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Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia

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-u...

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Autores principales: Cox, Jonathan, Dy Soley, Lek, Bunkea, Tol, Sovannaroth, Siv, Soy Ty, Kheang, Ngak, Song, Bjorge, Steven, Ringwald, Pascal, Mellor, Steven, Sintasath, David, Meek, Sylvia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110522/
https://www.ncbi.nlm.nih.gov/pubmed/25052222
http://dx.doi.org/10.1186/1475-2875-13-282
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author Cox, Jonathan
Dy Soley, Lek
Bunkea, Tol
Sovannaroth, Siv
Soy Ty, Kheang
Ngak, Song
Bjorge, Steven
Ringwald, Pascal
Mellor, Steven
Sintasath, David
Meek, Sylvia
author_facet Cox, Jonathan
Dy Soley, Lek
Bunkea, Tol
Sovannaroth, Siv
Soy Ty, Kheang
Ngak, Song
Bjorge, Steven
Ringwald, Pascal
Mellor, Steven
Sintasath, David
Meek, Sylvia
author_sort Cox, Jonathan
collection PubMed
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.
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spelling pubmed-41105222014-07-26 Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia Cox, Jonathan Dy Soley, Lek Bunkea, Tol Sovannaroth, Siv Soy Ty, Kheang Ngak, Song Bjorge, Steven Ringwald, Pascal Mellor, Steven Sintasath, David Meek, Sylvia Malar J Research 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. BioMed Central 2014-07-22 /pmc/articles/PMC4110522/ /pubmed/25052222 http://dx.doi.org/10.1186/1475-2875-13-282 Text en Copyright © 2014 Cox et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Cox, Jonathan
Dy Soley, Lek
Bunkea, Tol
Sovannaroth, Siv
Soy Ty, Kheang
Ngak, Song
Bjorge, Steven
Ringwald, Pascal
Mellor, Steven
Sintasath, David
Meek, Sylvia
Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
title Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
title_full Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
title_fullStr Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
title_full_unstemmed Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
title_short Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia
title_sort evaluation of community-based systems for the surveillance of day three-positive plasmodium falciparum cases in western cambodia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110522/
https://www.ncbi.nlm.nih.gov/pubmed/25052222
http://dx.doi.org/10.1186/1475-2875-13-282
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