Shifting the burden or expanding access to care? Assessing malaria trends following scale-up of community health worker malaria case management and reactive case detection

Malaria Journal

Research

John M. Miller¹  Daniel J. Bridges¹  Sanford Cheelo²  Anna Winters³  David A. Larsen⁴  Busiku Hamainza⁵  Mulakwa Kamuliwo⁵ 

[1] A Program at PATH, Malaria Control and Elimination Partnership in Africa, Lusaka, Zambia;Akros, Lusaka, Zambia;Akros, Lusaka, Zambia;University of Montana School of Public and Community Health Sciences, Missoula, MT, USA;Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, NY, USA;National Malaria Elimination Centre, Lusaka, Zambia;

关键词: Surveillance;    Elimination;    Community case management;    Reactive case detection;   

DOI  :  10.1186/s12936-017-2088-1

 received in 2017-02-10, accepted in 2017-10-27,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMalaria is a significant burden to health systems and is responsible for a large proportion of outpatient cases at health facilities in endemic regions. The scale-up of community management of malaria and reactive case detection likely affect both malaria cases and outpatient attendance at health facilities. Using health management information data from 2012 to 2013 this article examines health trends before and after the training of volunteer community health workers to test and treat malaria cases in Southern Province, Zambia.ResultsAn estimated 50% increase in monthly reported malaria infections was found when community health workers were involved with malaria testing and treating in the community (incidence rate ratio 1.52, p < 0.001). Furthermore, an estimated 6% decrease in outpatient attendance at the health facility was found when community health workers were involved with malaria testing and treating in the community.ConclusionsThese results suggest a large public health benefit to both community case management of malaria and reactive case detection. First, the capacity of the malaria surveillance system to identify malaria infections was increased by nearly one-third. Second, the outpatient attendance at health facilities was modestly decreased. Expanding the capacity of the malaria surveillance programme through systems such as community case management and reactive case detection is an important step toward malaria elimination.

【 授权许可】

CC BY   
© The Author(s) 2017