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马里卡蒂卫生区疟疾控制干预措施对人群的影响

Population impact of malaria control interventions in the health district of Kati, Mali.

作者信息

Katile Abdoulaye, Sagara Issaka, Cissoko Mady, Bationo Cédric Stéphane, Dolo Mathias, Dembélé Pascal, Kamate Bourama, Simaga Ismaila, Sissoko Mahamadou Soumana, Landier Jordi, Gaudart Jean

机构信息

INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Aix Marseille Univ, Marseille, France.

Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali.

出版信息

PLoS One. 2024 Dec 31;19(12):e0289451. doi: 10.1371/journal.pone.0289451. eCollection 2024.

Abstract

BACKGROUND

WHO and its partners have adopted alternative control interventions since the failure to eradicate malaria worldwide in the 1960s and 1970s. The aim of these interventions has been to redesign the control interventions to make them more effective and more efficient. The purpose of this study is to assess the population impact of control interventions implemented at the community health area level.

METHODS

The analysis used data from the health information system on malaria cases and interventions (distribution of long-lasting insecticide-treated nets (LLINs), seasonal malaria chemoprevention (SMC), access to rapid diagnostic tests (RDT), intermittent preventive treatment for pregnant women (IPTp)) collected in the Kati health district from 2017 to 2020. And the contextual parameters (temperature, normal difference vegetation index (NDVI) and rainfall) were obtained by remote sensing. A generalized additive model was used to assess the impact of malaria control interventions on malaria cases as a function of meteorological factors.

RESULTS

The incidence of malaria varies from year to year and from health area to health area, as do meteorological factors in the study area. The distribution of long-lasting insecticide-treated nets, chemoprevention of seasonal malaria in children and access to rapid diagnostic tests for malaria were found to have a significant impact on the incidence of malaria in the population. Seasonal malaria chemoprevention was effective in reducing the incidence of malaria, while distribution of long-lasting insecticide-treated nets and access to rapid diagnostic tests increased with the number of malaria cases, reflecting efforts to distribute and use bed nets and to diagnose malaria cases among the population in the study area.

CONCLUSION

The study showed the impact of SMC on reducing malaria cases in the population and the significant efforts in LLIN distribution and malaria case diagnosis. To further reduce the burden of malaria, sustained efforts and new interventions are needed, including improving access to rapid diagnosis and treatment in communities by developing community health workers and locally tailored mass drug administration.

摘要

背景

自20世纪60年代和70年代在全球范围内根除疟疾失败以来,世界卫生组织及其合作伙伴采用了替代控制干预措施。这些干预措施的目的是重新设计控制干预措施,使其更有效、更高效。本研究的目的是评估在社区卫生区域层面实施的控制干预措施对人群的影响。

方法

分析使用了来自卫生信息系统的关于疟疾病例和干预措施(长效驱虫蚊帐(LLINs)的分发、季节性疟疾化学预防(SMC)、快速诊断测试(RDT)的可及性、孕妇间歇性预防治疗(IPTp))的数据,这些数据是2017年至2020年在卡蒂卫生区收集的。背景参数(温度、归一化植被指数(NDVI)和降雨量)通过遥感获得。使用广义相加模型评估疟疾控制干预措施作为气象因素的函数对疟疾病例的影响。

结果

疟疾病例的发病率因年份和卫生区域而异,研究区域的气象因素也是如此。发现长效驱虫蚊帐的分发、儿童季节性疟疾化学预防以及疟疾快速诊断测试的可及性对人群中的疟疾病例发病率有显著影响。季节性疟疾化学预防在降低疟疾病例发病率方面是有效的,而长效驱虫蚊帐的分发和快速诊断测试的可及性随着疟疾病例数量的增加而增加,这反映了在研究区域分发和使用蚊帐以及诊断疟疾病例的努力。

结论

该研究显示了季节性疟疾化学预防对减少人群中疟疾病例的影响以及在长效驱虫蚊帐分发和疟疾病例诊断方面的重大努力。为了进一步减轻疟疾负担,需要持续努力和新的干预措施,包括通过培养社区卫生工作者和制定因地制宜的大规模药物管理来改善社区快速诊断和治疗的可及性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9077/11687661/0260dcf20d35/pone.0289451.g001.jpg

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