Nussbaum Lauren, Ortega Emma, Ríos López E Jennifer, Vizcarra Alfonso Simoné, Córdova López Jhonny J, Calarco Serafina, Marbán-Castro Elena, Tetteh Kevin, Shilton Sonjelle, Morrison Amy C, Fargnoli Vanessa, Paz-Soldán Valerie A
Department of Tropical Medicine and Infectious Disease, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Behavioral Sciences Research Unit, Asociación Benéfica PRISMA, Iquitos, Peru.
Malar J. 2025 Feb 1;24(1):32. doi: 10.1186/s12936-025-05273-1.
Malaria burden remains high in some Peruvian regions, especially in the Northeast Amazon rainforest state of Loreto and the tropical coastal state of Tumbes. Novel non-invasive diagnostic tools for malaria are being developed, and formative research in malaria-endemic areas with community members and health professionals who would potentially use these devices is vital for this process. This study aimed to examine the acceptability and feasibility of four new non-invasive malaria diagnostic tools in development in two regions of Peru with significant malaria burden.
The research team conducted focus group discussions and key informant interviews in Spanish to assess acceptability and ascertain questions and concerns regarding the non-invasive diagnostic tools. Focus group discussions included a range of community members (pregnant women, parents), professionals (health, education), and community leaders in Loreto. Vector control authorities and health professionals from Loreto, Tumbes, and Lima participated as key informants.
Participants were initially enthusiastic about all non-invasive diagnostic tools. However, as discussions proceeded, high enthusiasm remained for two devices that were easy to use, acceptable for the communities they were intended for, feasible to carry in remote areas, and did not require new supplies nor generate waste: the skin scan and the skin odour test. The breath and saliva tests were considered less hygienic. They were less acceptable to community members and health professionals due to concerns of disease transmission and other environmental and cultural concerns. Health professionals felt the finger scan test and the skin odour test would help triage community members in endemic sites and would be valuable in remote regions with difficult access to health facilities or laboratories.
Novel non-invasive malaria diagnostic tools can be valuable in malaria-endemic settings. As manufacturers evaluate the efficacy and effectiveness of these non-invasive diagnostic tools, international recommendations should be created to ensure their agile integration into national malaria programmes.
秘鲁的一些地区疟疾负担仍然很高，特别是在东北部的亚马逊雨林地区洛雷托省以及热带沿海地区通贝斯省。新型疟疾非侵入性诊断工具正在研发中，对于这一过程而言，在疟疾流行地区与可能使用这些设备的社区成员和卫生专业人员开展形成性研究至关重要。本研究旨在检验在秘鲁两个疟疾负担较重地区正在研发的四种新型疟疾非侵入性诊断工具的可接受性和可行性。
研究团队用西班牙语进行了焦点小组讨论和关键 informant 访谈，以评估可接受性，并确定关于非侵入性诊断工具的问题和担忧。焦点小组讨论包括洛雷托省的一系列社区成员（孕妇、家长）、专业人员（卫生、教育领域）以及社区领袖。来自洛雷托省、通贝斯省和利马的病媒控制当局人员和卫生专业人员作为关键 informant 参与其中。
参与者最初对所有非侵入性诊断工具都很感兴趣。然而，随着讨论的进行，对于两种易于使用、适合目标社区、便于在偏远地区携带且无需新耗材也不产生废物的设备，即皮肤扫描和皮肤气味测试，依然保持着高度热情。呼吸和唾液测试被认为卫生性较差。由于担心疾病传播以及其他环境和文化方面的问题，社区成员和卫生专业人员对它们的接受度较低。卫生专业人员认为手指扫描测试和皮肤气味测试有助于对流行地区的社区成员进行分流，并且在难以获得卫生设施或实验室服务的偏远地区会很有价值。
新型疟疾非侵入性诊断工具在疟疾流行地区可能很有价值。在制造商评估这些非侵入性诊断工具的有效性和效能时，应制定国际建议，以确保它们能灵活地融入国家疟疾防治计划。
