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

Maria Tseroni, Maria Georgitsou, Agoritsa Baka, Ourania Pinaka, Danai Pervanidou, Maria Tsironi, Panagiota Bleta, Maria Charvalakou, Ioanna Psinaki, Martha Dionysopoulou, Antonia Legaki, Annita Vakali, Elina Patsoula, Evdokia Vassalou, Spyridoula Bellou, Vasilis Diamantopoulos, Theano Georgakopoulou, Varvara Mouchtouri, Sotirios Tsiodras, Nicos Middleton, Andreas Charalambous, Vasilios Raftopoulos and Christos Hadjichristodoulou
Additional contact information
Maria Tseroni: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Maria Georgitsou: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece
Agoritsa Baka: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Ourania Pinaka: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece
Danai Pervanidou: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Maria Tsironi: Department of Nursing, University of Peloponnese, Karaiskaki 70, 22100 Tripoli, Greece
Panagiota Bleta: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece
Maria Charvalakou: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece
Ioanna Psinaki: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece
Martha Dionysopoulou: General Hospital of Sparti, 23100 Lakonia, Greece
Antonia Legaki: General Hospital of Molaoi, 23052 Lakonia, Greece
Annita Vakali: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Elina Patsoula: Public Health Parasitology and Entomology, Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
Evdokia Vassalou: Public Health Parasitology and Entomology, Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
Spyridoula Bellou: Directorate of Public Health, Prefecture of Peloponnese, 34 El. Venizelos, 22132 Tripoli, Greece
Vasilis Diamantopoulos: Directorate of Public Health, Prefecture of Peloponnese, 34 El. Venizelos, 22132 Tripoli, Greece
Theano Georgakopoulou: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Varvara Mouchtouri: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece
Sotirios Tsiodras: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Nicos Middleton: Department of Nursing, Cyprus University of Technology, 30 Arch. Kyprianos Str., 3036 Limassol, Cyprus
Andreas Charalambous: Department of Nursing, Cyprus University of Technology, 30 Arch. Kyprianos Str., 3036 Limassol, Cyprus
Vasilios Raftopoulos: National Public Health Organization of Greece, 3-5 Agrafon St., 15123 Marousi, Greece
Christos Hadjichristodoulou: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi St., 41222 Larissa, Greece

IJERPH, 2020, vol. 17, issue 11, 1-16

Abstract: Greece has been malaria-free since 1974. In October 2011, following an outbreak of 36 locally 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 indicators such as the number of locally acquired cases, the detection rate/sensitivity and the timeliness 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 between onset of symptoms, diagnosis and initiation of treatment. The total number of migrants who 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 reported in 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 between diagnosis and treatment initiation was 0 h. The implementation of PACD could be considered an effective prevention and response tool against malaria re-introduction.

Keywords: malaria; plasmodium vivax; active case detection; migrants; Greece (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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