Moir J S, Tulloch J L, Vrbova H, Jolley D J, Heywood P F, Alpers M P
P N G Med J. 1985 Dec;28(4):267-78.
A village-based programme of presumptive treatment of fever, using voluntary village aides to dispense oral chloroquine or amodiaquine, was established in 1982 by the Papua New Guinea Institute of Medical Research (PNG IMR) in 35 rural villages or hamlets near Madang, on the north coast of PNG. In the course of the following two years, village aides became an established health resource in many of those villages, although in others they were poorly utilized. In attempting to evaluate the impact of the programme on village health, a number of parameters were investigated. These included malaria-related mortality and morbidity, and the prevalence of parasitaemia and splenic enlargement in children in the study area. Deaths attributable to malaria, which accounted for 11% of deaths in the under-10 year age-group, and cerebral malaria cases were too few to be useful as parameters to evaluate the programme. No reduction in spleen or parasite rates occurred in children as a result of the village aide programme. In two villages, there was an unexplained increase in spleen rate following the introduction of a village aide. A study of malaria-related morbidity, by investigation of all fever cases occurring in a two-week recall period, was conducted in mid-1984. House-to-house interviews were carried out in 19 villages: 9 control villages, where there was no village aide, 6 where the village aide was well utilized, and 4 where the village aide was poorly utilized. The study showed that village aides had a measurable impact on morbidity due to fever in villages where they were well utilized, primarily by reducing the duration of fever through early treatment. The results also suggested that children benefitted even in the villages where the overall utilization of village aides was low. It is felt that such a programme would have had an even greater impact in areas where access to existing health services is more difficult than in the study area.
1982年，巴布亚新几内亚医学研究所（PNG IMR）在巴布亚新几内亚北海岸马当附近的35个乡村或小村庄，开展了一项以村庄为基础的发热推定治疗项目，利用志愿的村庄助手分发口服氯喹或阿莫地喹。在接下来的两年里，村庄助手在许多村庄成为了既定的卫生资源，尽管在其他一些村庄它们未得到充分利用。在试图评估该项目对村庄健康的影响时，对一些参数进行了调查。这些参数包括与疟疾相关的死亡率和发病率，以及研究区域内儿童的寄生虫血症患病率和脾肿大情况。因疟疾导致的死亡占10岁以下年龄组死亡人数的11%，而脑型疟病例太少，无法作为评估该项目的有用参数。村庄助手项目实施后，儿童的脾脏或寄生虫率并未降低。在两个村庄，引入村庄助手后，脾脏率出现了不明原因的上升。1984年年中，通过调查两周回忆期内发生的所有发热病例，对与疟疾相关的发病率进行了研究。在19个村庄进行了逐户访谈：9个对照村庄没有村庄助手，6个村庄村庄助手得到充分利用，4个村庄村庄助手未得到充分利用。研究表明，在村庄助手得到充分利用的村庄，它们对发热导致的发病率有显著影响，主要是通过早期治疗缩短发热持续时间。结果还表明，即使在村庄助手总体利用率较低的村庄，儿童也从中受益。人们认为，这样一个项目在获得现有卫生服务比研究区域更困难的地区会产生更大的影响。
