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恶性疟原虫疟疾家庭管理对撒哈拉以南非洲儿童疟疾控制的影响。

Impact of home management of Plasmodium falciparum malaria on childhood malaria control in sub-Saharan Africa.

作者信息

Uneka C J

机构信息

Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University, PMB 053 Abakaliki, Nigeria.

出版信息

Trop Biomed. 2009 Aug;26(2):182-99.

Abstract

In sub-Saharan Africa almost all of the malaria deaths occur in children below five years of age and these deaths occur within 48 hours of onset of symptoms. Consequently, the home management of malaria (HMM), was introduced to ensure early recognition of and prompt and appropriate response to malarial illness in children within the home or the community. In this report the impact of HMM in childhood malaria control in sub-Saharan Africa was reviewed using relevant publications identified through a Medline Entrez-Pubmed and Google search. There was convincing evidence from the studies reviewed that HMM played a contributory role in reducing progress to severe malaria and overall childhood mortality. The major challenges to the implementation of HMM included failure of caregivers to complete a full course of antimalarial drug, provision of financial motivation to community drug distributors, non-adherence of health workers to recommendations on the use of antimalarial drugs, limited acceptance, possible adverse outcomes, and long term sustainability of HMM. With increased political will and commitment of all stakeholders as well as the mobilization of additional and substantial resources for implementation by the global community, the Abuja declaration of halving mortality from malaria in African may be attained in the nearest future.

摘要

在撒哈拉以南非洲地区,几乎所有疟疾死亡病例都发生在五岁以下儿童身上,且这些死亡发生在症状出现后的48小时内。因此,引入了疟疾家庭管理(HMM)措施,以确保在家中或社区内能够早期识别儿童疟疾,并对疟疾疾病做出迅速且恰当的应对。在本报告中,利用通过医学在线数据库Entrez-Pubmed和谷歌搜索确定的相关出版物,回顾了HMM在撒哈拉以南非洲地区儿童疟疾控制中的影响。从所回顾的研究中有令人信服的证据表明,HMM在减少发展为重症疟疾和降低儿童总体死亡率方面发挥了作用。HMM实施面临的主要挑战包括照顾者未完成全程抗疟药物治疗、向社区药品分发商提供经济激励、卫生工作者未遵循抗疟药物使用建议、接受度有限、可能的不良后果以及HMM的长期可持续性。随着政治意愿增强、所有利益相关者的承诺以及全球社会为实施调动更多大量资源,在不久的将来,非洲将疟疾死亡率减半的《阿布贾宣言》或许能够实现。

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