The number of children with dengue fever admitted to Takeo Provincial Hospital in southeast Cambodia has slightly decreased. Admissions have fallen from an average of 200 patients per week to 125 this week. MSF is working at the hospital to help to fight an outbreak of dengue in the area.

"We've seen an encouraging drop in the number of admissions but it is too early to say if these results are significant," stresses Philippe Berneau, the MSF head of mission. "Health authorities at the provincial level must step up their prevention campaigns; still too many children die because they are brought to the hospital too late."

Seven children died in Takeo, mainly from dengue shock syndrome or dengue haemorrhagic fever, the most severe form of the disease.

"The central health authorities have just produced information leaflets in Khmer language, but at the provincial level the response has been slow and the leaflets still have not been distributed here," says Berneau.

The shortage of blood for transfusions, needed in case of complications, is also a concern. "We have convinced families to give blood but it remains difficult to get enough," explains Philippe Berneau. "There should be campaigns to raise awareness of the importance of donating blood."

Since the onset of the outbreak, MSF has worked closely with the ministry of health, sending additional doctors and nurses and providing medical supplies such as syringes, rehydration kits and infusions.

MSF has recruited a doctor with intensive experience in dengue to help the hospital provide 24-hour supervision of patients. "The staff felt uneasy about keeping children with complications and would refer them to Phnom Penh hospital, but finding transport was often a problem," explains Berneau. Today, more children can be treated immediately in Takeo Hospital.

MSF teams have assessed four other districts of the province