背景:随着许多国家本土疟疾病例接近零,消除疟疾的进展正在增加。在接近消除的环境中,当针对残留的传播病灶时,干预措施将最有效地中断传播。这些病灶可能因无症状感染而错过。为了解决这个问题,世界卫生组织建议反应性病例检测(RACD).这个案例研究是为了确定无症状疟疾的个体,他们的易感危险因素,并推荐阿苏托病的RACD,加纳基于文献综述和横断面研究。
方法:该研究涉及对PubMed和GoogleScholar在1月1日之间发表的文献进行搜索,2009-8月14日,2023年使用“Asutsuare”中的搜索词“疟疾”。此外,对100名没有疟疾症状的人进行了结构化问卷调查,并使用快速诊断测试(RDT)试剂盒进行了筛查,显微镜和实时聚合酶链反应(RT-PCR)。在横断面研究中,通过问卷调查评估了基于三种诊断技术的疟疾患病率以及潜在的疟疾危险因素。
结果:累计,六十四(64)项研究(谷歌学者,57和PubMed,7)进行了综述,文献中包括了22项关于阿兹多拉疟疾的研究,加纳。重要的危险因素是职业,从房子到水体的距离,年龄组和教育水平。在100个样本中,3(3%)为RDT阳性,6(6%)通过显微镜和9(9%)通过rt-PCR。在4名参与者中,5-14.9岁的平均疟疾寄生虫密度最高,为560个寄生虫/μl,恶性疟原虫为优势种。此外,在≥15岁的年龄组中,2名参与者(各1名)携带恶性疟原虫和疟原虫寄生虫.RDT的灵敏度(76.54%;CI9566.82-85.54)高于rt-PCR(33.33%;CI954.33-77.72),而rt-PCR和RDT均具有较高的特异性(92.55;CI9585.26-96.95)和(97.30;CI9593.87-99.13),分别诊断为疟疾。
结论:在白虫中,加纳,低流行区,消除疟疾可能需要寻找无症状感染的个体。鉴于本研究中确定的无症状个体的患病率较低,并且在文献综述中得到了重复,这有利于RCD,Asutsuare是RCD实施的可能设置。
BACKGROUND: Progress toward malaria elimination is increasing as many countries near zero indigenous malaria cases. In settings nearing elimination, interventions will be most effective at interrupting transmission when targeted at the residual foci of transmission. These foci may be missed due to asymptomatic infections. To solve this problem, the World Health Organization recommends reactive
case detection (RACD). This
case study was conducted to identify individuals with asymptomatic malaria, their predisposing risk factors and recommend RACD in Asutsuare, Ghana based on literature review and a cross sectional study.
METHODS: The study involved a search on PubMed and Google Scholar of literature published between 1st January, 2009-14th August, 2023 using the search terms \"malaria\" in \"Asutsuare\". Furthermore, structured questionnaires were administered to one hundred individuals without symptoms of malaria and screened using rapid diagnostic test (RDT) kits, microscopy and real-time polymerase chain reaction (rt-PCR). Malaria prevalence based on the three diagnostic techniques as well as potential malaria risk factors were assessed through questionnaires in a cross-sectional study.
RESULTS: Cumulatively, sixty-four (64) studies (Google Scholar, 57 and PubMed, 7) were reviewed and 22 studies included in the literature on malaria in Asutsuare, Ghana. Significant risk factors were occupation, distance from a house to a waterbody, age group and educational level. Out of the 100 samples, 3 (3%) were positive by RDT, 6 (6%) by microscopy and 9 (9%) by rt-PCR. Ages 5-14.9 years had the highest mean malaria parasite densities of 560 parasites/µl with Plasmodium falciparum as the dominant species in 4 participants. Moreover, in the age group ≥ 15, 2 participants (1 each) harboured P. falciparum and Plasmodium malariae parasites. RDT had a higher sensitivity (76.54%; CI95 66.82-85.54) than rt-PCR (33.33%; CI95 4.33-77.72), while both rt-PCR and RDT were observed to have a higher specificity (92.55; CI95 85.26-96.95) and (97.30; CI95 93.87-99.13), respectively in the diagnosis of malaria.
CONCLUSIONS: In Asutsuare, Ghana, a low endemic area, the elimination of malaria may require finding individuals with asymptomatic infections. Given the low prevalence of asymptomatic individuals identified in this study and as repleted in the literature review, which favours RACD, Asutsuare is a possible setting receptive for RACD implementation.