PDF(Pubmed)
Abstract：
BACKGROUND: Togo\'s National Malaria Control Programme has initiated an active home-based malaria management model for all age groups in rural areas of Bassar Health District. This report describes the model, reports its main results, and determines the factors associated with positive rapid diagnostic test results.
METHODS: From 2014 to 2017, in three peripheral care units of Bassar Health District (Binaparba, Nangbani, and Baghan), community health workers visited residents\' homes weekly to identify patients with malaria symptoms, perform rapid diagnostic tests in symptomatic patients, and give medication to positive cases. Univariate and multivariate logistic regression models were used to determine the factors associated with positive tests.
RESULTS: The study covered 11,337 people (817 in 2014, 1804 in 2015, 2638 in 2016, and 6078 in 2017). The overall mean age was 18 years (95% CI 5-29; min-max: 0-112 years). The median age was 10 years (SD: 16.9). The proportions of people tested positive were 75.3% in Binaparba, 77.4% in Nangbani, and 56.6% in Baghan. The 5-10 age group was the most affected category (24.2% positive tests). Positive tests were more frequent during the rainy than during the dry season (62 vs. 38%) and the probability of positive test was 1.76 times higher during the rainy than during the dry season (adjusted OR = 1.74; 95% CI 1.60-1.90). A fever (37.5 °C or higher) increased significantly the probability of positive test (adjusted OR = 2.19; 95% CI 1.89-2.54). The risk of positive test was 1.89 times higher in passive than in active malaria detection (adjusted OR = 1.89; 95% CI 1.73-2.0).
CONCLUSIONS: This novel experimental community and home-based malaria management in Togo suggested that active detection of malaria cases is feasible within 24 h, which allows rapid treatments before progression to often-fatal complications. This PECADOM + program will help Togo\'s National Malaria Control Programme reduce malaria morbidity and mortality in remote and hard-to-reach communities.
METHODS: From 2014 to 2017, in three peripheral care units of Bassar Health District (Binaparba, Nangbani, and Baghan), community health workers visited residents\' homes weekly to identify patients with malaria symptoms, perform rapid diagnostic tests in symptomatic patients, and give medication to positive cases. Univariate and multivariate logistic regression models were used to determine the factors associated with positive tests.
RESULTS: The study covered 11,337 people (817 in 2014, 1804 in 2015, 2638 in 2016, and 6078 in 2017). The overall mean age was 18 years (95% CI 5-29; min-max: 0-112 years). The median age was 10 years (SD: 16.9). The proportions of people tested positive were 75.3% in Binaparba, 77.4% in Nangbani, and 56.6% in Baghan. The 5-10 age group was the most affected category (24.2% positive tests). Positive tests were more frequent during the rainy than during the dry season (62 vs. 38%) and the probability of positive test was 1.76 times higher during the rainy than during the dry season (adjusted OR = 1.74; 95% CI 1.60-1.90). A fever (37.5 °C or higher) increased significantly the probability of positive test (adjusted OR = 2.19; 95% CI 1.89-2.54). The risk of positive test was 1.89 times higher in passive than in active malaria detection (adjusted OR = 1.89; 95% CI 1.73-2.0).
CONCLUSIONS: This novel experimental community and home-based malaria management in Togo suggested that active detection of malaria cases is feasible within 24 h, which allows rapid treatments before progression to often-fatal complications. This PECADOM + program will help Togo\'s National Malaria Control Programme reduce malaria morbidity and mortality in remote and hard-to-reach communities.
摘要：
背景：多哥的国家疟疾控制计划已针对Bassar卫生区农村地区的所有年龄段启动了积极的基于家庭的疟疾管理模式。此报告描述了该模型，报告其主要结果，并确定与阳性快速诊断测试结果相关的因素。
方法：从2014年到2017年，在巴萨卫生区的三个外围护理单位（Binaparba，Nangbani,和Baghan)，社区卫生工作者每周访问居民家中，以确定有疟疾症状的患者，对有症状的患者进行快速诊断测试，对阳性病例给予药物治疗。使用单变量和多变量逻辑回归模型来确定与阳性测试相关的因素。
结果：该研究涵盖了11,337人（2014年为817人，2015年为1804人，2016年为2638人，2017年为6078人）。总体平均年龄为18岁（95％CI5-29；最小-最大：0-112岁）。中位年龄为10岁（SD：16.9）。比纳帕巴检测呈阳性的人数比例为75.3%,南巴尼的77.4%，和56.6%在巴汉。5-10岁年龄组是受影响最大的类别（24.2％阳性测试）。雨季的阳性测试比旱季更频繁（62vs.38％），雨季期间的阳性测试概率是旱季期间的1.76倍（调整后的OR=1.74；95％CI1.60-1.90）。发烧（37.5°C或更高）显着增加了阳性测试的可能性（校正OR=2.19；95％CI1.89-2.54）。被动检测阳性的风险是主动检测的1.89倍（校正OR=1.89；95％CI1.73-2.0）。
结论：多哥这种新颖的实验性社区和基于家庭的疟疾管理表明，在24小时内积极检测疟疾病例是可行的，这允许在进展为通常致命的并发症之前进行快速治疗。该PECAOM计划将帮助多哥的国家疟疾控制计划降低偏远和难以到达的社区的疟疾发病率和死亡率。
方法：从2014年到2017年，在巴萨卫生区的三个外围护理单位（Binaparba，Nangbani,和Baghan)，社区卫生工作者每周访问居民家中，以确定有疟疾症状的患者，对有症状的患者进行快速诊断测试，对阳性病例给予药物治疗。使用单变量和多变量逻辑回归模型来确定与阳性测试相关的因素。
结果：该研究涵盖了11,337人（2014年为817人，2015年为1804人，2016年为2638人，2017年为6078人）。总体平均年龄为18岁（95％CI5-29；最小-最大：0-112岁）。中位年龄为10岁（SD：16.9）。比纳帕巴检测呈阳性的人数比例为75.3%,南巴尼的77.4%，和56.6%在巴汉。5-10岁年龄组是受影响最大的类别（24.2％阳性测试）。雨季的阳性测试比旱季更频繁（62vs.38％），雨季期间的阳性测试概率是旱季期间的1.76倍（调整后的OR=1.74；95％CI1.60-1.90）。发烧（37.5°C或更高）显着增加了阳性测试的可能性（校正OR=2.19；95％CI1.89-2.54）。被动检测阳性的风险是主动检测的1.89倍（校正OR=1.89；95％CI1.73-2.0）。
结论：多哥这种新颖的实验性社区和基于家庭的疟疾管理表明，在24小时内积极检测疟疾病例是可行的，这允许在进展为通常致命的并发症之前进行快速治疗。该PECAOM计划将帮助多哥的国家疟疾控制计划降低偏远和难以到达的社区的疟疾发病率和死亡率。
