Dataset Information

Improved access to early diagnosis and complete treatment of malaria in Odisha, India.

ABSTRACT:

Background

In 2013, the Comprehensive Case Management Programme (CCMP) was initiated to assess the impact of universal access to diagnosis and treatment and improved surveillance on malaria transmission in different settings in Odisha state, India.

Methods

Pairs of intervention and control sub-districts (blocks), matched on malaria incidence were selected in four districts with different transmission intensities. CCMP activities included training and supervision, ensuring no stock-outs of malaria tests and drugs, analysing verified surveillance data, stratifying areas based on risk factors, and appointing alternative providers to underserved areas. Composite risk scores were calculated for each sub-centre using principal component analysis. Post-pre changes (2013-2015 versus 2011-2012) for annual blood examination rates (ABER) and annual parasite incidence (API) across intervention and control groups were assessed using difference-in-difference (DID) estimates, adjusted for malaria transmission risk.

Results

In the intervention sub-centres, the mean increase in ABER was 6.41 tests/sub-centre (95%CI 4.69, 8.14; p<0.01) and in API was 9.2 cases diagnosed/sub-centre (95%CI 5.18, 13.21; p<0.01). The control sub-centres reported lower increases in ABER (2.84 [95%CI 0.35, 5.34]; p<0.05) and API (3.68 [95%CI 0.45, 6.90]; p<0.05). The control-adjusted post-pre changes in API showed that 5.52 more cases (95%CI 0.34, 10.70; p<0.05) were diagnosed, and a 3.6 more cases (95%CI 0.58, 6.56; p<0.05) were tested per sub-centre in the intervention versus control areas. Larger differences in post-pre changes in API between intervention and control sub-centres were registered in the higher transmission-risk areas compared with the lower risk areas. All the changes were statistically significant.

Conclusions

Intensive intervention activities targeted at improved access to malaria diagnosis and treatment produced a substantial increase in blood examination and case notification, especially in inaccessible, hard-to-reach pockets. CCMP provides insights into how to achieve universal coverage of malaria services through a routine, state-run programme.

SUBMITTER: Pradhan S

PROVIDER: S-EPMC6314604 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Improved access to early diagnosis and complete treatment of malaria in Odisha, India.

Pradhan Sreya S Pradhan Madan Mohan MM Dutta Ambarish A Shah Naman K NK Joshi Pyare Lal PL Pradhan Khageshwar K Sharma S K SK Grewal Daumerie Penny P Banerji Jaya J Duparc Stephan S Mendis Kamini K Murugasampillay Shiva S Valecha Neena N Anvikar Anupkumar R AR

PloS one 20190102 1

<h4>Background</h4>In 2013, the Comprehensive Case Management Programme (CCMP) was initiated to assess the impact of universal access to diagnosis and treatment and improved surveillance on malaria transmission in different settings in Odisha state, India.<h4>Methods</h4>Pairs of intervention and control sub-districts (blocks), matched on malaria incidence were selected in four districts with different transmission intensities. CCMP activities included training and supervision, ensuring no stock ...[more]

PMID: 30601833

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Dataset Information

Improved access to early diagnosis and complete treatment of malaria in Odisha, India.

Background

Methods

Results

Conclusions

Publications

Improved access to early diagnosis and complete treatment of malaria in Odisha, India.

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