What is the value of reactive case detection in malaria control? A case-study in India and a systematic review

Malaria Journal

Research

Anna Maria van Eijk¹  Jane M. Carlton¹  Steven A. Sullivan¹  Lalitha Ramanathapuram¹  Patrick L. Sutton²  Nisha Desai³  Nikunj Tandel³  H. C. Srivastava³  Ankita Patel³  Ranvir Singh³  Deena Kanagaraj⁴  G. Sri Lakshmi Priya⁴  Alex Eapen⁴  Sangamithra Ravishankaran⁴  Aswin Asokan⁴ 

[1] Center for Genomics and Systems Biology, Department of Biology, New York University, 10003, New York, NY, USA;Center for Genomics and Systems Biology, Department of Biology, New York University, 10003, New York, NY, USA;Acsel Health, 500 5th Ave, Suite 2760, 10110, New York, NY, USA;National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India;National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India;

关键词: Malaria;    Reactive case detection;    Surveillance;    Plasmodium falciparum;    Plasmodium vivax;   

DOI  :  10.1186/s12936-016-1120-1

 received in 2015-11-24, accepted in 2016-01-22,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundReactive case detection (RCD) for malaria is a strategy to identify additional malaria infections in areas of low malaria transmission and can complement passive surveillance. This study describes experiences with RCD in two Indian sites, and aimed to synthesize experiences with RCD across endemic countries.MethodsRCD programmes were piloted in two urban areas of India with a low prevalence of mainly Plasmodium vivax malaria in 2014. Cases were identified in a clinic by microscopy and contacts were screened within 2 weeks; PCR, in addition to microscopy, was used to detect Plasmodium parasites. A systematic review was conducted to identify RCD experiences in the literature.ResultsIn Chennai, 868 contacts were enrolled for 18 index cases of clinical malaria; in Nadiad, 131 contacts were enrolled for 20 index cases. No new malaria infections were detected in Nadiad among contacts, and four new infections were detected in Chennai (three P. vivax and one Plasmodium falciparum), of which two were among household members of index cases. An additional five studies describing results from an RCD strategy were identified in the literature: four in Africa and one in Thailand. Including the results from India, the average number of contacts screened per index case in a total of seven studies ranged from four to 50, and 126 in a case study in Thailand with one index case. Malaria was detected in 0–45 % of the contacted persons. The average number of index cases needed to be traced to find one new case of malaria ranged from one to five, and could not be assessed in one study in India (no contacts positive for 20 cases). Sharing the household with an index case was associated with a five-fold increased risk of malaria compared to contacts from households without an index case (pooled risk ratio 5.29, 95 % CI 3.31–8.47, I2 0 %, four studies).ConclusionsRCD in areas of low malaria transmission is a labour-intensive strategy, and its benefit is not clear. Studies are needed to assess how RCD can be optimized or into alternatives where interventions are targeted to family members or hotspots.

【 授权许可】

CC BY   
© van Eijk et al. 2016