Monitoring and evaluation of intervals from onset of fever to diagnosis before "1-3-7" approach in malaria elimination: a retrospective study in Shanxi Province, China from 2013 to 2018

BACKGROUND

China's 1-3-7 approach was extensively implemented to monitor the timeframe of case reporting, case investigation and foci response in the malaria elimination. However, activities before diagnosis and reporting (before '1') would counteract the efficiency of 1-3-7 approach but few data have evaluated this issue. This study aims to evaluate the timelines between onset of fever and diagnosis at healthcare facilities in Shanxi Province.

METHODS

Routine data were extracted from IDIRMS and NMISM database from 2013 to 2018. Time intervals between onset of fever and healthcare-seeking and between healthcare-seeking and diagnosis were calculated. Each of the documented malaria cases was geo-coded and paired to the county-level layers of polygon.

RESULTS

A total of 90 cases were reported in 2013-2018 in Shanxi Province, and 73% of cases reported at provincial health facilities. All malaria cases were imported from Africa (90%) and Southeast Asia (10%) especially around the Chinese Spring Festival (n = 46, 51%). The median days between fever and healthcare-seeking and between healthcare-seeking and diagnosis of malaria were 3 and 2, respectively.

CONCLUSIONS

The current "1-3-7" approach is well executed in Shanxi Province, but delays intervals observed in case finding before 1-3-7 approach occurred in all levels of facilities in Shanxi Province, which imply that more efforts are highlighted for timely case finding. Health education should be provided for improving awareness of healthcare-seeking, and various technical training aiming at the physicians should be carried out to improve diagnosis of malaria.

[Cases diagnosis of imported malaria in Jiangsu province, 2014-2016]

Objective: To understand the situation related to health seeking and diagnosis of imported malaria and to provide practical measures for malaria elimination in Jiangsu province. Methods: Data on imported malaria cases in Jiangsu province was retrieved in CISDCP from 2014 to 2016. Relevant information on health seeking behavior, diagnosis and treatment of the disease was gathered. Results: A total of 1 068 imported cases were reported in Jiangsu province from 2014 to 2016. Except for one malaria case that was caused by blood transfusion, the rest patients were all recognized as 'imported'. Majority of the cases were migrant laborers working in African countries. The accurate rates on the diagnosis of ovale, vivax and quartan malaria and mixed infection were relatively low, as 79.3% (107/135), 29.5% (18/61), 52.9% (18/34) and 0.0% (0/2) at the primary health care settings, respectively. Rate of seeking health care on the same day of onset was more in 2015 than in 2014 and 2016 (χ(2)=18.6, P=0.001). While only 65.4% (699/1 068) of the patients were diagnosed correctly at the primary health care settings. There appeared no statistical difference in the 3-year-study period (χ(2)=5.4, P=0.246). Capacity on 'correct diagnosis' seemed stronger at the CDC than at the hospital levels (χ(2)=13.2, P=0.000; χ(2)=5.4, P=0.020). Totally, 72.7% (32/44) of the severe falciparum malaria cases did not immediately seek for health care when the symptoms started. Conclusions: Migrant workers returning from the high endemic malaria areas seemed to have poor awareness in seeking health care services. Capability on correct diagnosis for malaria at the primary health care settings remained unsatisfactory and staff from these settings needs to receive adequate training.

Estimating the proportion of clinically diagnosed infectious and non-infectious animal diseases in Ganta Afeshum woreda, Eastern Tigray zone, Ethiopia

OBJECTIVE

This study was performed with the objective of identifying the proportion of emerging and endemic livestock diseases using cross sectional survey.

RESULT

A total of 285 clinically diseased animals were presented to a veterinary clinic and diagnosed tentatively based on history, clinical sign, and simple laboratory diagnostics and from the study, actinomycosis (15.83%), mastitis (15%), tick infestation (10%), respiratory diseases (9.16%) and gastro intestinal parasitism (9.16%) were confirmed with higher proportion in large animals. Pasteurollosis (38, 31%), contagious ecthyma (12, 10%), tick infestation (9, 0%), mite infestation (9, 10%), sheep and goat pox (9, 10%), and gastrointestinal parasitism (9, 17%) were frequently encountered diseases in sheep and goat respectively. In equids, back sore, epizootic lymphangitis and lameness accounted a proportion of 22.95, 21.31, and 13.11% respectively. In conclusion, result of the present study showed that the proportion of livestock disease is high, and it affects the socioeconomic status of the local community in the study area as a result of mortality and production loss.