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迈向消除疟疾:关于数字通报模块的思考,以提高巴西亚马逊地区疟疾病例通报速度和后续工作。

Towards malaria elimination: a reflection about digital notification modules to improve malaria cases notification speed and follow-up in the Brazilian Amazon region.

机构信息

Center for Tropical Medicine, University of Brasília, Brasília, Brazil.

Faculty of Health Sciences, University of Brasília, Brasília, Brazil.

出版信息

Malar J. 2024 May 23;23(1):162. doi: 10.1186/s12936-024-04971-6.

Abstract

BACKGROUND

Health information systems (HIS) are a pivotal element in epidemiological surveillance. In Brazil, malaria persists as a public health challenge, with 99% of its occurrences concentrated in the Amazon region, where cases are reported through the HIS Sivep-Malaria. Recent technological advancements indicate that case notifications can be expedited through more efficient systems with broader coverage. The objective of this study is to analyse opportunities for notification within Sivep-Malaria and explore the implementation of mobile electronic devices and applications to enhance the performance of malaria case notifications and use.

METHODS

This descriptive study analyses data on malaria-positive cases in the Brazilian Amazon from 2004 to 2022. Malaria Epidemiological Surveillance System (Sivep-Malaria) data were used. The Brazilian Amazon region area is approximately 5 million km across nine different states in Brazil. Data entry opportunities were assessed by considering the time difference between the 'date of data entry' and the 'date of notification.' Descriptive statistics, including analyses of means and medians, were conducted across the entire Amazon region, and for indigenous population villages and gold mining areas.

RESULTS

Between 2004 and 2022, 6,176,878 new malaria cases were recorded in Brazil. The average data entry opportunity throughout the period was 17.9 days, with a median of 8 days. The most frequently occurring value was 1 day, and 99% of all notifications were entered within 138 days, with 75.0% entered within 20 days after notification. The states with the poorest data entry opportunities were Roraima and Tocantins, with averages of 31.3 and 31.0 days, respectively. For indigenous population villages and gold mining areas, the median data entry opportunities were 23 and 15 days, respectively.

CONCLUSIONS

In malaria elimination, where surveillance is a primary strategy for evaluating each reported case, reducing notification time, enhancing data quality and being able to follow-up cases through computerized reports offer significant benefits for cases investigation. Technological improvements in Sivep-Malaria could yield substantial benefits for malaria control in Brazil, aiding the country in achieving disease elimination and fulfilling the Sustainable Development Goals.

摘要

背景

健康信息系统(HIS)是流行病学监测的关键要素。在巴西,疟疾仍然是一个公共卫生挑战,99%的疟疾病例集中在亚马逊地区,该地区的病例通过 HIS Sivep-Malaria 报告。最近的技术进步表明,可以通过更高效、覆盖范围更广的系统来加快病例通知。本研究的目的是分析 Sivep-Malaria 中的通知机会,并探讨移动电子设备和应用程序的实施,以提高疟疾病例通知和使用的效果。

方法

本描述性研究分析了 2004 年至 2022 年巴西亚马逊地区疟疾病例的阳性数据。使用了疟疾流行病学监测系统(Sivep-Malaria)的数据。巴西亚马逊地区横跨巴西的 9 个不同州,面积约为 500 万平方公里。通过考虑“数据录入日期”和“通知日期”之间的时间差来评估数据录入机会。在整个亚马逊地区以及土著人口村庄和金矿地区进行了描述性统计分析,包括平均值和中位数分析。

结果

2004 年至 2022 年期间,巴西共记录了 6176878 例新疟疾病例。整个期间的平均数据录入机会为 17.9 天,中位数为 8 天。最常见的值是 1 天,99%的通知在 138 天内录入,其中 75.0%在通知后 20 天内录入。数据录入机会最差的州是罗赖马州和托坎廷斯州,平均分别为 31.3 和 31.0 天。对于土著人口村庄和金矿地区,数据录入机会的中位数分别为 23 天和 15 天。

结论

在消除疟疾的过程中,监测是评估每例报告病例的主要策略,减少通知时间、提高数据质量以及能够通过计算机化报告跟进病例,这对病例调查具有重要意义。Sivep-Malaria 的技术改进可能会为巴西的疟疾控制带来巨大的好处,帮助该国实现疾病消除,并实现可持续发展目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d35/11119395/786cef9d0d4d/12936_2024_4971_Fig5_HTML.jpg

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