Progress and challenges to control malaria in a remote area of Chittagong hill tracts, Bangladesh

Malaria Journal

Research

Syed Masud Ahmed¹  Masahiro Hashizume²  Taro Yamamoto²  Toshihiko Sunahara²  Gregory E Glass³  Rashidul Haque⁴  Shahed Hossain⁴  Ubydul Haque⁵ 

[1] BRAC Research and Evaluation Division, BRAC Centre, 75 Mohakhali, 1212, Dhaka, Bangladesh;Department of International Health, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Programme, Nagasaki University, Japan;Department of Molecular Microbiology and Immunology, John Hopkins Bloomberg School of Public Health, 21205, Baltimore, MD, USA;International Center for Diarrhoeal Disease Research Bangladesh, 68 Shaheed Tajuddin Ahmed Sharani, 1212, Mohakhali, Dhaka, Bangladesh;International Center for Diarrhoeal Disease Research Bangladesh, 68 Shaheed Tajuddin Ahmed Sharani, 1212, Mohakhali, Dhaka, Bangladesh;Department of International Health, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Programme, Nagasaki University, Japan;

关键词: Malaria;    Malaria Control Programme;    National Malaria Control Programme;    Village Doctor;    Secondary Cluster;   

DOI  :  10.1186/1475-2875-9-156

 received in 2010-03-17, accepted in 2010-06-10,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundMalaria is endemic in 13 eastern districts where the overall infection prevalence is 3.97%. In 2006, Bangladesh received US$ 36.9 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to support the national malaria control programme of Bangladesh.ObjectivesThe objective of this study was to i) clarify factors associated with treatment seeking behaviours of malaria ii) distribution of LLIN, and iii) re-treatment of ITN in remote area of a CHT district of Bangladesh two years after implementation of national control programme.MethodsAll households of Rajasthali sub-district of Rangamati district (households about 5,322, population about 24,097), all BRAC health workers (n = 15), health facilities and drug vendors' locations were mapped. Distances from households to health facilities, BRAC health workers and drug vendors were calculated. Logistic regression analysis was performed to assess the associations between the choice of the treatment and the distance to various treatment sources, education, occupation and ethnicity. SaTScan was used to detect clustering of treatment-seeking approaches.FindingsLLIN distribution and the re-treatment of ITN exceeded target goals. The most common treatment facility for malaria-associated fever was malaria control programme led by BRAC and government (66.6%) followed by the drug vendor (48.8%).ConclusionCloseness to health facilities run by the malaria control programme and drug vendors were significantly associated with the choice of treatment. A high proportion of people preferred drug vendors without having a proper diagnosis. Drug vendors are highly patronized and thus there is a need to improve their services for public health good. Otherwise it may cause incomplete treatment, misuse of anti-malarial drugs that will contribute to the risk of drug resistance and jeopardize the present malaria control efforts in Bangladesh.

【 授权许可】

CC BY   
© Haque et al; licensee BioMed Central Ltd. 2010