Barriers to Malaria Testing and Treatment in Cambodia: Findings from an In-Depth Qualitative Study

Purpose: Cambodia has among the highest malaria rates of any country in Asia, yet only 17% of patients receive a biological diagnosis and only 8% obtain the recommended medical treatment. With drug resistance increasing, early diagnostic testing and appropriate treatment of malaria is of urgent importance. The purpose of this study is to explore the motivations and barriers to malaria diagnosis and treatment among Cambodian adults.

Data and Methods: Twelve in-depth and six focus group interviews were conducted with adults who either sought a diagnostic blood test and medical treatment, or did not receive a blood test and treated themselves with a variety of anti-malarial remedies. All participants were asked about their knowledge of malaria, illness diagnosis and management behavior, attitudes towards malaria testing and treatment and perceived barriers to testing and treatment.

Results: Although knowledge of the causes and symptoms of malaria are high, immediate testing and treatment is hindered by several barriers. Participants cited cost and transportation issues as the primary barrier to receiving timely medical attention, and most preferred to wait several days before seeking any type of care. Some participants lacked knowledge about appropriate treatment/testing and where to obtain them. Others also noted that certain health care providers did not inform or provide proper testing or treatment.

Recommendations: Increased access and availability of diagnostic testing and malaria treatment are needed. Patients should be educated on the importance of early diagnosis and testing. Providers should also standardize diagnostic blood testing and stress adherence to effective malaria treatments.