Using ante-natal clinic prevalence data to monitor temporal changes in malaria incidence in a humanitarian setting in the Democratic Republic of Congo.
Using ante-natal clinic prevalence data to monitor temporal changes in malaria incidence in a humanitarian setting in the Democratic Republic of Congo.
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DOI：
10.1186/s12936-018-2460-9
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发表时间：
2018-08-29
期刊：
影响因子：
3
通讯作者：
Churcher TS
中科院分区：
文献类型：
--
作者：
Hellewell J;Walker P;Ghani A;Rao B;Churcher TS
疟疾临床病例数通常记录在资源有限或冲突环境中，作为疾病负担的代表。由于安全问题、资源限制和人口流动造成人口规模的不确定性，解释人道主义需求地区的病例计数数据具有挑战性。如果不考虑症状而定期进行疟疾检测，那么去产前护理 (ANC) 诊所就诊的妇女的疟疾患病率有可能成为一种更简单、更准确的疟疾监测指标，并且不受人口规模的影响。将一套分布式滞后非线性模型与 5 岁以下儿童的临床发病时间序列数据以及刚果民主共和国无国界医生组织运营的健康中心的 ANC 患病率数据进行拟合，该中心在怀孕期间实施常规间歇性筛查和治疗以及间歇性预防性治疗。这些统计模型可以理清两个指标之间的时间关系。 ANC 患病率和临床发病率之间存在密切关系，表明两者都可以用来描述当前的疟疾流行情况。没有证据表明 ANC 患病率可以预测未来的临床发病率，尽管临床发病率的变化已被证明会影响未来 3 个月内的 ANC 患病率。结果表明，ANC 患病率可能是回顾性评估疟疾干预措施影响的合适指标，也是评估资源有限环境中长期疟疾趋势的有用方法。本文的在线版本 (10.1186/s12936-018-2460-9) 包含补充材料，可供授权用户使用。
The number of clinical cases of malaria is often recorded in resource constrained or conflict settings as a proxy for disease burden. Interpreting case count data in areas of humanitarian need is challenging due to uncertainties in population size caused by security concerns, resource constraints and population movement. Malaria prevalence in women visiting ante-natal care (ANC) clinics has the potential to be an easier and more accurate metric for malaria surveillance that is unbiased by population size if malaria testing is routinely conducted irrespective of symptoms. A suite of distributed lag non-linear models was fitted to clinical incidence time-series data in children under 5 years and ANC prevalence data from health centres run by Médecins Sans Frontières in the Democratic Republic of Congo, which implement routine intermittent screening and treatment alongside intermittent preventative treatment in pregnancy. These statistical models enable the temporal relationship between the two metrics to be disentangled. There was a strong relationship between the ANC prevalence and clinical incidence suggesting that both can be used to describe current malaria endemicity. There was no evidence that ANC prevalence could predict future clinical incidence, though a change in clinical incidence was shown to influence ANC prevalence up to 3 months into the future. The results indicate that ANC prevalence may be a suitable metric for retrospective evaluations of the impact of malaria interventions and is a useful method for evaluating long-term malaria trends in resource constrained settings. The online version of this article (10.1186/s12936-018-2460-9) contains supplementary material, which is available to authorized users.
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DOI：
10.4269/ajtmh.17-0620
发表时间：
2018-03
期刊：
The American journal of tropical medicine and hygiene
影响因子：
--
作者：
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影响因子：
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影响因子：
3.3
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DOI：
10.1016/s2214-109x(15)00049-2
发表时间：
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期刊：
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影响因子：
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作者：
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影响因子：
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