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Title: The importance of an active case detection (Acd) programme for malaria among migrants from malaria endemic countries: The greek experience in a receptive and vulnerable area
Authors: Tseroni, Maria 
Georgitsou, Maria 
Baka, Agoritsa 
Pinaka, Ourania 
Pervanidou, Danai 
Tsironi, Maria 
Bleta, Panagiota 
Charvalakou, Maria 
Psinaki, Ioanna 
Dionysopoulou, Martha 
Legaki, Antonia 
Vakali, Annita 
Patsoula, Elina 
Vassalou, Evdokia 
Bellou, Spyridoula 
Diamantopoulos, Vasilis 
Georgakopoulou, Theano 
Mouchtouri, Varvara 
Tsiodras, Sotirios 
Middleton, Nicos 
Charalambous, Andreas 
Raftopoulos, Vasilios 
Hadjichristodoulou, Christos 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Active case detection;Greece;Malaria;Migrants;Plasmodium vivax
Issue Date: 1-Jun-2020
Source: International Journal of Environmental Research and Public Health, 2020, vol. 17, iss. 11, article no. 4080
Volume: 17
Issue: 11
Journal: International Journal of Environmental Research and Public Health 
Abstract: Greecehasbeenmalaria-freesince1974. InOctober2011,followinganoutbreakof36locally acquired malaria (LAM) cases in Evrotas Municipality, a Pro-Active Case Detection (PACD) program for malaria was implemented among migrants from malaria-endemic countries, to support early diagnosis and treatment of cases. We evaluated the PACD program for the years 2012–2017 using indicatorssuchasthenumberoflocallyacquiredcases,thedetectionrate/sensitivityandthetimeliness of diagnosis and treatment. We visited each migrant home every 7–15 days to screen migrants for malaria symptoms, performing Rapid Diagnostic Tests (RDTs) and blood smears on symptomatic patients. We estimated: (i) the number of malaria cases detected by the PACD, divided by the total number of reported malaria cases during the same period among the same population; (ii) the time betweenonsetofsymptoms,diagnosisandinitiationoftreatment. Thetotalnumberofmigrantswho were screened for malaria symptoms for the years 2012–2017 was 5057 with 84,169 fever screenings conducted, while 2288 RDTs and 1736 blood smears were performed. During the same period, 53 imported P. vivax malaria cases were detected, while incidence of malaria among migrants was estimated at 1.8% annually. Ten and one LAM cases were also reportedin 2012 and 2015, respectively. Sensitivity of PACD ranged from 86% to 100%; median timeliness between onset of symptoms and diagnosis decreased from 72 h in 2012 to 12 h in 2017 (83% decrease), while timeliness betweendiagnosis and treatment initiation was 0 h. The implementation of PACD could be considered an effective prevention and response tool against malaria re-introduction.
ISSN: 1661-7827
DOI: 10.3390/ijerph17114080
Rights: © by the authors
Type: Article
Affiliation : National Public Health Organization of Greece 
Cyprus University of Technology 
University of Thessaly 
University of Peloponnese 
General Hospital of Sparti 
General Hospital of Molaoi 
University of West Attica 
Prefecture of Peloponnese 
Athens University 
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