Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia

Malaria Journal

Research

Song Ngak¹  Jonathan Cox²  David Sintasath³  Steven Mellor⁴  Sylvia Meek⁵  Siv Sovannaroth⁶  Tol Bunkea⁶  Lek Dy Soley⁷  Kheang Soy Ty⁸  Pascal Ringwald⁹  Steven Bjorge^1,10 

[1] FHI 360, Phnom Penh, Cambodia;Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Malaria Consortium, Phnom Penh, Cambodia;Malaria Consortium, Bangkok, Thailand;Malaria Consortium, London, UK;Malaria Consortium, Phnom Penh, Cambodia;National Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia;National Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia;National Institute of Public Health, Phnom Penh, Cambodia;University Research Co., Phnom Penh, Cambodia;World Health Organization, Geneva, Switzerland;World Health Organization, Phnom Penh, Cambodia;

关键词: Malaria;    Cambodia;    Surveillance;    Anti-malarials;    Artemisinin;    Case management;    Community health worker;    Village malaria worker;    Operational research;   

DOI  :  10.1186/1475-2875-13-282

 received in 2014-06-03, accepted in 2014-07-17,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundDelayed clearance of Plasmodium falciparum parasites is used as an operational indicator of potential artemisinin resistance. Effective community-based systems to detect P. falciparum cases remaining positive 72 hours after initiating treatment would be valuable for guiding case follow-up in areas of known resistance risk and for detecting areas of emerging resistance.MethodsSystems incorporating existing networks of village malaria workers (VMWs) to monitor day three-positive P. falciparum cases were piloted in three provinces in western Cambodia. Quantitative and qualitative data were used to evaluate the wider feasibility and sustainability of community-based surveillance of day three-positive P. falciparum cases.ResultsOf 294 day-3 blood slides obtained across all sites (from 297 day-0 positives), 63 were positive for P. falciparum, an overall day-3 positivity rate of 21%. There were significant variations in the systems implemented by different partners. Full engagement of VMWs and health centre staff is critical. VMWs are responsible for a range of individual tasks including preparing blood slides on day-0, completing forms, administering directly observed therapy (DOT) on days 0–2, obtaining follow-up slides on day-3 and transporting slides and paperwork to their supervising health centre. When suitably motivated, unsalaried VMWs are willing and able to produce good quality blood smears and achieve very high rates of DOT and day-3 follow-up.ConclusionsCommunity-based surveillance of day-3 P. falciparum cases is feasible, but highly intensive, and as such needs strong and continuous support, particularly supervision and training. The purpose and role of community-based day-3 surveillance should be assessed in the light of resource requirements; scaling-up would need to be systematic and targeted, based on clearly defined epidemiological criteria. To be truly comprehensive, the system would need to be extended beyond VMWs to other public and private health providers.

【 授权许可】

CC BY   
© Cox et al.; licensee BioMed Central Ltd. 2014