of pregnant women attended antenatal care6
  • 84% received iron and folic acid tablets7
  • 78% of HIV+ pregnant women received anti-retroviral treatment for protection from mother-to-child virus transmission.8

Cambodia had the highest prevalence of underweight newborns among nearly 30 countries studied in a 2014 report.9 Around 19% of recorded hospital births were infants small for their gestational age (the number of weeks they were carried). Premature and underweight births correlate with maternal illnesses like eclampsia.10

Between 2000 and 2010 the infant mortality rate (children dying before 1 year of age) declined from 95 to 45 deaths per 1,000 live births.11

Tuberculosis

Around 13,000 Cambodians die from tuberculosis (TB) each year.12 The country has seen a steady decrease in new TB infection rates, however: there were 764 cases per 100,000 people in 2013 compared to 1,670 cases per 100,000 in 1995.13

WHO estimates that up to 64 % of the population, more than 9.5 million people, carry latent TB bacteria. These people are not (yet) ill and cannot transmit the disease. One in 10 latent cases is expected to become an active infection, but this figure is higher for people with HIV, malnutrition or diabetes, or smokers. Without treatment, up to two thirds of people ill with TB will die.14

Malaria

Cambodia had 21,309 confirmed cases of malaria and 12 deaths in 2013.15 Cases per 1000 have followed a strong downward trend since 2000 while the number of deaths has declined dramatically, from over 500 in 2000 to 12 in 2013 and the same in 2014.16

A large part of the success is due to the majority of at-risk households being provided with insecticide-treated bed nets.

Unfortunately, a new strain of malaria that is resistant to the most commonly used drug combinations is a growing threat.

HIV/AIDS

UNAIDS estimates that in 2013 there were 75,000 people living with HIV in Cambodia, 70,000 of them 15 and over, and 39,000 of them women.17 The prevalence of HIV in the population aged 15–49 fell from a high of 2.4% in 1998 to an estimated 0.74% in 2013.18

HIV/AIDS deaths dropped from an estimated 14,000 in 199919 to 2,200 in 2013,20 and new infections fell from 3,500 in 2005 to 1,300 in 2013.21Of new infections in 2012, 50% (678) are attributed to heterosexual, non-commercial sex, 29% (394) from female sex work, 10% (136) mother-to-child transmission, 9% (125) people who inject drugs and 1% (15) male-to-male sex.22

Women make up over half the total number of people with HIV and account for many new HIV infections.23

Some 240 people in Rokar commune, Sangke district, Battambang, became infected with HIV in 2014 after the re-use of needles by an unlicensed doctor.24

Avian flu

Avian flu virus was first detected in poultry in Cambodia in January 2004 and found in a person in January 2005.25 Since then, the country has reported 56 human cases of the virus, 44 of them in people under 14, and 37 people have died.26,27

In 2013, 26 people were confirmed to have contracted the virus, the highest for any country. Twelve died.28 The last reported outbreak in Cambodia was in March 2014.29

There are 16 different types of avian flu, such as H5N1. This strain can infect humans. The U.N.’s Food and Agriculture Organization believes H5N1 is endemic in Cambodia’s poultry.30

Other health concerns

Other issues facing Cambodia include:

  • Malnutrition – a third of Cambodian children under 5 suffer from stunted growth due to malnutrition, although this has dropped from 40% in 2010. A 2014 report from the Asia Pacific Journal of Clinical Nutrition states that malnutrition costs Cambodia more than $400 million annually and contributes to the deaths of 6,000 children each year.31
  • Diarrhea diseases – UNICEF says 2,000 Cambodian children die from preventable diarrhea diseases annually.32
  • Acute respiratory infection – pneumonia is the third-highest cause of death in children under 5.33
  • Dengue fever – there were 502 cases of dengue fever in the first 16 weeks of 2015, a 67 per cent increase from the same period in 2014.34

Last updated: 23 May 2015

References

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