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Int Health. 2015 Sep;7(5):317-23. doi: 10.1093/inthealth/ihv046. Epub 2015 Jul 22.

Challenges to malaria surveillance following elimination of indigenous transmission: findings from a hospital-based study in rural Sri Lanka.

Author information

1
Department of Parasitology, Faculty of Medicine, University of Colombo, 25 Kynsey Road, Colombo 08, Sri Lanka ferndeep@gmail.com.
2
Department of Public Health, University of Oxford, Oxford, UK.
3
Anti Malaria Campaign, Colombo, Sri Lanka.
4
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.
5
Regional Malaria Office, Anuradhapura, Sri Lanka.

Abstract

INTRODUCTION:

Sri Lanka has eliminated local transmission of malaria. Assessing physician preparedness for early case detection is important, in order to prevent re-establishment of local transmission.

METHODS:

Adherence to malaria screening practices in patients admitted with fever to 12 hospitals in a previously malaria endemic district was evaluated using a cross sectional survey. In addition, knowledge and attitudes among doctors on current malaria surveillance practices and treatment recommendations was assessed.

RESULTS:

Of 403 fever patients, 150 warranted screening for malaria under the criteria defined by the Anti Malaria Campaign (AMC), with 93 of them having fever for over 7 days. Of these eligible patients, 12.6% (19/150) were investigated by doctors (including 3 persons with fever over 7 days), 14.6% (22/150) by laboratory staff and 72.6% (109/150) by the research team. The majority of doctors were not familiar with the treatment guidelines for malaria (76.5%, 75/98).

CONCLUSIONS:

Mandatory continuous medical education programmes need to continue to ensure that malaria remains on the differential diagnosis of a fever patient, especially in patients with fever over 7 days. It is essential to publicize the availability of free-of-charge malaria diagnostic facilities, and to ensure that proper notification procedures are followed when a malaria patient is diagnosed.

KEYWORDS:

Malaria; Sri Lanka; Transmission

PMID:
26204895
DOI:
10.1093/inthealth/ihv046
[Indexed for MEDLINE]

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