Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot

Autor: Darlene Bhavnani, Bernardo García Espinosa, Madeline Baird, Nicholas Presley, Arnaud Le Menach, Christina Bradley, Marcela Outten, Oscar González
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Malaria Journal, Vol 21, Iss 1, Pp 1-11 (2022)
Druh dokumentu: article
ISSN: 1475-2875
DOI: 10.1186/s12936-022-04318-z
Popis: 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
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