scholarly journals Malaria Rapid Diagnostic Test (HRP2/pLDH) Positivity, Incidence, Care Accessibility and Impact of Community WASH Action in DR Congo: Mixed Method Study involving 625 Households

2020 ◽  
Author(s):  
Nlandu Roger Ngatu ◽  
Basilua Andre Muzembo ◽  
Sakiko Kanbara ◽  
Roger Wumba ◽  
Mitsunori Ikeda ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Mixed Method ◽  
Malaria Incidence ◽  
Control Site ◽  
Post Intervention ◽  
Stagnant Water ◽  
Household Level ◽  
Malaria Burden ◽  
Study Sites

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub Saharan Africa (SSA). Despite recent gains made towards its control or elimination in past decades, many African countries still have endemic malaria transmission. Thus, the search for disease control strategies is indispensable. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory water, sanitation and hygiene (WASH) action.Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (WASH action site) and Kasangulu (WASH control site) between July 2017 to March 2018, involving 625 households (3,712 individuals). Baseline and post-intervention malaria surveys were conducted in 2017 and 2018, respectively, using the World Bank/WHO Malaria Indicator Questionnaire. In addition, an action research consisting of a six-month (September 2017 - February 2018) prospective study was carried out which comprised two interventions: (1) a community participatory WASH action aiming at eliminating mosquito breeding sites in the residential environment and a (2) community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention rapid diagnostic test (RDT) for malaria was performed among respondents. Furthermore, a six-month prospective hospital-based epidemiological study was simultaneously conducted using records of patients admitted at health settings located at both study sites.Results Prevalence of positive malaria RDT among respondents decreased significantly at WASH-action site (38% vs. 20%; p < 0.05), but no significant change was observed at the WASH control site. There were 96% of respondents (heads of households) who reported at least one malaria event occurring in the previous six-month period, only 66.5% of them received malaria care at a health setting. At household level, long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%), followed by mosquito repellent (15%), indoor residual spraying (IRS) (2%), LLIN-IRS combination (2%); however, 24% of households did not use any measures. Mean household malaria incidence decreased at the WASH action site; 2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases (p < 0.05), whereas no significant change was noted in control site. Moreover, malaria incidence rate was highest (60.9%) among households living in proximity to grassy and/or stagnant water spots. Low household monthly income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), Proximity to high risk area (grassy/stagnant water spots) for malaria (ORa = 5.13; 95%CI: 2-29-8.07; p < 0.001), poor general WASH status in residential area (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were determinants of household malaria. Furthermore, data collected from referral health settings showed high malaria frequency, 67.4% (1,108/1,645) occurring during the first semester of 2017, including 772 (70%) of pediatric malaria cases and 336 (30%) of cases from Internal medicine departments.Conclusion Findings from this research suggest the necessity for DRC government to scale up the fight against malaria by integrating efficient indoor and outdoor preventive measures, including WASH intervention in residential environment, and improve malaria care accessibility to reduce malaria burden. This would be a step towards achieving universal health coverage (UHC) in the Congo.

scholarly journals Malaria rapid diagnostic test (HRP2/pLDH) positivity, incidence, care accessibility and impact of community WASH Action programme in DR Congo: mixed method study involving 625 households

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nlandu Roger Ngatu ◽  
Basilua Andre Muzembo ◽  
Nattadech Choomplang ◽  
Sakiko Kanbara ◽  
Roger Wumba ◽  
...  
Keyword(s):  
Action Research ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Mixed Method ◽  
Malaria Incidence ◽  
Control Site ◽  
Malaria Rapid Diagnostic Test ◽  
Post Intervention ◽  
Referral Hospitals ◽  
Action Programme

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. Results Long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2–29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were predictors of household malaria. Conclusion This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.

scholarly journals Malaria Rapid Diagnostic Test (HRP2/pLDH) Positivity, Incidence, Care Accessibility and Impact of Community WASH Action in DR Congo: Mixed Method Study involving 625 Households

