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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
Malaria Journal, Volume 13, No. 1, Article 282, Year 2014
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Description
Background: Delayed clearance of Plasmodium falciparum parasites is used as an operational indicator of potential artemisinin resistance. Effective community-based systems to detect P. falciparum cases remaining positive 72 hours after initiating treatment would be valuable for guiding case follow-up in areas of known resistance risk and for detecting areas of emerging resistance. Methods. Systems incorporating existing networks of village malaria workers (VMWs) to monitor day three-positive P. falciparum cases were piloted in three provinces in western Cambodia. Quantitative and qualitative data were used to evaluate the wider feasibility and sustainability of community-based surveillance of day three-positive P. falciparum cases. Results: Of 294 day-3 blood slides obtained across all sites (from 297 day-0 positives), 63 were positive for P. falciparum, an overall day-3 positivity rate of 21%. There were significant variations in the systems implemented by different partners. Full engagement of VMWs and health centre staff is critical. VMWs are responsible for a range of individual tasks including preparing blood slides on day-0, completing forms, administering directly observed therapy (DOT) on days 0-2, obtaining follow-up slides on day-3 and transporting slides and paperwork to their supervising health centre. When suitably motivated, unsalaried VMWs are willing and able to produce good quality blood smears and achieve very high rates of DOT and day-3 follow-up. Conclusions: Community-based surveillance of day-3 P. falciparum cases is feasible, but highly intensive, and as such needs strong and continuous support, particularly supervision and training. The purpose and role of community-based day-3 surveillance should be assessed in the light of resource requirements; scaling-up would need to be systematic and targeted, based on clearly defined epidemiological criteria. To be truly comprehensive, the system would need to be extended beyond VMWs to other public and private health providers. © 2014 Cox et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Cox, Jonathan St H.
United Kingdom, London
London School of Hygiene & Tropical Medicine
United Kingdom, London
Malaria Consortium
Sovannaroth, Siv
Cambodia, Phnom Penh
National Centre for Parasitology, Entomology and Malaria Control
Ringwald, Pascal
Switzerland, Geneva
Organisation Mondiale de la Santé
Sintasath, David M.
Unknown Affiliation
Meek, Sylvia R.
United Kingdom, London
Malaria Consortium
Statistics
Citations: 13
Authors: 5
Affiliations: 7
Identifiers
Doi:
10.1186/1475-2875-13-282
ISSN:
14752875
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Approach
Qualitative
Quantitative