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Local constraints to access appropriate malaria treatment in the context of parasite resistance in Cambodia: a qualitative study

Overview of attention for article published in Malaria Journal, February 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (83rd percentile)

Mentioned by

1 news outlet
3 tweeters


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Readers on

81 Mendeley
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Local constraints to access appropriate malaria treatment in the context of parasite resistance in Cambodia: a qualitative study
Published in
Malaria Journal, February 2017
DOI 10.1186/s12936-017-1732-0
Pubmed ID

Jesse Verschuere, Tom Decroo, Dara Lim, Jean-Marie Kindermans, Chea Nguon, Rekol Huy, Yasmine Alkourdi, Koen Peeters Grietens, Charlotte Gryseels


Despite emerging drug resistance in Cambodia, artemisinin-based combination therapy (ACT) is still the most efficacious therapy. ACT is available free of charge in the Cambodian public sector and at a subsidized rate in the private sector. However, un- and mistreated cases in combination with population movements may lead to the further spread of resistant parasites, stressing the importance of understanding how the perceived aetiology of malaria and associated health-seeking behaviour may delay access to appropriate treatment. A qualitative study explored these factors after an epidemiological survey confirmed parasite resistance in Preah Vihear province. In Cambodian cosmology, illnesses can be inflicted by supernatural beings or originate from 'natural' causes because of disorder in the social, domestic or outdoor environment. Initial treatment options consist of cheap and accessible home-based care (manual therapy, herbs and biomedical medication) targeting single symptoms. If there is no steady recovery or if the condition quickly aggravates, care will be sought from 'village doctors', public health facilities, private pharmacies or, in case of suspicion of a supernatural cause, from a specialized indigenous healer. The choice of provider is mostly based on the family's financial situation, access to and trust in the provider, and the congruence between the suspected aetiology of the illness and the treatment offered by the provider. Different treatment options are often combined during the same illness episode through a serial process of trial and error guided by the observable improvements in the patient's condition. Cambodian perceptions of illness that focus on single symptoms and their perceived severity may lead to the identification of one or multiple illnesses at the same time, rarely suspecting malaria from the start and implying different patterns of health seeking behaviour and treatment choice. However, decisions to self-diagnose and treat at home are also pragmatic and must be understood in the context of poverty, a major barrier to seeking prompt and appropriate care for malaria in an area characterized by parasite resistance.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 81 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 22%
Researcher 15 19%
Student > Bachelor 8 10%
Student > Doctoral Student 7 9%
Other 6 7%
Other 12 15%
Unknown 15 19%
Readers by discipline Count As %
Medicine and Dentistry 22 27%
Social Sciences 11 14%
Nursing and Health Professions 7 9%
Agricultural and Biological Sciences 3 4%
Biochemistry, Genetics and Molecular Biology 3 4%
Other 14 17%
Unknown 21 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 February 2017.
All research outputs
of 19,864,708 outputs
Outputs from Malaria Journal
of 5,145 outputs
Outputs of similar age
of 273,506 outputs
Outputs of similar age from Malaria Journal
of 1 outputs
Altmetric has tracked 19,864,708 research outputs across all sources so far. Compared to these this one has done well and is in the 88th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,145 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.3. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,506 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 83% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them