Enhanced Health Facility Surveys to Support Malaria Control and Elimination across Different Transmission Settings in the Philippines.
Enhanced Health Facility Surveys to Support Malaria Control and Elimination across Different Transmission Settings in the Philippines.
复制标题
DOI：
10.4269/ajtmh.20-0814
复制
发表时间：
2021-01-18
期刊：
影响因子：
--
通讯作者：
Espino FEJ
中科院分区：
文献类型：
--
作者：
Reyes RA;Fornace KM;Macalinao MLM;Boncayao BL;De La Fuente ES;Sabanal HM;Bareng APN;Medado IAP;Mercado ES;Baquilod MS;Luchavez JS;Hafalla JCR;Drakeley CJ;Espino FEJ
随着菲律宾在疟疾控制方面取得重大进展，需要新的监测方法来确定和瞄准疟疾残留传播。这项研究评估了一种增强的监测方法，通过对所有卫生机构参与者进行滚动横断面调查，并增加了分子诊断和地理位置。在代表不同传播强度的三个地点进行了设施调查：Morong、Bataan(消除前)、Abra de ILOG、西方Mindoro(稳定、中等风险)和里萨尔、巴拉望(高风险、控制)。在巴丹和西方民多罗只发现一例快速诊断试验(RDT)阳性感染，没有发现经PCR确认的感染，这表明没有传播。在巴拉望岛，纳入所有卫生机构的参与者，无论症状如何，并使用分子诊断技术，除了通过RDT或显微镜对发热患者进行常规筛查确定的300例病例外，还发现了313名感染者。其中，大多数(313/613)是亚专利感染，只能用分子方法检测。同时在平板电脑应用程序上收集GPS坐标，可以实时绘制疟疾感染情况的地图。风险因素分析显示，儿童和土著群体的风险更高，使用蚊帐具有保护作用。亚专利感染在男性和老年人群中更常见。总体而言，疟疾风险与参与者的分类无关，一些非患者门诊就诊者报告患有发烧疾病(1.9%，26/1,369人)，尽管没有寻求治疗，这突显了感染在社区中的广泛分布。总而言之，这些数据说明了以卫生机构为基础的调查的效用，以增强监测数据，以增加在更广泛的社区中发现感染的可能性。
Following substantial progress in malaria control in the Philippines, new surveillance approaches are needed to identify and target residual malaria transmission. This study evaluated an enhanced surveillance approach using rolling cross-sectional surveys of all health facility attendees augmented with molecular diagnostics and geolocation. Facility surveys were carried out in three sites representing different transmission intensities: Morong, Bataan (pre-elimination), Abra de Ilog, Occidental Mindoro (stable medium risk), and Rizal, Palawan (high risk, control). Only one rapid diagnostic test (RDT)–positive infection and no PCR confirmed infections were found in Bataan and Occidental Mindoro, suggesting the absence of transmission. In Palawan, the inclusion of all health facility attendees, regardless of symptoms, and use of molecular diagnostics identified 313 infected individuals in addition to 300 cases identified by routine screening of febrile patients with the RDT or microscopy. Of these, the majority (313/613) were subpatent infections and only detected using molecular methods. Simultaneous collection of GPS coordinates on tablet-based applications allowed real-time mapping of malaria infections. Risk factor analysis showed higher risks in children and indigenous groups, with bed net use having a protective effect. Subpatent infections were more common in men and older age-groups. Overall, malaria risks were not associated with participants’ classification, and some of the non-patient clinic attendees reported febrile illnesses (1.9%, 26/1,369), despite not seeking treatment, highlighting the widespread distribution of infection in communities. Together, these data illustrate the utility of health facility–based surveys to augment surveillance data to increase the probability of detecting infections in the wider community.
登录
查看更多内容
影响因子：
6.4
作者：
Grignard, Lynn;Shah, Sonal;Fornace, Kimberly M.
通讯作者：
Fornace, Kimberly M.
影响因子：
3.7
作者：
Okebe, Joseph;Affara, Muna;D'Alessandro, Umberto
通讯作者：
D'Alessandro, Umberto
影响因子：
2.7
作者：
Lansang, MAD;Belizario, VY;Aguirre, A
通讯作者：
Aguirre, A
使用贝叶斯模型平均检测加纳北部残留疟疾的局部危险因素。
影响因子：
3
作者：
Millar J;Psychas P;Abuaku B;Ahorlu C;Amratia P;Koram K;Oppong S;Valle D
通讯作者：
Valle D
影响因子：
3
作者：
Hwang J;Jaroensuk J;Leimanis ML;Russell B;McGready R;Day N;Snounou G;Nosten F;Imwong M
通讯作者：
Imwong M