Improvements in timely malaria diagnosis and appropriate therapy with the use of rapid tests by health promoters in peruvian Amazon jungle

Abstract

Objectives. To compare the achievement of a timely diagnosis and appropriate therapy for malaria before and after the incorporation of rapid tests for diagnosing this disease used by health promoters in peripheral communities in Iquitos. Material and methods. A longitudinal study with pre- and post- intervention assessments was performed. Two hundred febrile patients (suspected malaria cases) seen by health promoters during the last 6 weeks were selected, and data related to a timely malaria diagnosis and therapy, as well as confirmatory diagnoses using thick smears was collected. Results. There was a significant decrease in the time elapsed from symptom onset to therapy initiation with the intervention, from 110 hours (4.6 days) to 46,3 hours (1.9 days) (p<0.001). This variation was mainly due to a reduction of the time since the patient was first seen by a health promoter until the time when a diagnosis was achieved, from 69 hours (2.9 days) to only 20 minutes (p<0.001). There was also a significant increase in the frequency of malaria patients who received timely antimalarial therapy, from 1,5% to 54,9% (p<0.001); the proportion of malaria patients receiving appropriate therapy according to the parasite species increased from 26.7% to 83.5% (p<0.001), and the proportion of P. falciparum malaria patients who received appropriate therapy rose from 5.3% to 73.1% (p<0.001). Conclusions. Now it is possible to achieve a timely diagnosis and appropriate therapy for malaria with the use of rapid tests by health promoters in these selected communities.