Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot
Abstract Background Panama is one of eight countries in Mesoamerica that aims to eliminate malaria by 2022. Malaria is concentrated in indigenous and remote regions like Guna Yala, a politically autonomous region where access to health services is limited and cases are predominately detected through...
Published in: | Malaria Journal |
---|---|
Main Authors: | , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
BMC
2022
|
Subjects: | |
Online Access: | https://doi.org/10.1186/s12936-022-04318-z https://doaj.org/article/7830a835c1154387968edc59466af647 |
id |
ftdoajarticles:oai:doaj.org/article:7830a835c1154387968edc59466af647 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:7830a835c1154387968edc59466af647 2023-05-15T15:17:35+02:00 Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot Darlene Bhavnani Bernardo García Espinosa Madeline Baird Nicholas Presley Arnaud Le Menach Christina Bradley Marcela Outten Oscar González 2022-10-01T00:00:00Z https://doi.org/10.1186/s12936-022-04318-z https://doaj.org/article/7830a835c1154387968edc59466af647 EN eng BMC https://doi.org/10.1186/s12936-022-04318-z https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04318-z 1475-2875 https://doaj.org/article/7830a835c1154387968edc59466af647 Malaria Journal, Vol 21, Iss 1, Pp 1-11 (2022) Malaria Community health worker Rapid diagnostic test Surveillance Case management Plasmodium vivax Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2022 ftdoajarticles https://doi.org/10.1186/s12936-022-04318-z 2022-12-30T21:43:04Z Abstract Background Panama is one of eight countries in Mesoamerica that aims to eliminate malaria by 2022. Malaria is concentrated in indigenous and remote regions like Guna Yala, a politically autonomous region where access to health services is limited and cases are predominately detected through intermittent active surveillance. To improve routine access to care, a joint effort was made by Guna Yala authorities and the Ministry of Health to pilot a network of community health workers (CHWs) equipped with rapid diagnostic tests and treatment. The impact of this pilot is described. Methods Access to care was measured using the proportion of villages targeted by the effort with active CHWs. Epidemiological impact was evaluated through standard surveillance and case management measures. Tests for differences in proportions or rates were used to compare measures prior to (October 2014-September 2016) and during the pilot (October 2016-September 2018). Results An active CHW was placed in 39 (95%) of 41 target communities. During the pilot, CHWs detected 61% of all reported cases from the region. Test positivity in the population tested by CHWs (22%) was higher than in those tested through active surveillance, both before (3.8%) and during the pilot (2.9%). From the pre-pilot to the pilot period, annual blood examination rates decreased (9.8 per 100 vs. 8.0 per 100), test positivity increased (4.2% to 8.5%, Χ2 = 126.3, p < 0.001) and reported incidence increased (4.1 cases per 1000 to 6.9 cases per 1000 [Incidence Rate Ratio = 1.83, 95% CI 1.52, 2.21]). The percent of cases tested on the day of symptom onset increased from 8 to 27% and those treated on the day of their test increased from 26 to 84%. Conclusions The CHW network allowed for replacement of routine active surveillance with strong passive case detection leading to more targeted and timely testing and treatment. The higher test positivity among those tested by CHWs compared to active surveillance suggests that they detected cases in a high-risk ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 21 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Malaria Community health worker Rapid diagnostic test Surveillance Case management Plasmodium vivax Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Community health worker Rapid diagnostic test Surveillance Case management Plasmodium vivax Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Darlene Bhavnani Bernardo García Espinosa Madeline Baird Nicholas Presley Arnaud Le Menach Christina Bradley Marcela Outten Oscar González Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot |
topic_facet |
Malaria Community health worker Rapid diagnostic test Surveillance Case management Plasmodium vivax Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Panama is one of eight countries in Mesoamerica that aims to eliminate malaria by 2022. Malaria is concentrated in indigenous and remote regions like Guna Yala, a politically autonomous region where access to health services is limited and cases are predominately detected through intermittent active surveillance. To improve routine access to care, a joint effort was made by Guna Yala authorities and the Ministry of Health to pilot a network of community health workers (CHWs) equipped with rapid diagnostic tests and treatment. The impact of this pilot is described. Methods Access to care was measured using the proportion of villages targeted by the effort with active CHWs. Epidemiological impact was evaluated through standard surveillance and case management measures. Tests for differences in proportions or rates were used to compare measures prior to (October 2014-September 2016) and during the pilot (October 2016-September 2018). Results An active CHW was placed in 39 (95%) of 41 target communities. During the pilot, CHWs detected 61% of all reported cases from the region. Test positivity in the population tested by CHWs (22%) was higher than in those tested through active surveillance, both before (3.8%) and during the pilot (2.9%). From the pre-pilot to the pilot period, annual blood examination rates decreased (9.8 per 100 vs. 8.0 per 100), test positivity increased (4.2% to 8.5%, Χ2 = 126.3, p < 0.001) and reported incidence increased (4.1 cases per 1000 to 6.9 cases per 1000 [Incidence Rate Ratio = 1.83, 95% CI 1.52, 2.21]). The percent of cases tested on the day of symptom onset increased from 8 to 27% and those treated on the day of their test increased from 26 to 84%. Conclusions The CHW network allowed for replacement of routine active surveillance with strong passive case detection leading to more targeted and timely testing and treatment. The higher test positivity among those tested by CHWs compared to active surveillance suggests that they detected cases in a high-risk ... |
format |
Article in Journal/Newspaper |
author |
Darlene Bhavnani Bernardo García Espinosa Madeline Baird Nicholas Presley Arnaud Le Menach Christina Bradley Marcela Outten Oscar González |
author_facet |
Darlene Bhavnani Bernardo García Espinosa Madeline Baird Nicholas Presley Arnaud Le Menach Christina Bradley Marcela Outten Oscar González |
author_sort |
Darlene Bhavnani |
title |
Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot |
title_short |
Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot |
title_full |
Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot |
title_fullStr |
Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot |
title_full_unstemmed |
Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot |
title_sort |
malaria surveillance and case management in remote and indigenous communities of panama: results from a community-based health worker pilot |
publisher |
BMC |
publishDate |
2022 |
url |
https://doi.org/10.1186/s12936-022-04318-z https://doaj.org/article/7830a835c1154387968edc59466af647 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 21, Iss 1, Pp 1-11 (2022) |
op_relation |
https://doi.org/10.1186/s12936-022-04318-z https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04318-z 1475-2875 https://doaj.org/article/7830a835c1154387968edc59466af647 |
op_doi |
https://doi.org/10.1186/s12936-022-04318-z |
container_title |
Malaria Journal |
container_volume |
21 |
container_issue |
1 |
_version_ |
1766347818595778560 |