Sociobehavorial reactive case detection strategies targeting high-risk populations to increase the detection of malaria infections in Aceh Province, Indonesia

• Reactive case detection (RACD), or testing and treatment of close contacts and household members of a recent malaria case, is commonly practiced in settings nearing malaria elimination, but RACD strategies and diagnostics used may not be effective at identifying and targeting the most at risk for malaria. A sociobehavorial RACD approach is an alternative approach that may provide a more effective approach to identify and screen high-risk populations for malaria and detect additional infections compared to a household-based RACD approach. We assessed the utility, and effectiveness of microscopy, LAMP and PCR comparing household-based RACD and sociobehavorial RACD approaches in Aceh Province, Indonesia. Characteristics of the different study populations were analyzed, including prevalence of microscopy and molecular detection. The study enrolled 34 index cases for household-based RACD (HH-RACD) of which 33 were sociobehavorial-RACD (SB-RACD) eligible cases. A total of 847 household members and neighbors were screened in HH-RACD, providing 1 LAMP and PCR positive RACD-identified infection. In SB-RACD 180 individuals were screened and 3 LAMP and PCR positive RACD-identified infections were identified.(p=0.018) Important shared risk factors were identified between SB-RACD screened individuals and index cases. These include: 1) men having a higher likelihood of being an index case and being screened during SB-RACD; 2) being between 30-45 years of age; 3) occupation of logging, mining, or other outdoor labor compared to farming or other; 4) having slept in the forest or family members with forest exposure in the past 60 days; 5) and having a traditional housing type as their main residence. In low transmission settings, targeting of sociobehavorial contacts of malaria index cases when conducting RACD has the potential to yield more RACD-identified infections, particularly when molecular diagnostics are used, making it potentially a more effective screening strategy compared to HH-RACD only.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

malaria elimination

reactive case detection

sociobehavorial

high-risk populations

Aceh Province

Indonesia

Infektionssjukdomar

Infectious Diseases

Infektionssjukdomar

Infectious Diseases

Infektionssjukdomar

Infectious Diseases

Infektionssjukdomar

Infectious Diseases

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)