We launched a hepatitis C programme in Cambodia in May 2016, offering the first free treatment for the blood-borne virus in the country. Although the prevalence of the disease is unknown, it is estimated that between 2 and 5 per cent of the population is infected.
The team started by screening HIV patients at the hospital for co-infection; today teams have expanded screening to include patients referred by Preah Kossamak hospital’s hepatology department.
Our malaria research project in northern Cambodia was set up to find ways to eliminate malaria in an area where there is proven resistance to the most powerful antimalarial drug, artemisinin.
MSF teams responded to the coronavirus COVID-19 pandemic in the country between February and June 2020, in which training and technical support was provided in six hospitals.
Our activities in 2020 in Cambodia
Data and information from the International Activity Report 2020.
MSF continued to provide hepatitis C diagnosis and treatment at the Municipal Referral Hospital (MRH) in the capital Phnom Penh. Our staff also work in the outpatient departments of three other hospitals, where we organise referrals to MRH for confirmatory testing and treatment. From March, patients already enrolled were given their remaining dose so they could continue treatment from home, while newly diagnosed patients were put on hold.
We supported the health ministry’s response to COVID-19 by assisting with the tracing of contacts of patients who tested positive for the virus, and the drafting of guidelines on infection prevention and control and clinical care, which were previously unavailable in the country. We also improved triage in six hospitals close to the border with Thailand, where hospital staff treated many migrant workers who were returning home.
The fear of infection with COVID-19 prevented many people from seeking care, including for hepatitis C. Our teams adopted comprehensive personal protective equipment measures, which allowed the resumption of hepatitis C activities in Phnom Penh and Battambang province from May.
Working with provincial health staff, the team in Battambang finalised the roll-out of hepatitis C screening and diagnosis in all rural health centres across the province. MSF has trained nurses to screen the patient history and check if they currently have symptoms of cirrhosis, a complication of the disease. If they do, they are referred to the district hospital. Otherwise, the nurses initiate treatment with direct-acting antivirals at the health centre. The success of this simplified model of care demonstrates that it could be adopted nationally.
A mobile team was sent to Pursat and Kampong Chhnang provinces to investigate exceptionally high rates of hepatitis C (>30 per cent) among younger age groups and to provide treatment where necessary. Possible sources of the high infection rates include a traditional healer using the same needle and knife during consultations with patients from both provinces, and a dentist providing door-to-door care in Kampoing Chhnang.