Limitations of malaria reactive case detection in an area of low and unstable transmission on the Myanmar-Thailand border.
Limitations of malaria reactive case detection in an area of low and unstable transmission on the Myanmar-Thailand border.
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DOI：
10.1186/s12936-016-1631-9
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发表时间：
2016-11-25
期刊：
影响因子：
3
通讯作者：
Nosten FH
中科院分区：
文献类型：
--
作者：
Parker DM;Landier J;von Seidlein L;Dondorp A;White L;Hanboonkunupakarn B;Maude RJ;Nosten FH
反应性病例检测是一种被提议作为在低传播环境中消除疟疾的工具的方法。这是一种直观合理的方法，其基础是疟疾病例的时空聚类概念。当发现指示疟疾临床病例时，就会在指示房屋和邻近房屋进行反应性筛查和治疗。然而，这种方法在不同的筛查半径和疟疾流行率的有效性仍然不明确。数据是从缅甸-泰国边境的四个村庄的详细人口和地理监测研究中获得的。在村疟疾诊所记录了临床病例，并与病人的居住地联系起来。这些数据用于模拟使用快速诊断测试（RDT）的临床病例的反应性病例检测的功效。模拟在给定的一个月内获得临床病例，并将下一个月在索引房屋周围不同的筛查半径下检测到的病例数制成表格。对恶性疟和间日疟分别进行了模拟。每一个反应性的情况下检测工作的模拟运行比较使用随机选择的房屋进行筛选的策略。在大约一半的恶性疟原虫筛查和10%的间日疟筛查中，无论筛查策略如何，都不可能发现任何疟疾病例，因为筛查是在没有病例的时候进行的。当在模拟中出现地理上有联系的病例时，反应性病例检测只有在使用更大的筛查半径（150米及以上半径）时才能成功检测到大多数疟疾病例。在这个筛查半径及以上，反应性病例检测的效果并不比随机筛查村里相同数量的房屋好。在非常小的半径范围内进行筛查只能检测到非常小比例的病例，但尽管如此，性能仍优于相同样本量的随机筛查。这些模拟的结果表明，使用RDT的临床病例的反应性病例检测在低和不稳定的传播区域中停止传播的能力有限。这与病例的高度空间异质性、在村庄外获得疟疾感染以及遗漏无症状感染有关。当病例很少且零星时，被动的病例检测将导致重大的时间和预算损失。本文的在线版本（doi：10.1186/s12936-016-1631-9）包含补充材料，可供授权用户使用。
Reactive case detection is an approach that has been proposed as a tool for malaria elimination in low-transmission settings. It is an intuitively justified approach based on the concept of space–time clustering of malaria cases. When an index malaria clinical case is detected, it triggers reactive screening and treatment in the index house and neighbouring houses. However, the efficacy of this approach at varying screening radii and malaria prevalence remains ill defined. Data were obtained from a detailed demographic and geographic surveillance study in four villages on the Myanmar–Thailand border. Clinical cases were recorded at village malaria clinics and were linked back to patients’ residencies. These data were used to simulate the efficacy of reactive case detection for clinical cases using rapid diagnostic tests (RDT). Simulations took clinical cases in a given month and tabulated the number of cases that would have been detected in the following month at varying screening radii around the index houses. Simulations were run independently for both falciparum and vivax malaria. Each simulation of a reactive case detection effort was run in comparison with a strategy using random selection of houses for screening. In approximately half of the screenings for falciparum and 10% for vivax it would have been impossible to detect any malaria cases regardless of the screening strategy because the screening would have occurred during times when there were no cases. When geographically linked cases were present in the simulation, reactive case detection would have only been successful at detecting most malaria cases using larger screening radii (150-m radius and above). At this screening radius and above, reactive case detection does not perform better than random screening of an equal number of houses in the village. Screening within very small radii detects only a very small proportion of cases, but despite this low performance is better than random screening with the same sample size. The results of these simulations indicate that reactive case detection for clinical cases using RDTs has limited ability in halting transmission in regions of low and unstable transmission. This is linked to high spatial heterogeneity of cases, acquisition of malaria infections outside the village, as well missing asymptomatic infections. When cases are few and sporadic, reactive case detection would result in major time and budgetary losses. The online version of this article (doi:10.1186/s12936-016-1631-9) contains supplementary material, which is available to authorized users.
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DOI：
10.4269/ajtmh.2012.12-0095
发表时间：
2013-02-01
影响因子：
3.3
作者：
Baltzell, Kimberly A.;Shakely, Deter;Greenhouse, Bryan
通讯作者：
Greenhouse, Bryan
影响因子：
3.7
作者：
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影响因子：
15.8
作者：
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通讯作者：
Brooker, Simon J.
影响因子：
3
作者：
Parker, Daniel M.;Matthews, Stephen A.;Cui, Liwang
通讯作者：
Cui, Liwang
影响因子：
4.3
作者：
Gerardin J;Bever CA;Hamainza B;Miller JM;Eckhoff PA;Wenger EA
通讯作者：
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