Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting.
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DOI：
10.1371/journal.pone.0043162
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Feachem RG
中科院分区：
文献类型：
--
作者：
Abeyasinghe RR;Galappaththy GN;Smith Gueye C;Kahn JG;Feachem RG
斯里兰卡在疟疾控制方面有着悠久的历史，在过去十年中，在国家冲突期间病例急剧下降。对斯里兰卡疟疾方案进行了个案研究，以确定该方案的特点并解释最近的进展。案例研究采用定性和定量相结合的方法。数据收集自已发表的文献和灰色文献、地区级和国家记录以及33个关键信息提供者访谈。编制了2004年和2009年两个地区的两年开支。自1999年以来，斯里兰卡的疟疾发病率下降了99.9%。在此期间，间日疟原虫引起的疟疾感染比例有所增加，成年男性感染的比例也有所增加。室内残留喷洒和分发长效驱虫蚊帐可能是造成低传播的原因。保持昆虫学监测。介绍了一个强大的被动病例检测系统，可以捕获感染和主动病例检测。在比较冲突地区和非冲突地区时，冲突地区保持了病媒控制和监测措施，据报告冲突地区的覆盖率往往更高。该研究中有两个地区之一报告说，2004年至2009年，人均疟疾规划支出下降了48%。另一个地区的疟疾支出稳定。斯里兰卡的疟疾目前处于低水平——2011年发现了124例本土病例。大多数感染发生在成年男性中，是由间日疟原虫引起的。以证据为导向的政策和适应新环境的能力促成了这种下降。尽管战争持续不断，但仍在冲突地区维持疟疾干预措施。斯里兰卡设定了到2014年底消灭疟疾的目标。早期发现和治疗感染，特别是输入性感染，以及有效的监测和应对，对于实现这一目标至关重要。
Sri Lanka has a long history of malaria control, and over the past decade has had dramatic declines in cases amid a national conflict. A case study of Sri Lanka's malaria programme was conducted to characterize the programme and explain recent progress. The case study employed qualitative and quantitative methods. Data were collected from published and grey literature, district-level and national records, and thirty-three key informant interviews. Expenditures in two districts for two years – 2004 and 2009 – were compiled. Malaria incidence in Sri Lanka has declined by 99.9% since 1999. During this time, there were increases in the proportion of malaria infections due to Plasmodium vivax, and the proportion of infections occurring in adult males. Indoor residual spraying and distribution of long-lasting insecticide-treated nets have likely contributed to the low transmission. Entomological surveillance was maintained. A strong passive case detection system captures infections and active case detection was introduced. When comparing conflict and non-conflict districts, vector control and surveillance measures were maintained in conflict areas, often with higher coverage reported in conflict districts. One of two districts in the study reported a 48% decline in malaria programme expenditure per person at risk from 2004 to 2009. The other district had stable malaria spending. Malaria is now at low levels in Sri Lanka – 124 indigenous cases were found in 2011. The majority of infections occur in adult males and are due to P. vivax. Evidence-driven policy and an ability to adapt to new circumstances contributed to this decline. Malaria interventions were maintained in the conflict districts despite an ongoing war. Sri Lanka has set a goal of eliminating malaria by the end of 2014. Early identification and treatment of infections, especially imported ones, together with effective surveillance and response, will be critical to achieving this goal.
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影响因子：
2.1
作者：
AMERASINGHE, PH;AMERASINGHE, FP;RATHNAYAKE, AMS
通讯作者：
RATHNAYAKE, AMS
影响因子：
3
作者：
Beier, John C.;Keating, Joseph;Githure, John I.;Macdonald, Michael B.;Impoinvil, Daniel E.;Novak, Robert J.
通讯作者：
Novak, Robert J.
影响因子：
168.9
作者：
Feachem, Richard G. A.;Phillips, Allison A.;Targett, Geoffrey A.;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
3
作者：
Cohen JM;Moonen B;Snow RW;Smith DL
通讯作者：
Smith DL
影响因子：
3
作者：
Briët OJ;Galappaththy GN;Konradsen F;Amerasinghe PH;Amerasinghe FP
通讯作者：
Amerasinghe FP