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Uncomplicated Malaria Infection and Severe Malaria Disease Case Management in Sussundenga District, Mozambique
Uncomplicated Malaria Infection and Severe Malaria Disease Case Management in Sussundenga ...
Uncomplicated Malaria Infection and Severe Malaria Disease Case Management in Sussundenga District, Mozambique

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자료유형  
 학위논문 서양
최종처리일시  
20260202103629
ISBN  
9798290909479
DDC  
614.4
저자명  
Earland, Dominique.
서명/저자  
Uncomplicated Malaria Infection and Severe Malaria Disease Case Management in Sussundenga District, Mozambique
발행사항  
[Sl] : University of Minnesota, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
128 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-01, Section: B.
주기사항  
Advisor: Searle, Kelly M.;Boulware, David.
학위논문주기  
Thesis (Ph.D.)--University of Minnesota, 2025.
초록/해제  
요약Malaria case management through prompt diagnosis and artesunate treatment within 24 hours of symptom onset reduces malaria mortality 1. The Mozambican National Malaria Control Program (NMCP) supports universal access to care; however, malaria health disparities persist 2. Sussundenga District is a rural community in Western Mozambique, with moderate-high Plasmodium falciparum transmission 3,4. Research focused on health access and case management are traditionally research priorities in settings close to elimination. Few community-based studies on malaria prevention and treatment have occurred in Western Mozambique, although malaria prevalence for children under five was 48% higher in Manica compared to Maputo province in 2019 5. This dissertation aimed to (1) measure the community Plasmodium falciparum prevalence and symptomatic malaria health-seeking behaviors in a cross-sectional study, (2) determine the impact of ecological health access domains on severe malaria case management based on a case-control study, and (3) identify the facilitators and barriers to severe malaria case management through provider and traditional medicine practitioner interviews at the Sussundenga-Sede rural health center (RHC).In Manuscript 1, I designed surveys for a pilot cross-sectional study in Sussundenga village. The cross-sectional study occurred from December 2019 to February 2020. The community prevalence and health-seeking behaviors analysis was published in 2022. I analyzed individual and household data on malaria infection risk and factors impacting health-seeking. I identified the community Plasmodium falciparum prevalence and individual, household, and provider-level determinants of malaria treatment. I found significant gaps in individual health-seeking behaviors, while the primary site of care to receive the standard diagnosis and treatment was the Sussundenga-Sede RHC.In Manuscript 2, I designed a convergent parallel mixed-method study based at Sussundenga-Sede RHC from April 2023 to August 2024. I designed surveys, piloted with local providers, and led the completion of a case-control study for quantitative data collection. I compared severe malaria hospitalized cases and non-malarial hospitalized controls to understand ecological health access determinants. The exploratory factor analysis and generated composite variables indicated the built, social, and physical environment components impact health access. I found less built or social environment health access increased the average predicted probability for severe malaria hospitalization.In Manuscript 3, At the same time as the hospital based case-control study, I designed semi-structured interviews, piloted them with local providers, and led the qualitative data collection. I used thematic analysis, joint display tables, and data integration at multiple levels to understand severe malaria case management facilitators and barriers from diverse key decision makers. I found traditional medicine and traditional medicine practitioners could improve delayed health seeking, a common barrier from all key decision makers.In partnership with Sussundenga-Sede RHC, the Ministry of Health, and Consultores Associados de Manica, I identified multi-level determinants of malaria infection and severe disease. Future research on key determinants could improve outcomes in Sussundenga district, Mozambique.
일반주제명  
Epidemiology
일반주제명  
Public health
키워드  
Global health
키워드  
Health access
키워드  
Health seeking
키워드  
Malaria
기타저자  
University of Minnesota Epidemiology
기본자료저록  
Dissertations Abstracts International. 87-01B.
전자적 위치 및 접속  
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MARC

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■1001  ▼aEarland,  Dominique.
■24510▼aUncomplicated  Malaria  Infection  and  Severe  Malaria  Disease  Case  Management  in  Sussundenga  District,  Mozambique
■260    ▼a[Sl]▼bUniversity  of  Minnesota▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a128  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-01,  Section:  B.
■500    ▼aAdvisor:  Searle,  Kelly  M.;Boulware,  David.
■5021  ▼aThesis  (Ph.D.)--University  of  Minnesota,  2025.
