Some E S, Koech D K, Ochogo J O, Ocholla F, Mumbi F
Malaria Unit, Environmental Health Programme, African Medical and Research Foundation, Nairobi, Kenya.
East Afr Med J. 1997 Sep;74(9):573-5.
As less than twenty five per cent of persons suffering from malaria seek formal treatment in most of sub-Saharan Africa, Facility-based morbidity statistics are inadequate for monitoring malaria control programmes. This explorative study assessed whether a health centre equipped with a microscope and trained personnel could monitor malaria transmission within its catchment area. The study was conducted at Chemase Health Centre in Nandi District in Kenya, an area holoendemic for malaria with Anopheles gambiae as the main vector and Plasmodium falciparum as the commonest cause of malaria. From first August to 31 October 1991, first seven children under five years of age on each working day accompanied by their mothers to the maternal and child health clinic were studied. A general examination was performed by a Registered Clinical Officer (Medical Assistant) and thin and thick blood smears made, stained with Giemsa stain and examined for malaria parasites by a Medical Laboratory Technologist. Mothers were interviewed by enrolled community nurses on antimalarial measures they were using in their homes. Four hundred and fifty five children mostly under five years of age, consisting of 48.1% males and 51.9% females, were studied. Malaria parasites were present in 209 (45.9%) blood smears of the children. The percentage of blood smears positive for malaria parasites was high in children below 36 months of age. There was a tendency for low percentage of blood smears positive for malaria in children whose mothers reported using mosquito nets or insecticide sprays. The study did not interrupt the routine of the health centre. Periodic monitoring of new malaria illnesses. and percentage of blood smears positive for malaria parasites in children aged 0 to 35 months should be introduced into health centre practice in Kenya. This catchment area approach could be used to monitor malaria control programmes as well as predicting malaria epidemics.
在撒哈拉以南非洲的大部分地区，不到25%的疟疾患者会寻求正规治疗，因此基于医疗机构的发病率统计数据不足以监测疟疾控制项目。这项探索性研究评估了配备显微镜和经过培训人员的健康中心是否能够监测其服务范围内的疟疾传播情况。该研究在肯尼亚南迪区的Chemase健康中心开展，该地区疟疾高度流行，冈比亚按蚊是主要传播媒介，恶性疟原虫是疟疾最常见的病因。1991年8月1日至10月31日，对每个工作日随母亲前往母婴健康诊所的前七名五岁以下儿童进行了研究。由注册临床干事（医疗助理）进行全面检查，并制作厚薄血涂片，用吉姆萨染色，由医学实验室技术人员检查疟原虫。社区护士对母亲进行访谈，了解她们在家中采取的抗疟措施。共研究了455名主要为五岁以下的儿童，其中男性占48.1%，女性占51.9%。209名（45.9%）儿童的血涂片中发现疟原虫。36个月以下儿童血涂片疟原虫阳性率较高。母亲报告使用蚊帐或杀虫剂喷雾的儿童，其血涂片疟原虫阳性率有降低的趋势。该研究未干扰健康中心的日常工作。肯尼亚的健康中心应将定期监测新的疟疾病例以及0至35个月儿童血涂片疟原虫阳性率纳入日常工作。这种服务范围方法可用于监测疟疾控制项目以及预测疟疾流行情况。