2021 ◽  
Author(s):  
Nlandu Roger Ngatu ◽  
Basilua Andre Muzembo ◽  
Sakiko Kanbara ◽  
Roger Wumba ◽  
Mitsunori Ikeda ◽  
...  
Keyword(s):  
Mixed Method ◽  
Preventive Measures ◽  
Malaria Incidence ◽  
Indoor Residual Spraying ◽  
Control Site ◽  
Malaria Rapid Diagnostic Test ◽  
Post Intervention ◽  
Household Level ◽  
Malaria Burden ◽  
Referral Hospitals

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub Saharan Africa. Despite recent gains made towards its control or elimination in past decades, many African countries still have endemic malaria transmission. Thus, the search for disease control strategies is indispensable. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory water, sanitation and hygiene (WASH) action. Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (WASH action site) and Kasangulu (WASH control site) between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys focusing on malaria episodes and preventive measures in previous six-month period using the World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both the WASH action and Control sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among respondents. Furthermore, a six-month hospital-based epidemiological study was conducted from 1 January through June 2017. Medical records of patients admitted at selected referral hospitals (one hospital per study site) were used to determine malaria trend in the sites. Results Long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%), followed by mosquito repellent (15%), indoor residual spraying (2%), LLIN and indoor residual spraying combination (2%); however, 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) have reported at least one malaria episode occurring in the previous six-month period (January-June 2017); of them only 66.5% of them received malaria care at a health setting. In the Action Research, at household level, mean number of self-reported incident malaria cases decreased at WASH action site (2.3±2.2 cases vs. 1.2±0.7 cases, respectively; p<0.05), whereas it remained unchanged at the Control site. Similarly, RDT results showed that the prevalence rate of positive RDT among the respondents decreased significantly at WASH-action site (38% in pre-test vs. 20% in post-test; p<0.05), whereas no significant change was observed at the Control site. Data collected from referral hospitals showed high malaria incidence rate, 67.4%, as compared to other diseases (70% of pediatric malaria cases and 30% of cases from Internal medicine departments). Low household monthly income (ORa=2.37; 95%CI: 1.05-3.12; p<0.05), proximity to high risk area (grassy/stagnant water spots) for malaria (ORa=5.13; 95%CI: 2-29-8.07; p<0.001), poor general WASH status in residential area (ORa=4.10; 95%CI: 2.11-7.08; p<0.001) were predictors of household malaria. Conclusion This research showed high prevalence of positive malaria RDT among study participants, which was significantly reduced by a 6-month WASH intervention. Additionally, hospital-based epidemiological data showed high malaria incidence. The findings suggest the necessity for DRC government to scale up the fight against malaria by integrating efficient indoor and outdoor preventive measures, including WASH intervention in residential environment, and improve malaria care accessibility to reduce malaria burden in Congolese population. This would be a step towards achieving universal health coverage in the Congo.

scholarly journals Malaria Surveillance in the Anak Dalam Tribe, Jambi, Indonesia

2021 ◽  
Vol 12 (2) ◽  
pp. 104-116
Author(s):  
Ade Suryaman ◽  
Chairil Anwar ◽  
Dwi Handayani ◽  
Irsan Saleh ◽  
Dalillah Dalillah ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Malaria Incidence ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Patient Identification ◽  
Chain Reaction ◽  
Nested Polymerase Chain Reaction ◽  
Polymerase Chain