■520    ▼aMalaria  case  management  through  prompt  diagnosis  and  artesunate  treatment  within  24  hours  of  symptom  onset  reduces  malaria  mortality  1.  The  Mozambican  National  Malaria  Control  Program  (NMCP)  supports  universal  access  to  care;  however,  malaria  health  disparities  persist  2.  Sussundenga  District  is  a  rural  community  in  Western  Mozambique,  with  moderate-high  Plasmodium  falciparum  transmission  3,4.  Research  focused  on  health  access  and  case  management  are  traditionally  research  priorities  in  settings  close  to  elimination.  Few  community-based  studies  on  malaria  prevention  and  treatment  have  occurred  in  Western  Mozambique,  although  malaria  prevalence  for  children  under  five  was  48%  higher  in  Manica  compared  to  Maputo  province  in  2019  5.  This  dissertation  aimed  to  (1)  measure  the  community  Plasmodium  falciparum  prevalence  and  symptomatic  malaria  health-seeking  behaviors  in  a  cross-sectional  study,  (2)  determine  the  impact  of  ecological  health  access  domains  on  severe  malaria  case  management  based  on  a  case-control  study,  and  (3)  identify  the  facilitators  and  barriers  to  severe  malaria  case  management  through  provider  and  traditional  medicine  practitioner  interviews  at  the  Sussundenga-Sede  rural  health  center  (RHC).In  Manuscript  1,  I  designed  surveys  for  a  pilot  cross-sectional  study  in  Sussundenga  village.  The  cross-sectional  study  occurred  from  December  2019  to  February  2020.  The  community  prevalence  and  health-seeking  behaviors  analysis  was  published  in  2022.  I  analyzed  individual  and  household  data  on  malaria  infection  risk  and  factors  impacting  health-seeking.  I  identified  the  community  Plasmodium  falciparum  prevalence  and  individual,  household,  and  provider-level  determinants  of  malaria  treatment.  I  found  significant  gaps  in  individual  health-seeking  behaviors,  while  the  primary  site  of  care  to  receive  the  standard  diagnosis  and  treatment  was  the  Sussundenga-Sede  RHC.In  Manuscript  2,  I  designed  a  convergent  parallel  mixed-method  study  based  at  Sussundenga-Sede  RHC  from  April  2023  to  August  2024.  I  designed  surveys,  piloted  with  local  providers,  and  led  the  completion  of  a  case-control  study  for  quantitative  data  collection.  I  compared  severe  malaria  hospitalized  cases  and  non-malarial  hospitalized  controls  to  understand  ecological  health  access  determinants.  The  exploratory  factor  analysis  and  generated  composite  variables  indicated  the  built,  social,  and  physical  environment  components  impact  health  access.  I  found  less  built  or  social  environment  health  access  increased  the  average  predicted  probability  for  severe  malaria  hospitalization.In  Manuscript  3,  At  the  same  time  as  the  hospital  based  case-control  study,  I  designed  semi-structured  interviews,  piloted  them  with  local  providers,  and  led  the  qualitative  data  collection.  I  used  thematic  analysis,  joint  display  tables,  and  data  integration  at  multiple  levels  to  understand  severe  malaria  case  management  facilitators  and  barriers  from  diverse  key  decision  makers.  I  found  traditional  medicine  and  traditional  medicine  practitioners  could  improve  delayed  health  seeking,  a  common  barrier  from  all  key  decision  makers.In  partnership  with  Sussundenga-Sede  RHC,  the  Ministry  of  Health,  and  Consultores  Associados  de  Manica,  I  identified  multi-level  determinants  of  malaria  infection  and  severe  disease.  Future  research  on  key  determinants  could  improve  outcomes  in  Sussundenga  district,  Mozambique.
■590    ▼aSchool  code:  0130.
■650  4▼aEpidemiology
■650  4▼aPublic  health
■653    ▼aGlobal  health
■653    ▼aHealth  access
■653    ▼aHealth  seeking
■653    ▼aMalaria
■690    ▼a0766
■690    ▼a0769
■690    ▼a0573
■71020▼aUniversity  of  Minnesota▼bEpidemiology.
■7730  ▼tDissertations  Abstracts  International▼g87-01B.
■790    ▼a0130
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17358001▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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