Temporal variation in confirmed diagnosis of fever-related malarial cases among children under-5 years by community health workers and in health facilities between years 2013 and 2015 in Siaya County, Kenya.
Temporal variation in confirmed diagnosis of fever-related malarial cases among children under-5 years by community health workers and in health facilities between years 2013 and 2015 in Siaya County, Kenya.
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DOI：
10.1186/s12936-017-2100-9
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发表时间：
2017-11-09
期刊：
影响因子：
3
通讯作者：
Sachs SE
中科院分区：
文献类型：
--
作者：
Apat DO;Gachohi JM;Karama M;Kiplimo JR;Sachs SE
疟疾病例管理继续经历动态变化。建设社区能力有助于预防和治疗疟疾。世界卫生组织 (WHO) 建议利用训练有素且受监督的社区卫生工作者 (CHW) 来减轻非洲 5 岁以下儿童因疟疾死亡的负担。就 5 岁以下儿童疟疾诊断趋势而言，对社区社区卫生工作者的利用情况进行纵向跟踪信息对于影响国家和地方疟疾控制政策和战略至关重要。对数据库进行了桌面审查，该数据库包含 2013 年 1 月至 2015 年 12 月期间 3 岁期间使用社区卫生工作者和 10 个卫生机构的门诊部治疗 5 岁以下儿童的 10 个村庄的确诊无并发症疟疾病例。使用泊松回归模型对诊断病例与卫星降雨量、村庄和时间（月和年）之间的关联进行了分析。对社区卫生工作者的疟疾诊断分析显示出以下趋势：(i) 报告记录的疟疾阳性发热病例的发生率随着时间的推移（2013-2015 年）而增加，且多年来的差异具有统计学意义（P < 0.001），(ii) 特定村庄与报告的疟疾阳性发热病例显着相关（P < 0.001），(iii) 报告的疟疾阳性发热病例从最高到最低发生率的长期每月序列为7 月、5 月和 6 月、3 月、8 月、4 月、9 月、11 月、2 月、10 月以及最后的 1 月，各月份之间报告的疟疾阳性病例差异具有统计显着性 (P = 0.001)，并且 (iv) 所测试的降雨状况（当前、滞后或累积）均与 3 年期间报告的疟疾阳性发烧病例无关 (P > 0.1)。从卫生机构的诊断数量来看，（i）报告的疟疾阳性发热病例数随时间的推移（2013-2015年）而减少，且各年份之间的差异无统计学意义（P = 0.399），（ii）长期每月报告的疟疾阳性发热病例数从最高到最低的顺序为7月、6月、5月、4月、1月、8月、3月、2月、9月、11月、10月和12月，各月份之间的差异为具有统计学意义（P < 0.001）。社区卫生工作者有潜力在诊断和治疗疟疾方面发挥重要作用，从而降低五岁以下儿童的死亡率。从暂时来看，诊断疟疾的风险似乎是可以预测的，这可能为有针对性的疟疾防备和控制提供机会。研究结果预计将支持政策行动，扩大偏远农村地区的社区卫生服务。
Malaria case management continues to experience dynamic changes. Building community capacity is instrumental in both prevention and treatment of malaria. The World Health Organization (WHO) recommends utilization of well-trained and supervised community health workers (CHWs) to reduce the burden of malaria deaths among children under-5 years of age in Africa. Longitudinally-tracked information on utilization of CHWs by communities in terms of trends in diagnosis of malaria in children under-5 years of age is essential in influencing national and local malaria control policies and strategies. A desktop review was carried out of a database consisting of confirmed uncomplicated malaria cases in 10 villages using CHWs and out-patient departments of 10 health facilities in children under-five for the period of 3 years between January 2013 and December 2015. Analyses of association between the diagnosed cases and satellite-based rainfall, village and time (months and years) were carried out using a Poisson regression model. Analysis of malaria diagnoses made by CHWs showed the following trends: (i) the incidence of reported documented malaria-positive fever cases increased with time (2013–2015) and the difference over the years was statistically significant (P < 0.001), (ii) specific village was significantly associated (P < 0.001) with reporting malaria-positive fever cases, (iii) the long-term monthly sequence starting from highest to lowest incidence of reported malaria-positive fever cases was July, May and June, March, August, April, September, November, and February, October and, finally, January, and the difference in reported malaria-positives between the months was statistically significant (P = 0.001) and (iv) none of the tested rainfall regimes (current, lagged or cumulative) was associated with reported malaria-positive fever cases during the 3-year period (P > 0.1). Looking at the number of diagnoses made at the health facilities, (i) The number of reported malaria-positive fever cases decreased with time (2013–2015) and the difference among the years was not statistically significant (P = 0.399), (ii) The long-term monthly sequence starting from highest to lowest number of reported malaria-positive fever cases was July, June, May, April, January, August, March, February, September, November, October and December, and the difference between the months was statistically significant (P < 0.001). CHWs have the potential to play a major role in diagnosing and treating malaria, thereby decreasing under-five children mortality. Temporally, the risk of diagnosing malaria seems predictable and this may present opportunities for policy-targeted malaria preparedness and control. The findings are expected to support policy actions that may scale-up community health services in remote rural settings.
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影响因子：
3
作者：
Chanda, Pascalina;Hamainza, Busiku;Pagnoni, Franco
通讯作者：
Pagnoni, Franco
DOI：
10.1016/j.trstmh.2008.10.003
发表时间：
2009-04-01
影响因子：
2.2
作者：
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通讯作者：
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影响因子：
3
作者：
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通讯作者：
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影响因子：
3.4
作者：
Dinku, T.;Chidzambwa, S.;Ropelewski, C. F.
通讯作者：
Ropelewski, C. F.
影响因子：
3.8
作者：
Crump, John A.;Morrissey, Anne B.;Bartlett, John A.
通讯作者：
Bartlett, John A.