Kandel Shashi, Dahal Gokarna, Marasini Rudra Prasad, Paudel Krishna Prasad, Parajuli Ashna, Thapa Susmita, Aryal Rizu, Jongcherdchootrakul Kanlaya, Thitichai Phanthanee
Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal.
Ministry of Health and Population, Kathmandu, Nepal.
PLOS Glob Public Health. 2024 Aug 26;4(8):e0003589. doi: 10.1371/journal.pgph.0003589. eCollection 2024.
In order to monitor public health trends and identify disease outbreaks early, efficient and reliable notification and surveillance systems are essential. Nepal uses a 1-3-7 malaria surveillance approach. The Short Message System (SMS) -based system for timely notification has been established. However, knowledge gaps exist regarding the timeliness of notification, treatment initiation, and case-based investigations. Hence, this study identifies the timeliness of notification and factors associated with delayed notification. This study used a cross-sectional approach and used secondary malaria surveillance data from Nepal's national malaria elimination program for the period of 2018 to 2022. The study revealed that the majority (79.9%) of malaria cases were male, with a male-to-female ratio of 3.96:1. Occupation was found to be significantly associated with delayed notification. Repatriate workers had 0.60 times lower odds of experiencing delayed notification compared to the reference occupation. Similarly, individuals diagnosed in the Sudurpaschim and Lumbini provinces had significantly lower odds (0.48 and 0.38, respectively) of encountering delayed notification compared to the reference province. Furthermore, relying on a single laboratory tool for malaria diagnosis (either RDT or microscopy only) was significantly associated with delayed notification. Individuals diagnosed solely with RDT or microscopy had 2.04 and 1.79 times higher odds of experiencing delayed notification, respectively, compared to those diagnosed using both laboratory tools. This study provides insight into the timeliness of surveillance system approach by assessing delayed notification and the factors associated with it. No delays are identified in median notification, treatment time and in case investigation. Improvement in the timeliness of malaria reporting over the years was observed. Provinces with high burden of malaria and repatriate workers showed lower delayed notification and conversely, cases diagnosed with single laboratory tool showed delayed notification time.
为了监测公共卫生趋势并尽早发现疾病暴发，高效可靠的通报和监测系统至关重要。尼泊尔采用1-3-7疟疾监测方法。已建立基于短信系统的及时通报系统。然而，在通报及时性、治疗启动和基于病例的调查方面存在知识差距。因此，本研究确定了通报的及时性以及与延迟通报相关的因素。本研究采用横断面研究方法，使用了尼泊尔国家疟疾消除计划2018年至2022年期间的疟疾监测二级数据。研究显示，大多数（79.9%）疟疾病例为男性，男女比例为3.96:1。发现职业与延迟通报显著相关。与参考职业相比，归国工人延迟通报的几率低0.60倍。同样，与参考省份相比，在苏都尔帕希姆省和蓝毗尼省确诊的个体延迟通报的几率显著更低（分别为0.48和0.38）。此外，仅依靠单一实验室工具进行疟疾诊断（仅使用快速诊断测试或显微镜检查）与延迟通报显著相关。与使用两种实验室工具进行诊断的个体相比，仅通过快速诊断测试或显微镜检查确诊的个体延迟通报的几率分别高2.04倍和1.79倍。本研究通过评估延迟通报及其相关因素，深入了解了监测系统方法的及时性。在中位通报时间、治疗时间和病例调查中未发现延迟情况。观察到多年来疟疾报告及时性有所改善。疟疾负担高的省份和归国工人延迟通报较低，相反，仅通过单一实验室工具确诊的病例显示出延迟通报时间。
