The Importance of an Active Case Detection (ACD) Programme for Malaria among Migrants from Malaria Endemic Countries: The Greek Experience in a Receptive and Vulnerable Area

International Journal of Environmental Research and Public Health

Maria Georgitsou¹  Panagiota Bleta¹  Christos Hadjichristodoulou¹  Ioanna Psinaki¹  Varvara Mouchtouri¹  Maria Charvalakou¹  Ourania Pinaka¹  Andreas Charalambous²  Nicos Middleton²  Maria Tsironi³  Spyridoula Bellou⁴  Vasilis Diamantopoulos⁴  Antonia Legaki⁵  Martha Dionysopoulou⁶  Theano Georgakopoulou⁷  Vasilios Raftopoulos⁷  Maria Tseroni⁷  Danai Pervanidou⁷  Annita Vakali⁷  Sotirios Tsiodras⁷  Agoritsa Baka⁷  Evdokia Vassalou⁸  Elina Patsoula⁸ 

[1] Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece;Department of Nursing, Cyprus University of Technology, 30 Arch. Kyprianos Str., 3036 Limassol, Cyprus;Department of Nursing, University of Peloponnese, Karaiskaki 70, 22100 Tripoli, Greece;Directorate of Public Health, Prefecture of Peloponnese, 34 El. Venizelos, 22132 Tripoli, Greece;General Hospital of Molaoi, 23052 Lakonia, Greece;General Hospital of Sparti, 23100 Lakonia, Greece;National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece;Public Health Parasitology and Entomology, Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece;

关键词: malaria;    plasmodium vivax;    active case detection;    migrants;    Greece;   

DOI  :  10.3390/ijerph17114080

来源: DOAJ

【 摘 要 】

Greece has been malaria-free since 1974. In October 2011, following an outbreak of 36 locally acquired malaria (LAM) cases in Evrotas Municipality, a Pro-Active Case Detection (PACD) program for malaria was implemented among migrants from malaria-endemic countries, to support early diagnosis and treatment of cases. We evaluated the PACD program for the years 2012–2017 using indicators such as the number of locally acquired cases, the detection rate/sensitivity and the timeliness of diagnosis and treatment. We visited each migrant home every 7–15 days to screen migrants for malaria symptoms, performing Rapid Diagnostic Tests (RDTs) and blood smears on symptomatic patients. We estimated: (i) the number of malaria cases detected by the PACD, divided by the total number of reported malaria cases during the same period among the same population; (ii) the time between onset of symptoms, diagnosis and initiation of treatment. The total number of migrants who were screened for malaria symptoms for the years 2012–2017 was 5057 with 84,169 fever screenings conducted, while 2288 RDTs and 1736 blood smears were performed. During the same period, 53 imported P. vivax malaria cases were detected, while incidence of malaria among migrants was estimated at 1.8% annually. Ten and one LAM cases were also reported in 2012 and 2015, respectively. Sensitivity of PACD ranged from 86% to 100%; median timeliness between onset of symptoms and diagnosis decreased from 72 h in 2012 to 12 h in 2017 (83% decrease), while timeliness between diagnosis and treatment initiation was 0 h. The implementation of PACD could be considered an effective prevention and response tool against malaria re-introduction.

【 授权许可】

Unknown