Transmission of malaria is common in countries with tropical and subtropical. In several cases, malaria presents in the sufferer especially in individuals that have never received treatment shortly. As the early phase of patient identification, screening is important as an effort to eradicate malaria, in addition to the gold standard which currently used, other diagnostic tools are needed to conduct a malaria incidence survey to obtain comparative data using 3 diagnostic tools, goal standard checks, which are currently unable to detect asymptomatic malaria. This study aims to compare three standard diagnostic test (Rapid Diagnostic Test, Giemsa, and Nested Polymerase Chain Reaction) for the measurement of malaria prevalence within the Anak Dalam Tribe community in Jambi, Indonesia. This descriptive research with a survey design was conducted on 99 persons in Anak Dalam Tribe. It was discovered that majority of the respondents were the adult age category (52.5%),were female (50.5%). The prevalence of this infectious disease as detected by Rapid Diagnostic Test, microscopy, and Nested Polymeras Chain Reaction examination were 3%, 5% and 35.3% respectively. Non-Plasmodium falciparum was detected by examining samples with Rapid Diagnostic Test, on microscope, P. vivax and P. falciparum were found, while on Nested Polymerase Chain Reaction, two bands at 120bp and 205bp showed P. vivax and P. falciparum respectively. Nested Polymeras Chain Reaction is more sensitive to detected asymptomatic malaria, however, Rapid Diagnostic Test and Giemsa sensitive with parasitemia threshold.

scholarly journals Analisis Risiko Karakteristik, Sosial Ekonomi, Perilaku dan Kondisi Lingkungan Rumah terhadap Kejadian Malaria

2014 ◽  
Vol 9 (2) ◽  
pp. 150
Author(s):  
Susy Sriwahyuni Sukiswo ◽  
Rinidar Rinidar ◽  
Sugito Sugito
Keyword(s):  
Logistic Regression ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Home Environment ◽  
Malaria Incidence ◽  
Bivariate Analysis ◽  
Control Group ◽  
Chi Square ◽  
Purposive Sampling ◽  
Control Approach

Malaria merupakan penyakit menular yang menjadi perhatian global. Kecamatan Arongan Lambalek merupakan daerah rawan malaria di Kabupaten Aceh Barat dengan kategori Medium Incidence Area dengan nilai Annual Parasite Incidence (API) 3,67 per 1000 penduduk masih di atas target API Nasional pada fase eliminasi API kurang dari 1 per 1000 penduduk tahun 2013. Penelitian ini bertujuan menganalisis karakteristik, sosial ekonomi, perilaku, dan kondisi lingkungan rumah yang berpengaruh terhadap kejadian malaria di Kecamatan Arongan Lambalek, Kabupaten Aceh Barat. Jenis penelitian ini adalah observasional analitik dengan pendekatan kasus kontrol dengan metode penarikan sampel yaitu purposive sampling. Jumlah sampel dalam penelitian ini terdiri 33 kasus dan 33 kontrol, kelompok kasus adalah orang yang dinyatakan positif malaria sedangkan kelompok kontrol orang yang dinyatakan negatif berdasarkan pemeriksaan mikroskopis/rapid diagnostic test tahun 2014. Analisis statistik yang digunakan analisis univariat, bivariat (kai kuadrat), dan multivariat (regresi logistik). Hasil analisis bivariat diketahui ada lima variabel yang berpengaruh, yaitu pekerjaan (p = 0,000, OR = 0,05), pengetahuan (p = 0,000; OR = 17,5), sikap (p = 0,001; OR = 7,43), tindakan (p = 0,000; OR = 9,8), dan lingkungan (p = 0,000; OR = 9,0). Berdasarkan hasil analisis multivariat, pengetahuan adalah determinan yang paling berpengaruh (p = 0,006; OR = 12,783, CI 95% = 2,045–79,893). Penyuluhan yang intensif mengenai malaria perlu dilakukan untuk lebih menambah pengetahuan dan informasi masyarakat. The Risk Analysis of Characteristic, Socioeconomics, Behavioral, and Home Environment Conditions toward Malaria IncidenceMalaria is an infectious disease of global concern. The Subdistrict of Arongan Lambalek in West Aceh which belongs to the Medium Incidence Area category was a malaria endemic area with Annual Parasite Incidence (API) 3,67 at 1000 population in 2013. The API was higher than national API on elimination phage less than 1 at 1000 population. The objective of this research was to analyze the characteristic, socioeconomic, behavioral, home environment conditions to determine of malaria incidence in Arongan Lambalek Subdistrict, of West Aceh District. This research was analytic observational case control approach with purposive sampling method. The number of samples in this study comprised 33 cases and 33 controls, the cases are people who tested positive for malaria, while the control group of people who tested negative by examination microscopic/rapid diagnostic test in 2014. The statistical analysis used univariate, bivariate (chi-square), and multivariate (logistic regression). The results of the bivariate analysis are five variables known to affect malaria, they are job (p = 0.000, OR = 0.05), knowledge (p = 0.000; OR = 17.5), attitude (p = 0.001; OR = 7.43 ), action (p = 0.000; OR = 9.8), and the environment (p = 0.000; OR = 9.0). Based on the results of the multivariate analysis (logistic regression) knowledge is the most dominan determinan (p = 0.006; OR = 12.783, 95% CI = 2.045 to 79.893). Intensive counseling regarding malaria is needed, to make people know more knowledge and information about malaria.

