Moise Kenny, Achille Aude Melody, Duvilaire Roubens, Fedna Jimmy, Thermidor Roody, Bourdeau Bertiny, Nestor Jessica Maureen, Lerebours Gérald, Henrys Jean Hugues, Raccurt Christian
Equipe de Recherche sur l'Ecologie des Maladies Infectieuses et Tropicales, Université Quisqueya, Port-au-Prince, Haïti.
CUNY Graduate School of Public Health & Health Policy, New York City, USA.
BMC Health Serv Res. 2024 Dec 18;24(1):1588. doi: 10.1186/s12913-024-12063-z.
Haiti is on the verge of possibly eliminating malaria, an endemic parasitic infection primarily caused by Plasmodium falciparum on the island of Hispaniola. Owing to its associated morbidity and mortality, malaria is a leading public health priority in Haiti. This scoping review aims to identify the scope of research on access and coverage of malaria surveillance, diagnosis, and treatment in Haiti in the elimination setting.
We compiled, analyzed, and synthesized the literature on access and coverage of antimalarial services in Haiti in the elimination setting based on Arksey and O'Malley's framework for scoping reviews and held a formal meeting with the PNCM leadership and stakeholders of malaria programs in Haiti. Results were reported following PRISMA-ScR guidelines.
We found 376 citations and five technical reports related to our keywords from 2016 to 2023 and retained 225 after eliminating duplicates. Based on our selection criteria, we retrieved 81 citations and excluded 56 after in-depth readings. Therefore, the review includes 26 articles and five technical reports. The Ministry of Health established a strategic plan covering the 2021-2030 period, providing a framework for operational planning to increase efficiency, strengthen the health system, and ensure the sustainability of interventions. However, the current weaknesses in surveillance underline a lack of well-trained personnel, difficulty in establishing the epidemiological profile of malaria, unreliability, lack of completeness of data, and delay in their transmission. In addition, access to malaria diagnosis and treatment in Haiti is limited due to a lack of available state-of-the-art testing modalities, variations in the geographic availability of rapid diagnostic tests and microscopy, and the widespread use of substandard antimicrobial drugs.
Research and reports on malaria surveillance, diagnosis, and treatment access and coverage in Haiti are limited; however, the available sources reveal significant shortcomings and challenges in implementing WHO-recommended policies and strategies for malaria elimination. Future studies should aim to fill this gap and investigate the determinants of the persistence of malaria cases in certain municipalities and departments of the country.
海地即将有可能消除疟疾，疟疾是一种主要由恶性疟原虫引起的地方性寄生虫感染，在伊斯帕尼奥拉岛流行。由于其相关的发病率和死亡率，疟疾是海地首要的公共卫生重点。本综述旨在确定海地在消除疟疾背景下，疟疾监测、诊断和治疗的可及性与覆盖范围的研究范畴。
我们依据阿克西和奥马利的综述框架，汇编、分析并综合了海地在消除疟疾背景下抗疟服务可及性与覆盖范围的文献，并与海地国家疟疾防治项目（PNCM）领导层及疟疾项目利益相关者召开了一次正式会议。结果按照PRISMA-ScR指南进行报告。
我们在2016年至2023年间找到了376条与我们关键词相关的引文和5份技术报告，去除重复后保留了225条。根据我们的选择标准，我们检索到81条引文，深入阅读后排除了56条。因此，本综述纳入了26篇文章和5份技术报告。卫生部制定了涵盖2021 - 2030年期间的战略计划，为提高效率、加强卫生系统以及确保干预措施的可持续性提供了业务规划框架。然而，当前监测方面的薄弱环节凸显出缺乏训练有素的人员、难以确定疟疾的流行病学特征、不可靠性、数据不完整以及数据传输延迟等问题。此外，由于缺乏可用的先进检测方式、快速诊断检测和显微镜检查在地理可及性上存在差异，以及不合格抗菌药物的广泛使用，海地疟疾诊断和治疗的可及性受到限制。
海地关于疟疾监测、诊断、治疗可及性与覆盖范围的研究和报告有限；然而，现有资料揭示了在实施世界卫生组织推荐的疟疾消除政策和战略方面存在重大缺陷和挑战。未来的研究应旨在填补这一空白，并调查该国某些市和部门疟疾病例持续存在的决定因素。
