Active case detection for malaria elimination: a survey among Asia Pacific countries.
Active case detection for malaria elimination: a survey among Asia Pacific countries.
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DOI：
10.1186/1475-2875-12-358
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发表时间：
2013-10-09
期刊：
影响因子：
3
通讯作者：
Gosling RD
中科院分区：
文献类型：
--
作者：
Smith Gueye C;Sanders KC;Galappaththy GN;Rundi C;Tobgay T;Sovannaroth S;Gao Q;Surya A;Thakur GD;Baquilod M;Lee WJ;Bobogare A;Deniyage SL;Satimai W;Taleo G;Hung NM;Cotter C;Hsiang MS;Vestergaard LS;Gosling RD
从控制疟疾转向消灭疟疾，需要国家疟疾控制方案执行战略，在社区发现有症状和无症状的病例。为此，消灭疟疾方案跟踪保健设施报告的疟疾病例，进行病例调查，以确定感染的来源，是输入性的还是由于当地疟疾传播。如有必要，疟疾方案还将进行积极监测，以发现当地的其他疟疾病例，防止进一步传播。为了了解目前的做法和分享关于消灭疟疾战略的信息，在亚洲太平洋消灭疟疾网络的14个国家中开展了一项调查，专门探讨关于病例调查和反应性病例检测的国家政策。向制定了国家或国家以下各级消除疟疾目标的14个亚太国家的疟疾控制方案管理人员分发了一份调查问卷。结果表明，对调查作出答复的13个国家开展了各种各样的病例调查和积极的病例发现活动。所有答复者都报告说，作为监测活动的一部分进行了案件调查。这些国家中有一半以上对每个案件进行调查。超过一半的人的目标是在案件报告后一至两天内完成调查。各方案在调查过程中收集了广泛的人口数据，对输入性病例的定义因答复者而异。一些国家报告了国内（来自不同的省或地区）进口，而另一些国家则只报告了国际（来自不同的国家）进口。在答复国，反应性病例检测的定义是在预先确定的半径范围内对住户进行筛查，以查明其他在当地获得的感染，无论是有症状的还是无症状的。答复者报告说，可以以不同的方式触发反应性病例检测，在某些情况下，只有一个病例报告，而在其他情况下，如果出现多个病例的定义阈值。筛查的空间范围从一定数量的家庭到整个行政单位（如村庄）不等。一些国家针对有症状的人，而另一些国家则针对所有人，以发现无症状感染。大多数作出答复的方案从接受疟疾筛查的人那里收集一系列信息，与病例调查期间收集的信息范围相似。在亚太地区的消灭疟疾方案中，实施了病例调查和反应性病例检测，但各国的做法差别很大。没有多少证据可支持各国决定维持、改变或采用何种方法来提高效力和效率。为这些活动制定和使用共同评价指标将使疟疾方案能够评估资源密集型监测措施的业绩和成果，并可能使正在考虑开展这些活动的其他国家受益。
Moving from malaria control to elimination requires national malaria control programmes to implement strategies to detect both symptomatic and asymptomatic cases in the community. In order to do this, malaria elimination programmes follow up malaria cases reported by health facilities to carry out case investigations that will determine the origin of the infection, whether it has been imported or is due to local malaria transmission. If necessary, the malaria programme will also carry out active surveillance to find additional malaria cases in the locality to prevent further transmission. To understand current practices and share information on malaria elimination strategies, a survey specifically addressing country policies on case investigation and reactive case detection was carried out among fourteen countries of the Asia Pacific Malaria Elimination Network (APMEN). A questionnaire was distributed to the malaria control programme managers amongst 14 countries in the Asia Pacific who have national or sub-national malaria elimination goals. Results indicate that there are a wide variety of case investigation and active case detection activities employed by the 13 countries that responded to the survey. All respondents report conducting case investigation as part of surveillance activities. More than half of these countries conduct investigations for each case. Over half aim to accomplish the investigation within one to two days of a case report. Programmes collect a broad array of demographic data during investigation procedures and definitions for imported cases are varied across respondents. Some countries report intra-national (from a different province or district) importation while others report only international importation (from a different country). Reactive case detection in respondent countries is defined as screening households within a pre-determined radius in order to identify other locally acquired infections, whether symptomatic or asymptomatic. Respondents report that reactive case detection can be triggered in different ways, in some cases with only a single case report and in others if a defined threshold of multiple cases occurs. The spatial range of screening conducted varies from a certain number of households to an entire administrative unit (e g, village). Some countries target symptomatic people whereas others target all people in order to detect asymptomatic infections. The majority of respondent programmes collect a range of information from those screened for malaria, similar to the range of information collected during case investigation. Case investigation and reactive case detection are implemented in the malaria elimination programmes in the Asia Pacific, however practices vary widely from country to country. There is little evidence available to support countries in deciding which methods to maintain, change or adopt for improved effectiveness and efficiency. The development and use of common evaluation metrics for these activities will allow malaria programmes to assess performance and results of resource-intensive surveillance measures and may benefit other countries that are considering implementing these activities.