CONCLUDE
1. Epidemiological characteristics of malaria in Huong Hoa district in 5 years from 2005-2009, in 2010 and factors related to malaria in 4 border communes
1.1. Epidemiological characteristics of malaria in Huong Hoa district in 5 years from 2005-2009
The average rate of malaria patients is 19.9‰ of the population, with a decreasing trend from 22.7‰ to 13.6‰. There were 3 deaths due to Plasmodium falciparum malaria parasite. The rate of people with (+) parasites is 14.5‰ of the population, with a fluctuating trend from 10.2‰; 18.8‰; to 14.7‰. P.falcifarum rate is 91.6%.
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In 4 border communes: Thuan, Xy, Thanh and A xing communes, the average malaria rate is 66.1‰; of which, malaria patients returning from Laos account for 22.4-47.8%; malaria patients under 5 years old account for 14.8-18.2%.
1.2. Epidemiological characteristics of malaria and factors related to malaria incidence in 2010
The current malaria prevalence is 2.6%; the malaria parasite prevalence is 2.2%. Malaria patients with parasites account for 76.6%, including P.falciparum 46.9%; P.vivax 46.9%; mixed 6.2%. Malaria vectors include 18 species of Anophelles ( An.minimus and An.dirus ); density is 5.0 individuals/light/night.
The rate of people with correct knowledge is 69.0%; with correct attitude is 51%, and has practice.
correct 50%; People have mosquito nets 57.1%;
Malaria is associated with the following factors: Going to the forest and sleeping in the fields, not sleeping under a mosquito net, going to Laos, living near the forest, rainy season, p<0.05.
People sleeping under mosquito nets have 4.7% malaria; people not sleeping under mosquito nets have 28.5% malaria;
The rate of people going to the forest and sleeping in the fields is 4.5% with malaria; people not going to the forest or sleeping in the fields have malaria 2.3%; people who go to Laos to sleep have malaria 5.6%; people who do not go to Laos have malaria 4.3%. People living near the forest have malaria at a rate of 3.7%, people living far from the forest have malaria at a rate of 2.1%.
2. Evaluation of the effectiveness of malaria prevention intervention model in households in border areas
After 2 years of intervention at the household level: People proactively carried out malaria prevention activities: Early detection of the disease; early reporting; blood smear testing at home; sleeping under mosquito nets when going to the fields and staying in Laos; participating in counseling and educational communication sessions.
Health education at home. Results:
Malaria incidence in the intervention group decreased from 2.2% to 0.7%; compared to the control group, from 3.1% to 1.8%; Intervention effectiveness was 26.3% (p<0.05).
The rate of patients with malaria parasites in the intervention group decreased from 1.7% to 0.5%; compared to the control group from 2.4% to 1.4%; The intervention effectiveness was 28.9%.
The rate of detection and treatment of malaria patients at households in the intervention group increased by 25%, compared to 0% in the control group.
Detection and treatment of malaria patients due to border exchanges: Intervention group: Malaria incidence decreased from 7.8% to 2.6%. Compared with the control group, the intervention effectiveness was 56.5%; p<0.05.
Increase the rate of people practicing correct malaria prevention in the intervention group. Of which, 81.5% of households have mosquito nets; 91.7% of households do not have stagnant water; 74.4% of households move livestock pens away from the house; 75% of households do not have bushes around the house; 90% of households move the stove outside the house; Compared with the control group: The intervention effectiveness is 30.2%.
Discovery of a new malaria parasite species, Plasmodium knowlesi , the fifth malaria parasite species in the world, transmitted from monkeys to humans in the border area of Quang Tri province.
Malaria vectors: Before intervention, there were 18 Anophelles species, An
5.0 individuals/light/night in general. After intervention, there were 10 species left, density 0.81 individuals/light/night.
Coordinate malaria prevention in border areas . In the intervention group: Management, detection, and early treatment of Vietnamese people crossing the border and contracting malaria: 13.8% of malaria patients in the 2 communes. Treatment of Laotian malaria patients/number of Laotians crossing the 2 communes: 20.2%. Spraying chemicals in 10/10 villages bordering Laos.
PROPOSAL
1. The model of malaria prevention at the household level is effective, feasible and can be replicated in other malaria-endemic areas with similar ecological characteristics at the border. It is necessary to organize management and supervision of the activities of the commune health network, and the YTTB to test and treat cases of positive malaria parasites that reach the household.
2. Continue to investigate the prevalence and pathogenic role of Plasmodium knowlesi in Quang Tri province.
3. Continue molecular biological and epidemiological studies of malaria in Quang Tri province to find more factors related to malaria, especially since malaria is specific to remote, mountainous areas on the border.