Lim Sachiko, Yasuoka Junko, Poudel Krishna C, Ly Po, Nguon Chea, Jimba Masamine
Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan.
BMC Res Notes. 2012 Aug 3;5:405. doi: 10.1186/1756-0500-5-405.
Cambodia has been investing in Village Malaria Workers (VMWs) to improve malaria case management in rural areas. This study assessed the quality of the VMWs' services compared to those by a government-run health center from the perspective of community members. We focused on VMWs' contribution to promote their action to control malaria. A community-based cross-sectional study was conducted in Kampot province in 2009. Interviews were conducted at every accessible household in a village with VMWs (n = 153) and a village with a health center (n = 159), using interviewer administered questionnaire. Preference of the interview was given to female household head. Multiple regression analyses were run to compare knowledge about malaria, preventive measures taken, and time before first malaria treatment between the two villages.
The villagers perceived the VMWs' services equally as good as those provided by the health center. After controlling for confounding factors, the following indicators did not show any statistical significance between two villages: community members' knowledge about malaria transmission (AOR = 0.60, 95% CI = 0.30-1.22) and government-recommended antimalarial (AOR = 0.55, 95% CI = 0.25-1.23), preventive measures taken (Beta = -0.191, p = 0.315), and time before the first treatment (Beta = 0.053, p = 0.721). However, knowledge about malaria symptoms was significantly lower in the village with VMWs than the village with a health center (AOR = 0.40, 95% CI = 0.19-0.83).
VMWs played an equivalent role as the health center in promoting malaria knowledge, action, and effective case management. Although VMWs need to enhance community knowledge about malaria symptoms, the current government policy on VMWs is reasonable and should be expanded to other malaria endemic villages.
柬埔寨一直在投入资金用于乡村疟疾防治员（VMW）项目，以改善农村地区的疟疾病例管理。本研究从社区成员的角度评估了乡村疟疾防治员与政府运营的卫生中心所提供服务的质量。我们关注乡村疟疾防治员在促进疟疾防控行动方面的贡献。2009年在贡布省开展了一项基于社区的横断面研究。使用访谈员管理的问卷，对设有乡村疟疾防治员的村庄（n = 153）和设有卫生中心的村庄（n = 159）中每个可及的家庭进行访谈。优先选择女性户主进行访谈。进行多元回归分析以比较两个村庄之间关于疟疾的知识、采取的预防措施以及首次疟疾治疗前的时间。
村民认为乡村疟疾防治员的服务与卫生中心提供的服务同样良好。在控制混杂因素后，以下指标在两个村庄之间未显示出任何统计学意义：社区成员关于疟疾传播的知识（调整后比值比[AOR] = 0.60，95%置信区间[CI] = 0.30 - 1.22）和政府推荐的抗疟药（AOR = 0.55，95% CI = 0.25 - 1.23）、采取的预防措施（β = -0.191，p = 0.315）以及首次治疗前的时间（β = 0.053，p = 0.721）。然而，设有乡村疟疾防治员的村庄中关于疟疾症状的知识显著低于设有卫生中心的村庄（AOR = 0.40，95% CI = 0.19 - 0.83）。
乡村疟疾防治员在促进疟疾知识、行动及有效病例管理方面发挥了与卫生中心同等的作用。尽管乡村疟疾防治员需要加强社区对疟疾症状的了解，但当前政府关于乡村疟疾防治员的政策是合理的，应推广至其他疟疾流行村庄。
