肯尼亚疟疾控制参与式综合病媒管理评估
An Assessment of Participatory Integrated Vector Management for Malaria Control in Kenya.
作者信息
Mutero Clifford Maina, Mbogo Charles, Mwangangi Joseph, Imbahale Susan, Kibe Lydia, Orindi Benedict, Girma Melaku, Njui Annah, Lwande Wilber, Affognon Hippolyte, Gichuki Charity, Mukabana Wolfgang Richard
机构信息
International Centre of Insect Physiology and Ecology, Nairobi, Kenya.
出版信息
Environ Health Perspect. 2015 Nov;123(11):1145-51. doi: 10.1289/ehp.1408748. Epub 2015 Apr 10.
BACKGROUND
The World Health Organization (WHO) recommends integrated vector management (IVM) as a strategy to improve and sustain malaria vector control. However, this approach has not been widely adopted.
OBJECTIVES
We comprehensively assessed experiences and findings on IVM in Kenya with a view to sharing lessons that might promote its wider application.
METHODS
The assessment used information from a qualitative external evaluation of two malaria IVM projects implemented between 2006 and 2011 and an analysis of their accumulated entomological and malaria case data. The project sites were Malindi and Nyabondo, located in coastal and western Kenya, respectively. The assessment focused on implementation of five key elements of IVM: integration of vector control methods, evidence-based decision making, intersectoral collaboration, advocacy and social mobilization, and capacity building.
RESULTS
IVM was more successfully implemented in Malindi than in Nyabondo owing to greater community participation and multistakeholder engagement. There was a significant decline in the proportion of malaria cases among children admitted to Malindi Hospital, from 23.7% in 2006 to 10.47% in 2011 (p < 0.001). However, the projects' operational research methodology did not allow statistical attribution of the decline in malaria and malaria vectors to specific IVM interventions or other factors.
CONCLUSIONS
Sustaining IVM is likely to require strong participation and support from multiple actors, including community-based groups, non-governmental organizations, international and national research institutes, and various government ministries. A cluster-randomized controlled trial would be essential to quantify the effectiveness and impact of specific IVM interventions, alone or in combination.
CITATION
Mutero CM, Mbogo C, Mwangangi J, Imbahale S, Kibe L, Orindi B, Girma M, Njui A, Lwande W, Affognon H, Gichuki C, Mukabana WR. 2015. An assessment of participatory integrated vector management for malaria control in Kenya. Environ Health Perspect 123:1145-1151; http://dx.doi.org/10.1289/ehp.1408748.
背景
世界卫生组织（WHO）推荐采用综合病媒管理（IVM）作为改善和维持疟疾病媒控制的一项策略。然而，这种方法尚未得到广泛采用。
目的
我们全面评估了肯尼亚在综合病媒管理方面的经验和研究结果，以期分享可能促进其更广泛应用的经验教训。
方法
该评估使用了对2006年至2011年间实施的两个疟疾综合病媒管理项目进行定性外部评估的信息，以及对其积累的昆虫学和疟疾病例数据的分析。项目地点分别是位于肯尼亚沿海地区的马林迪和西部地区的尼亚邦多。评估重点关注综合病媒管理五个关键要素的实施情况：病媒控制方法的整合、循证决策、部门间协作、宣传与社会动员以及能力建设。
结果
由于社区参与度更高以及多方利益相关者的参与，马林迪比尼亚邦多更成功地实施了综合病媒管理。马林迪医院收治的儿童中疟疾病例的比例显著下降，从2006年的23.7%降至2011年的10.47%（p < 0.001）。然而，项目的运筹学方法无法从统计学上确定疟疾和疟疾病媒的减少是归因于特定的综合病媒管理干预措施还是其他因素。
结论
维持综合病媒管理可能需要包括社区团体、非政府组织、国际和国家研究机构以及政府各部委在内的多个行为主体的大力参与和支持。一项整群随机对照试验对于量化特定综合病媒管理干预措施单独或联合使用时的有效性和影响至关重要。
引用文献
Mutero CM, Mbogo C, Mwangangi J, Imbahale S, Kibe L, Orindi B, Girma M, Njui A, Lwande W, Affognon H, Gichuki C, Mukabana WR. 2015. An assessment of participatory integrated vector management for malaria control in Kenya. Environ Health Perspect 123:1145 - 1151; http://dx.doi.org/10.1289/ehp.1408748.
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