Ouédraogo Thierry Damien Adamo, Badolo Ousmane, Sawadogo Youssouf
U.S. President's Malaria Initiative (PMI) Integrated Family Health Service Project.
Med Trop Sante Int. 2024 Feb 29;4(1). doi: 10.48327/mtsi.v4i1.2024.495. eCollection 2024 Mar 31.
To observe the evolution in malaria case-fatality rate among children under 5 years of age receiving care at the Bittou district hospital (CMA) after an improvement of the care practices. The management team implemented an emergency plan in 2016 with 5 components: i) health facilities staff sensitization to enable rapid referral of severe malaria cases to CMA; ii) reorganization of CMA paediatric emergencies to make a physician as the mainpoint of contact; iii) ensuring availability of supplies for severe malaria case management, including the availability of blood; iv) daily medical check-ups of hospitalized patients; v) reinforcement of clinical staff skills at all peripheral health facilities. At the same time were introduced i) free care for children under 5 years; ii) municipality involvement to finance ambulance fuel for the referrals of patients; iii) free blood collection in professional schools and soldiers; iv) a free telephone line between the health structures; v) presence of 5 medical doctors at the CMA.
Analysis of data collected from the statistical yearbooks of the Ministry of Health of Burkina Faso from 2014 to 2021.
The malaria case-fatality rate (CFR) in under-five in the Bittou health district (1.39% and 1.52% in 2014 and 2015) was higher than the average for all districts in this region (1.08%). After implementation of the emergency plan, the malaria CFR in Bittou declined to 0% in 2016 and 2017, 0.2% in 2018, 0% in 2019, 0.07% in 2020 and 0.05% in 2021. The same trend was observed at the CMA level with 2.94% and 2.59% in 2014 and 2015, 0% in 2016 and 2017, 0.38% in 2018, 0% in 2019, then 0.17% and 0.47% in 2020 and 2021.
Malaria control remains a challenge in Burkina Faso. However, the improved malaria CFRs observed in Bittou show that effective involvement of health district teams could potentially contribute to substantial reductions in malaria case-fatality risk.
观察在改善医疗实践后，比图地区医院（CMA）接受治疗的5岁以下儿童疟疾病死率的变化情况。管理团队在2016年实施了一项包含5个部分的应急计划：i）提高卫生设施工作人员的认识，以便将重症疟疾病例迅速转诊至CMA；ii）重组CMA儿科急诊，以医生作为主要联系人；iii）确保提供重症疟疾病例管理所需物资，包括血液供应；iv）对住院患者进行每日医学检查；v）加强所有基层卫生设施临床工作人员的技能。同时还引入了以下措施：i）为5岁以下儿童提供免费治疗；ii）市政府参与为转诊患者的救护车燃料提供资金；iii）在专业学校和军人中进行免费采血；iv）卫生机构之间设立免费电话线；v）CMA有5名医生驻诊。
分析从布基纳法索卫生部2014年至2021年统计年鉴中收集的数据。
比图卫生区5岁以下儿童的疟疾病死率（2014年和2015年分别为1.39%和1.52%）高于该地区所有区的平均水平（1.08%）。实施应急计划后，比图的疟疾病死率在2016年和2017年降至0%，2018年为0.2%，2019年为0%，2020年为0.07%，2021年为0.05%。在CMA层面也观察到了相同趋势，2014年和2015年分别为2.94%和2.59%，2016年和2017年为0%，2018年为0.38%，2019年为0%，2020年和2021年分别为0.17%和0.47%。
疟疾控制在布基纳法索仍然是一项挑战。然而，在比图观察到的疟疾病死率改善表明，卫生区团队的有效参与可能有助于大幅降低疟疾病例的死亡风险。
