Evaluation of a New Malaria Control Strategy Amongst Gold Miners Working Illegally in French Guiana (Malakit)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,733
- 试验地点
- 2
- 主要终点
- KAP Questionnaire
研究概览
简要总结
Illegal gold miners in French Guiana, a French overseas territory ('département') located in Amazonia, often carry malaria parasites (up to 46.8%). While the Guiana Shield Region aims at malaria elimination, the high prevalence of Plasmodiumin this hard-to-reach population in conjunction with frequent incorrect use of artemisinin-based anti-malarials could favor the emergence of resistant parasites. Due to geographical and regulatory issues in French Guiana, usual malaria control strategies cannot be implemented in this particular context.Therefore, new strategies targeting this specific population in the forest are required.
Numerous discussions among health institutions and scientific partners from French Guiana, Brazil and Suriname have led to an innovative project based on the distribution of kits for self-diagnosis and self-treatment of Plasmodium infections. The kit-distribution will be implemented at "resting sites", which are areas across the border of French Guiana regularly frequented by gold miners. The main objective is to increase the appropriate use and complete malaria treatment after a positive malaria diagnosis with a rapid test, which will be evaluated with before-and-after cross-sectional studies. Monitoring indicators will be collected from health mediators at the time of kit distribution and during subsequent visits, and from illegal gold miners themselves, through a smartphone application. The project funding is multisource, including Ministries of Health of the three countries, WHO/PAHO, and the European Union.
详细描述
Background Despite a decrease in the number of cases reported to CIRE "Cellule de l'Institut de Veille Sanitaire", an interregional epidemiological surveillance center, malaria affects many gold miners working illegally in French Guiana. The ORPAL study carried out by CIC "Centre d'Investigation Clinique" (clinical investigation center) in 2015, showed that the prevalence of Plasmodium in illegal gold miners was 22.3%, of which 84% were asymptomatic. Self-medication practices are very common (52.4%) using artemisinin derivatives.
Key issues identified:
- The mobile population of workers in illegal gold mining sites is particularly affected by malaria due to their living and working conditions and as such represents a reservoir of transmission.
- Their undocumented irregular status and difficult access to health centers makes care from health professionals rare or belated.
- The use of inadequate drugs, without prior diagnosis and with improper compliance, mainly due to the high cost of treatment on the black market, is common. These non-recommended practices contribute to the risk of emergence of ACT resistance.
- Knowledge of the disease by illegal gold miners (causes, symptoms, preventive measures and treatment) remains insufficient.
Considering the problems, the identified need is to ensure sufficient intervention coverage of appropriate and rapid care, amongst the malaria "reservoir" population, in order to reduce:
- Malaria transmission and ACT non-compliance;
- The ensuing risk of P. falciparum resistance to ACT;
- The morbidity and mortality of illegal workers in gold-mining sites;
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 15 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •over 15 years-old
- •working or accompanying someone working in illegal gold mining in French Guiana
- •agreing to take part of the study
- •to have parents authorization if age between 15 and 17 ;
- •capable of performing a self-RDT during the training (validation by the facilitator);
排除标准
- •refusing to participate in the study ;
- •under 15 years old ;
- •no parents authorization ;
- •weighing less than 35 kg ;
- •who has not been able to perform a self-RDT during the training (invalidation by the facilitator).
结局指标
主要结局
KAP Questionnaire
时间窗: 12 months
change the part of illegal gold miners in French Guiana who take a correct antimalarial treatment (with artemisinin-combined therapy) with a good adherence and after a positive rapid diagnostic test.
次要结局
- malaria prevalence(12 months)
- KAP questionnaire(12 months)