scholarly journals 69. Implementation of a Pharmacist-Driven Blood Culture Communication Process in a Non-Profit Community Hospital

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S152-S152
Author(s):  
Alexis Thumann ◽  
Jennifer Williams ◽  
Megan Bernabe ◽  
Jillien Hankewich
Keyword(s):  
Blood Culture ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Antimicrobial Therapy ◽  
Hospital Length ◽  
Communication Process ◽  
Hospital Length Of Stay ◽  
Test Results ◽  
Post Intervention ◽  
Community Based

Abstract Background Rapid diagnostic testing allows for faster identification of culture results and quicker time to targeted antimicrobial therapy. For this to be effective, however, the clinician needs to understand its capabilities and limitations. Pharmacists are well-positioned to assist providers in interpreting rapid diagnostic test results and in the selection of optimal antimicrobial therapy. This study aims to determine if implementing a process in which pharmacists communicate positive blood culture and rapid diagnostic test results improves time to optimal antimicrobial therapy in a community-based hospital. Methods In November 2020, Mercy Medical Center implemented a new process in which positive blood culture and rapid diagnostic test results are communicated to a pharmacist instead of a nurse on the patient care unit. The pharmacist is responsible for interpreting the results, assessing patient information, and providing the culture results along with drug therapy recommendations to the appropriate licensed independent practitioner. This study was a single-center, pre-post, quasi-experimental study (Pre: November 2019-March 2020; Post: November 2020-March 2021). The electronic medical record was used to identify admitted patients 18 years and older with positive blood cultures in which treatment was provided. Time from culture positivity to optimal antimicrobial therapy was collected and compared pre-post intervention. Secondary outcomes included hospital length of stay and mortality. Results A total of 480 patients were identified during the study period, of which 247 met inclusion criteria (n = 125 in 2019-2020; n = 122 in 2020-2021) with comparable baseline characteristics. There was no statistical difference in time to appropriate therapy between the groups (p = 0.796). Time to optimal therapy was 6.12 hours shorter in the post-intervention cohort (p = 0.0492). No difference was found for both secondary outcomes of hospital length of stay and inpatient mortality (p = 0.2958, p = 0.096, respectively). Conclusion A pharmacist-led blood culture communication process improved the care of hospitalized patients in a non-academic, community-based hospital by shortening time to optimal antimicrobial therapy. Disclosures All Authors: No reported disclosures

scholarly journals Mass Screening and Treatment on the Basis of Results of a Plasmodium falciparum-Specific Rapid Diagnostic Test Did Not Reduce Malaria Incidence in Zanzibar

2014 ◽  
Vol 211 (9) ◽  
pp. 1476-1483 ◽  
Author(s):  
Jackie Cook ◽  
Weiping Xu ◽  
Mwinyi Msellem ◽  
Marlotte Vonk ◽  
Beatrice Bergström ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Mass Screening ◽  
Malaria Incidence
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