Management of imported malaria cases and healthcare institutions in central China, 2012–2017: application of decision tree analysis

et al. 2020

Preprint

Background: China launched the National Malaria Elimination Program (NMEP) in 2010 that set the goal that all health facilities had the ability to diagnose malaria along with the hospitals at all levels had the ability to treat malaria by 2015. To provide a reference for the control of imported malaria, we conducted a study on the distribution of malaria patients seeking care in different types of health facilities. Methods: The data used for the analysis was obtained through the Infectious Diseases Information Reporting Management System (IDIRMS) and stratified multistage sampling. Descriptive statistical analysis was used to investigate the distribution of malaria patients in different types of health facilities, and the Chi-square test was used to compare the proportions of patients seeking care outside their current residence region between different types of hospitals. Point maps were drawn to visualize the spatial distribution of hospitals reporting malaria cases, and flow maps were created to show spatial flow of malaria patients by using the ArcGIS software. Results: The proportions of malaria patients who sought care in hospitals, township hospitals, and Centers for Disease Control and Prevention (CDCs) were 81.7%, 14.7% and 3.6%, respectively. For those who sought care in hospitals, the percentages who sought care in provincial, prefecture-level and county-level hospitals were 17.4%, 60.5% and 22.1%, correspondingly; the proportions of malaria patients who sought care in tertiary hospitals, secondary hospitals, and primary hospitals were 59.8%, 39.9% and 0.3%, respectively. Moreover, the proportions of patients seeking care in hospitals within county and prefectural administrative area were 18.2%, 63.4%, respectively. Conclusion: During the implementation of NMEP, malaria patients tended to seek care in tertiary hospitals and prefecture-level hospitals, and more than half of patients could be treated in hospitals in prefecture-level areas. In the current phase, it is necessary to establish referral system from grassroots medical institutions to hospitals designated for malaria treatment. Keywords: Geographic variation; Care-seeking behavior; Geospatial distribution; Medical treatment preference

Section: Discussionmentioning

confidence: 99%

Section: Subject Areasmentioning

confidence: 99%

Distribution of malaria patients seeking care in different types of health facilities during the implementation of National Malaria Elimination Program

Gang

et al. 2020

Preprint

“…However, the proportions of patients seeking care in hospitals within county-level areas were also low. It is speculated that maybe clinicians in secondary hospitals could not make a malaria diagnosis and treatment [24]. However, the proportions of patients seeking care within prefecture-level areas were relatively high in most provinces.…”

Section: Table 3 Characteristics Of Proportions Of Patients Seeking Cmentioning

confidence: 99%

“…In China, the Centers for Disease Control and Prevention (CDCs) provide malaria diagnostic services and free anti-malarial medications; clinics, township hospitals, and hospitals at all levels perform both diagnostic and treatment services [23]. If the township hospital failed to treat malaria patients after making an exact diagnosis, patients would be referred to county-level or higher-level hospitals [24].…”

Section: Introductionmentioning

confidence: 99%

Distribution of malaria patients seeking care in different types of health facilities during the implementation of National Malaria Elimination Programme

Feng

et al. 2020

Malar J

Background: China launched the National Malaria Elimination Programme (NMEP) in 2010 and set the goal that all health facilities should be able to diagnose malaria. Additionally, hospitals at all levels could treat malaria by 2015. To provide a reference for the control of imported malaria, a study was conducted on the distribution of malaria patients seeking care in different types of health facilities. Methods: There were two data sources. One was obtained through the Infectious Diseases Information Reporting Management System (IDIRMS), which only contained the name of health facilities and the number of cases. The other was obtained through multistage stratified cluster sampling. Descriptive statistical analysis was used to investigate the distribution of malaria patients attending different types of health facilities (hospitals, township hospitals, and Centers for Disease Control and Prevention), hospital tiers (county-level, prefecture-level, and provincial-level), and hospital levels (primary, secondary, and tertiary). Chi-square test was also used to compare the proportions of patients seeking care outside their current residence region between different types of hospitals. Point maps were drawn to visualize the spatial distribution of hospitals reporting malaria cases, and flow maps were created to show the spatial flow of malaria patients by using the ArcGIS software. Results: The proportions of malaria patients who sought care in hospitals, township hospitals, and Centers for Disease Control and Prevention were 81.7%, 14.7%, and 3.6%, respectively. For those who sought care in hospitals, the percentages of patients who sought care in provincial-level, prefecture-level and county-level hospitals were 17.4%, 60.5% and 22.1%, correspondingly; the proportions of patients who sought care in tertiary hospitals, secondary hospitals, and primary hospitals were 59.8%, 39.9%, and 0.3%, respectively. Moreover, the proportions of patients seeking care in hospitals within county and prefectural administrative areas were 18.2%, 63.4%, respectively. Conclusion: During the implementation of NMEP, malaria patients tended to seek care in tertiary hospitals and prefecture-level hospitals, and more than half of patients could be treated in hospitals in prefecture-level areas. In

Section: Introductionmentioning

confidence: 99%

Distribution of malaria patients seeking care in different types of health facilities during the implementation of National Malaria Elimination Program

et al. 2020

Preprint

Background: China launched the National Malaria Elimination Program (NMEP) in 2010 that set the goal that all health facilities had the ability to diagnose malaria along with the hospitals at all levels had the ability to treat malaria by 2015. To provide a reference for the control of imported malaria, we conducted a study on the distribution of malaria patients seeking care in different types of health facilities. Methods: There were two data source. One was obtained through the Infectious Diseases Information Reporting Management System (IDIRMS), which only contained the name of health facilities and the number of cases. The other was obtained through multistage stratified cluster sampling. Descriptive statistical analysis was used to investigate the distribution of malaria patients attending different types of health facilities (hospitals, township hospitals and CDCs), hospital tiers (county-level, prefecture-level or provincial-level) and hospital levels (primary, secondary or tertiary), and the Chi-square test was used to compare the proportions of patients seeking care outside their current residence region between different types of hospitals. Point maps were drawn to visualize the spatial distribution of hospitals reporting malaria cases, and flow maps were created to show spatial flow of malaria patients by using the ArcGIS software. Results: The proportions of malaria patients who sought care in hospitals, township hospitals, and Centers for Disease Control and Prevention (CDCs) were 81.7%, 14.7% and 3.6%, respectively. For those who sought care in hospitals, the percentages who sought care in provincial-level, prefecture-level and county-level hospitals were 17.4%, 60.5% and 22.1%, correspondingly; the proportions of malaria patients who sought care in tertiary hospitals, secondary hospitals, and primary hospitals were 59.8%, 39.9% and 0.3%, respectively. Moreover, the proportions of patients seeking care in hospitals within county and prefectural administrative area were 18.2%, 63.4%, respectively. Conclusion: During the implementation of NMEP, malaria patients tended to seek care in tertiary hospitals and prefecture-level hospitals, and more than half of patients could be treated in hospitals in prefecture-level areas. In the current phase, it is necessary to establish referral system from county-level hospitals to higher-level hospitals for malaria treatment.