Background In 2020, the Kingdom of Cambodia experienced a nationwide outbreak of chikungunya virus (CHIKV). Despite an increase in the frequency of outbreaks and expanding geographic range of CHIKV, diagnostic challenges remain, and limited surveillance data of sufficient granularity are available to characterize epidemiological profiles and disease dynamics of the virus. Methods An ongoing and long-standing cross-sectional study of acute undifferentiated febrile illness (AUFI) in Cambodia was leveraged to describe the disease epidemiology and characterize the clinical presentation of patients diagnosed with CHIKV during the 2020 outbreak. Participants presenting with AUFI symptoms at ten study locations provided acute and convalescent blood samples and were tested for CHIKV using a reverse transcription-polymerase chain reaction (RT-PCR) and serological diagnostic methods including IgM and IgG. Acute and follow-up clinical data were also collected. Results From 1194 participant blood samples tested, 331 (27.7%) positive CHIKV cases were detected. Most CHIKV positive individuals (280, 84.6%) reported having a fever 3 to 4 days prior to visiting a health facility. Symptoms including chills, joint pain, nausea, vomiting, and lesions were all statistically significant among CHIKV positive participants compared to CHIKV negative AUFI participants. Cough was negatively associated with CHIKV positive participants. Positivity proportions were significantly higher among adults compared to children. No significant difference was found in positivity proportion between rainy and dry seasons during the outbreak. Positive CHIKV cases were detected in all study site provinces, with the highest test positivity proportion recorded in the rural northeast province of Kratie. Conclusions Surveillance data captured in this study provided a clinical and epidemiological characterization of positive CHIKV patients presenting at selected health facilities in Cambodia in 2020, and highlighted the widespread distribution of the outbreak, impacting both urban and rural locations. Findings also illustrated the importance of utilizing both RT-PCR and serological testing for effective CHIKV surveillance.

The objective of this prospective cohort study was to assess the incidence of dengue, chikungunya, respiratory viruses, and diarrheal etiologies among periurban and rural Cambodians with confirmed acute febrile illness. During a 2-year period (2016–2017), 612 participants aged 6 months to 30 years who exhibited vector-borne febrile illness (median [interquartile range] age, 8.0 [4–11] years), in which 288 (48.0%) were female, were tested for acute dengue virus and chikungunya virus infection. A total of 67 (11.2%) clinical specimens were positive for dengue virus by either nucleic acid detection (n = 23 [34.3%]; dengue serotype 1 [n = 5] and dengue serotype 2 [n = 18]) or dengue IgM capture enzyme-linked immunosorbent assay (n = 44 [65.7%]), and only 8 specimens were both positive. Clinical presentations included fever (100%), headache (74.1%), muscle aches (27.2%), and joint pain (17.3%). Forty-two of the 612 participants were diagnosed with chikungunya (7.0%) by anti–chikungunya virus enzyme-linked immunosorbent assay (IgM) or chikungunya-specific reverse transcription polymerase chain reaction. By understanding the incidence of diseases causing morbidity and mortality in rural areas within Cambodia, mitigating strategies can be developed to reduce infections.

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> The objective of this study was to establish the type of microbiology along with antimicrobial resistance related to orthopedic related trauma infections in this area in order to help guide diagnosis and treatment regimens.</span></p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>This study evaluated the microbial etiology of orthopedic-related infections (ORI) between September 2015 and September 2016 in three tertiary hospitals in Phnom Penh, Cambodia. Clinical records were for clinical features and demographics. Standard laboratory bacteriology was used to recover, identified and perform antibiotic susceptibility testing (AST) by disk diffusion or broth microdilution<span lang="EN-US">.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>119 patients were categorized as ORI cases. In the cases identified, median interquartile range (IQR) age was 38 (IQR: 26-46) years and 80.0% were male. Of the 119 ORI cases, a total of 156 bacterial strains were recovered, identified and after review, 128 of these pathogenic bacterial strains underwent AST. Among the gram-positive pathogens, the following susceptibilities were as follows: <em>Staphylococcus aureus</em> (n=57) (Methicillin-resistant<em> S. aureus</em> (n=35; 61.4%), (Methicillin‐sensitive<em> S. aureus</em> (n=22; 38.6%)), coagulase-negative<em> staphylococcus</em> (all MS-CoNS; n=6) and four isolates of <em>Enterococcus </em>sp<em>.</em> (non-VRE). A total of 44 gram-negative pathogens were recovered and AST was performed. Among these 44, a total of nine extended-spectrum beta-lactamase (ESBL) producing strains (20.5%) were discovered including <em>Escherichia coli</em> (n=8), <em>Klebsiella pneumoniae</em> (n=1) and carbapenemase-resistant <em>Enterobacteriaceae</em> (CRE) (<em>Morganella morganii</em>). In addition, a single <em>E. coli</em> isolate contained both the ESBL and CRE genotypes was noted.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>This data suggests that ORI rates in Cambodia appear to be comparable to other studies in the literature. However, further studies need to be done in order to establish definitive data related to orthopedic infections in the region.</p>