Cambodia is one of 30 countries in the world with the highest burden of tuberculosis (TB). Caused by bacteria, TB is an infectious disease. Any healthy person can be infected through breathing the airborne bacteria. While the majority of infected people remain healthy, others go on to develop TB disease. This can occur within a year or years later after being infected. The risk of developing TB disease is higher when the infected persons’ immune system is weakened due to poor nutrition, other diseases, such as HIV infection and diabetes, and ageing. TB disease commonly occurs in the lungs, but can develop in any part of the body, including the brain, kidney and bones. TB bacteria are spread in the air by people coughing due to TB disease in the lungs. This makes TB disease of the lungs the most infectious and affects healthy people in the community.
In the majority of patients, effective treatment to cure TB includes taking appropriate medicines for six months. Many lives of those suffering from TB have been saved through treatment, widely available free of charge at public health facilities in Cambodia.
By identifying infectious patients suffering from TB of the lungs and providing prompt effective treatment, they quickly become noninfectious. Diagnosing such cases as early as possible is the best way to cut the cycle of infection and prevent the spread of the bacteria in communities. To speed up the reduction of TB infection, the fight against TB disease in Cambodia has shifted from the conventional method of doctors and nurses waiting for coughing patients to come to clinics for diagnosis, to newer proactive approaches of actively seeking out those developed TB disease at early stages of the disease in communities. TB screening for the whole population is not possible or practical since TB is not a common disease. Based on scientific surveys conducted in Cambodia, people at higher risk for TB, such as those in close contact with infectious TB patients, the elderly and those with diabetes, are targeted for active TB screening.
Key achievements of TB programme in Cambodia
Directly Observed Treatment (DOTS) expansion initiated in 2001 was expanded nationwide with 100% of health centres implementing the DOTS Strategy by the end of 2004. TB notification quadrupled between 1991 and 2010, before declining from 2010 onward to 2.8% per year. The treatment success rate has been maintained at over 90%.
Current status of TB control
In the past 15 years (between 2000 and 2015), the estimated incidence of all forms of TB fell from 575 to 380 per 100 000 population (34% reduction). Mortality due to TB, excluding TB/HIV, declined from 161 in 2000 to 55 per 100 000 population in 2015 (66% reduction). The prevalence of drug-resistant TB has remained relatively low. According to the WHO global report in 2016, there was an estimated prevalence of multi-drug resistant TB of 1.8% among new cases and 11% among previously treated cases.
The goal of the TB programme in Cambodia
The goal for Cambodia’s TB programme is to reduce the prevalence of bacteriologically positive TB cases, bring mortality due to TB down to at least 5% and lower the incidence of TB to 4% annually. To achieve this goal, the treatment coverage rate (notified/estimated incidence) of 59% in 2015 is expected to increase to 80% in 2020.
The role of WHO in TB control in Cambodia
Based on the global TB strategy called “End TB Strategy” in line with the Sustainable Development Goals of the United Nations, WHO has been providing strategic and policy guidance, as well as technical assistance to the National TB Control Programme of the Ministry of Health, the Government of Cambodia.
World Health Organization Representative Office Cambodia
1st Floor, No. 61-64,
Preah Norodom Blvd, Corner Street 306,
Sangkat Boeung Keng Kang I,
Khan Chamkamorn, Phnom Penh, Cambodia
Telephone: (855) 23 216610
Facsimile: (855) 23 216211