Document Detail

Aggressive active case detection: a malaria control strategy based on the Brazilian model.
MedLine Citation:
PMID:  15550304     Owner:  NLM     Status:  MEDLINE    
Since 1996, the Brazilian Ministry of Health has adopted a malaria control strategy known as aggressive active case detection (AACD) in which most or all members of every community are tested and treated for malaria on a monthly basis. The strategy attempts to identify and treat cases of asymptomatic malaria, which, if untreated, continue to transmit the infection. Malaria remains uncontrolled because almost all health care systems in the world rely on passive case detection: the treatment of only symptomatic cases of malaria. Research has shown conclusively that asymptomatic cases exist in any population where malaria transmission is stable and incidence is high: therefore passive case detection simply will not succeed in breaking the cycle of transmission. Numerous case studies show that malaria has been successfully controlled on a regional or national level by mass blood surveys. AACD is an effective malaria control strategy if used in conjunction with other methods, especially when (1) an effective treatment exists, (2) influx of potential carriers of the infection can be monitored, and (3) people are inclined to cooperate with monthly blood testing. AACD requires access to rapid diagnostic tests (RDTs), microscopy supplies, extensive human resources, and prompt, affordable, and effective treatment. AACD is compared to PCD in terms of clinical efficacy and cost effectiveness in a case study of malaria in the Brazilian Yanomami Indians. Where it is feasible, AACD could drastically reduce the incidence of malaria and should be an integral part of the World Health Organization's Roll Back Malaria strategy.
Cameron Macauley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  60     ISSN:  0277-9536     ISO Abbreviation:  Soc Sci Med     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2004-11-19     Completed Date:  2005-04-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  563-73     Citation Subset:  IM    
International Health, Boston University School of Public Health, 8 Feneno Terrace, #2, Allston, MA 02134, USA.
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MeSH Terms
Brazil / epidemiology
Malaria / epidemiology,  prevention & control*,  transmission
Malaria, Falciparum / epidemiology,  prevention & control
Malaria, Vivax / epidemiology,  prevention & control
Microscopy / economics
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