[布基纳法索比图卫生区实施改善病例管理应急计划后疟疾病死率降低]

[Reduction in malaria case-fatality rate after implementation of an emergency plan for improved case management in the Bittou health district, Burkina Faso].

作者信息

Ouédraogo Thierry Damien Adamo, Badolo Ousmane, Sawadogo Youssouf

机构信息

U.S. President's Malaria Initiative (PMI) Integrated Family Health Service Project.

出版信息

Med Trop Sante Int. 2024 Feb 29;4(1). doi: 10.48327/mtsi.v4i1.2024.495. eCollection 2024 Mar 31.

DOI:10.48327/mtsi.v4i1.2024.495

PMID:38846124

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11151928/

Abstract

OBJECTIVE

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.

MATERIAL AND METHODS

Analysis of data collected from the statistical yearbooks of the Ministry of Health of Burkina Faso from 2014 to 2021.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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%。