Shanxi Center for Disease Control and Prevention, Taiyuan, 030012, China.
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.
Malar J. 2019 Jul 12;18(1):235. doi: 10.1186/s12936-019-2865-0.
China's 1-3-7 approach was extensively implemented to monitor the timeframe of case reporting, case investigation and foci response in the malaria elimination. However, activities before diagnosis and reporting (before '1') would counteract the efficiency of 1-3-7 approach but few data have evaluated this issue. This study aims to evaluate the timelines between onset of fever and diagnosis at healthcare facilities in Shanxi Province.
Routine data were extracted from IDIRMS and NMISM database from 2013 to 2018. Time intervals between onset of fever and healthcare-seeking and between healthcare-seeking and diagnosis were calculated. Each of the documented malaria cases was geo-coded and paired to the county-level layers of polygon.
A total of 90 cases were reported in 2013-2018 in Shanxi Province, and 73% of cases reported at provincial health facilities. All malaria cases were imported from Africa (90%) and Southeast Asia (10%) especially around the Chinese Spring Festival (n = 46, 51%). The median days between fever and healthcare-seeking and between healthcare-seeking and diagnosis of malaria were 3 and 2, respectively.
The current "1-3-7" approach is well executed in Shanxi Province, but delays intervals observed in case finding before 1-3-7 approach occurred in all levels of facilities in Shanxi Province, which imply that more efforts are highlighted for timely case finding. Health education should be provided for improving awareness of healthcare-seeking, and various technical training aiming at the physicians should be carried out to improve diagnosis of malaria.
中国的“1-3-7”策略广泛应用于监测疟疾消除过程中的病例报告时间范围、病例调查和疫点响应。然而，在诊断和报告之前（“1”之前）的活动将降低“1-3-7”策略的效率，但很少有数据评估这个问题。本研究旨在评估山西省发热至医疗机构就诊和就诊至确诊之间的时间间隔。
从 2013 年至 2018 年，从 IDIRMS 和 NMISM 数据库中提取常规数据。计算发热至求医和求医至确诊之间的时间间隔。将每个记录的疟疾病例进行地理编码，并与县级多边形图层配对。
2013-2018 年山西省共报告 90 例疟疾病例，73%的病例在省级卫生机构报告。所有疟疾病例均来自非洲（90%）和东南亚（10%），特别是在中国春节前后（n=46，51%）。发热至求医和求医至确诊的中位数天数分别为 3 天和 2 天。
目前的“1-3-7”策略在山西省得到了很好的执行，但在山西省各级医疗机构中，在“1-3-7”策略实施之前发现病例的延迟间隔都观察到了，这意味着需要更加重视及时发现病例。应开展卫生教育，提高求医意识，针对医务人员开展各种技术培训，提高疟疾诊断水平。
