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Chaparro P.,Instituto Nacional Of Salud | Soto E.,Organismo Andino de Salud Convenio Hipolito Unanue | Padilla J.,General de Salud Publica | Vargas D.,Organismo Andino de Salud Convenio Hipolito Unanue
Biomedica | Year: 2012

Introduction: The complete and effective collection of data of malaria cases is essential to formulate operative plans, as well as to develop and apply policies for its prevention and control. However, in Colombia, not all of the identified cases are notified nor incorporated into the surveillance system. This underreport represents a serious problem for decision makers. Objective: To estimate the type and quantity of errors made during the completion of the malaria individual case reporting form and its digitization level, through the use and monitoring of the reporting form in ten municipalities of Nariño in 2009. Materials and methods. A descriptive cross-sectional study with a non-probabilistic and convenience sample of diagnosis and treatment sites was carried out. Copies of the reporting forms from these sites and of the Public Health Surveillance System database were taken to compare them case-by-case. Proportions were calculated. Results: In more than 60% of the 2,816 reporting forms of positive cases the information about municipality of residence, municipality of origin and occupation was not reported. The case-by-case comparison revealed that 845 (30.0%) notification forms were not digitized at all. Information of variables such as residence, name of the municipality, and date of onset of symptoms were neither complete nor exact in more than 50% of the cases. Conclusions: The use of copies of the reporting forms allows knowing the underreporting due to lack of digitization. One third of the cases can be recovered.

Rosas-Aguirre A.,Organismo Andino de Salud Convenio Hipolito Unanue | Rosas-Aguirre A.,Cayetano Heredia Peruvian University | Gamboa D.,Cayetano Heredia Peruvian University | Rodriguez H.,Organismo Andino de Salud Convenio Hipolito Unanue | And 4 more authors.
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2010

Objectives. To assess the competency of microscopists for malaria diagnosis using standardized slide sets in the Peruvian Amazon. Material and methods. Cross-sectional study carried out in 122 first level health facilities of the Peruvian Amazon, between July and September 2007. Within the frame of the project "Control Malaria in the border areas of the Andean Region: A community approach" (PAMAFRO), we evaluated the malaria diagnosis performance in 68 microscopists without expertise (< 1 year of expertise) and 76 microscopists with expertise (> 1 year) using standardized sets of 20 blood smear slides according to the World Health Organization (WHO) recommendations. A correct diagnosis (correct species identification) was defined as "agreement", a microscopist was qualified as an "expert" if they have an agreement ≥90% (≥ 18 slides with correct diagnosis), as a "referent" with an agreement between 80% and <90%, "competent" if they are between 70 and <80% and "in training" if they have <70%. Results. Microscopists with expertise (68.6%) had more agreement than those without expertise (48.2%). The competency assessment was acceptable (competent, referent, or experts levels) in 11.8% of the microscopists without expertise and in 52.6% from those with expertise. The agreement was lower using blood smear slides with P. falciparum with low parasitaemia, with P. malariae and with mixed infections. Conclusions. Is the first assessment, we found only one of three microscopists from the Peruvian Amazon is competent fro malaria diagnosis according to the WHO standards. From this baseline data, we have to continue working in order to improve the competency assessment of the microscopists within the frame of a quality assurance system.

Grietens K.P.,Institute of Tropical Medicine | Muela Ribera J.,Partners for Applied Social science | Soto V.,Cayetano Heredia Peruvian University | Tenorio A.,Organismo Andino de Salud Convenio Hipolito Unanue | And 9 more authors.
PLoS ONE | Year: 2013

Background: While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. Methods: The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). Results: A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p<0.001). Conclusion: Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent, appropriate quantitative and qualitative methods for collecting information on net preference should be developed before any LLIN procurement decision is made. © 2013 Grietens et al.

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