Valero-Bernal María V, Tanner Marcel, Muñoz-Navarro Sergio, Valero-Bernal José F
Ph. D. Epidemiology and Dr. Public Health. Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
MD. Ph. D. Epidemiology. Dhc. Director-Emeritus, Swiss Tropical and Public Health Institute, University of Basel. President, Academia of Sciences. Basel, Switzerland.
Rev Salud Publica (Bogota). 2017 Jan-Feb;19(1):45-51. doi: 10.15446/rsap.v19n1.55933.
Identify and characterize indicators to assess progress in terms of control and monitoring of malaria in endemic areas of Colombia and compare malaria elimination findings with those of countries in the same region.
Cross-sectional surveys were carried out in 2011 and 2014 in malaria endemic areas in Colombia, Pacific and Caribbean regions. A socio-demographic and a clinical questionnaire were applied to each participant; likewise, written and informed consents were obtained. Capillary blood samples were taken and examined through microscopic tests and rapid diagnostic test. A narrative systematic review was conducted to correlate malaria elimination in Colombia and in countries of the Amazon Region.
The sample consisted of 548 participants from the departments of Córdoba and Nariño, Colombia. The proportion of positive malaria cases was 3 % (17/548), in which the prevalence of malaria mixed infections was 47 % (8/17). Regarding fever, temperature over 38.0o C, its prevalence was 2.7 % (15/548). Only two febrile patients tested positive for the disease. Prevalence of asymptomatic malaria cases among all positive cases was 88 %.
Asymptomatic malaria cases, mixed infections and self-medication are the challenges that malaria control and elimination programs face. It is important to note that studies on subclinical malaria in the region are scarce. Endemic areas with dense populations and experiencing an increase in immigration levels are more vulnerable to malaria reemergence. Imported malaria cases impact the basic reproduction rate (Ro). Funding resources availability has impact on the sustainability of public health actions and the elimination of malaria in South America.
确定并描述用于评估哥伦比亚疟疾流行地区疟疾控制和监测进展的指标，并将疟疾消除结果与该地区其他国家的结果进行比较。
2011年和2014年在哥伦比亚太平洋和加勒比地区的疟疾流行地区开展了横断面调查。对每位参与者进行了社会人口统计学和临床问卷调查；同样，获得了书面知情同意书。采集毛细血管血样，通过显微镜检查和快速诊断检测进行检测。进行了叙述性系统评价，以关联哥伦比亚和亚马逊地区国家的疟疾消除情况。
样本包括来自哥伦比亚科尔多瓦省和纳里尼奥省的548名参与者。疟疾阳性病例的比例为3%（17/548），其中疟疾混合感染的患病率为47%（8/17）。关于发热，体温超过38.0摄氏度，其患病率为2.7%（15/548）。只有两名发热患者检测出该疾病呈阳性。所有阳性病例中无症状疟疾病例的患病率为88%。
无症状疟疾病例、混合感染和自我用药是疟疾控制和消除计划面临的挑战。需要注意的是，该地区关于亚临床疟疾的研究很少。人口密集且移民水平上升的流行地区更容易出现疟疾再次流行。输入性疟疾病例影响基本繁殖率（Ro）。资金资源的可用性影响公共卫生行动的可持续性以及南美洲疟疾的消除。
