1,7-疟疾反应性社区检测和应对(1,7-mRCTR)方法对坦桑尼亚疟疾流行率的影响

IF 4.8 1区 医学 Q1 INFECTIOUS DISEASES
Wei Chang, Jessica Cohen, Duo-Quan Wang, Salim Abdulla, Muhidin Kassim Mahende, Tegemeo Gavana, Valerie Scott, Hajirani M. Msuya, Mary Mwanyika-Sando, Ritha John A. Njau, Shen-Ning Lu, Silas Temu, Honorati Masanja, Wilbald Anthony, Maru Aregawi W., Naveen Sunder, Tang Kun, Katia Bruxvoort, Jovin Kitau, Fadhila Kihwele, Godlove Chila, Mihayo Michael, Marcia Castro, Nicolas A. Menzies, Sein Kim, Xiao Ning, Xiao-Nong Zhou, Prosper Chaki, Yeromin P. Mlacha
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引用次数: 0

摘要

近年来,疟疾控制工作的进展停滞不前,需要采用创新的监测和应对方法来加快非洲疟疾流行地区的疟疾控制和消除工作。在此前中英坦桑尼亚疟疾控制试点研究的基础上,本研究旨在评估在坦桑尼亚三个地区实施两年的1,7-疟疾反应性社区检测和应对(1,7-mRCTR)方法的影响。根据医疗机构的监测数据,1,7-mRCTR 方法通过快速诊断检测为疟疾发病率最高的村庄提供社区疟疾检测和治疗。我们采用线性概率模型和两波横断面家庭调查的差分准实验设计,评估了 1,7-mRCTR 对疟疾流行率的影响。我们进行了敏感性分析以评估结果的稳健性,研究了干预效果在亚组中的差异,并探讨了观察到的结果的其他解释。2019 年 10 月至 2021 年 9 月期间,干预地区完成了 244771 次社区疟疾快速检测,每个干预村平均接受了 3.85 轮 1-7mRCTR 检测。干预地区的疟疾流行率从基线时的 27.4% 降至终点时的 11.7%,对照地区则从 26.0% 降至 16.0%。1,7-mRCTR 与疟疾流行率下降 4.5 个百分点(95% 置信区间:- 0.067, - 0.023)相关,相当于从基线下降 17%。在疟疾流行率较低的鲁菲吉区,1,7-mRCTR 可使疟疾流行率下降 63.9%。1,7-mRCTR 方法降低了疟疾流行率。尽管由于 COVID-19 大流行和供应链方面的挑战,实施工作出现了中断,但这项研究提供了新的证据,证明基于社区的反应性方法在中度至高度流行地区的有效性,并展示了南南合作在应对全球健康挑战方面的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of 1,7-malaria reactive community-based testing and response (1,7-mRCTR) approach on malaria prevalence in Tanzania
Progress in malaria control has stalled in recent years and innovative surveillance and response approaches are needed to accelerate malaria control and elimination efforts in endemic areas of Africa. Building on a previous China-UK-Tanzania pilot study on malaria control, this study aimed to assess the impact of the 1,7-malaria Reactive Community-Based Testing and Response (1,7-mRCTR) approach implemented over two years in three districts of Tanzania. The 1,7-mRCTR approach provides community-based malaria testing via rapid diagnostic tests and treatment in villages with the highest burden of malaria incidence based on surveillance data from health facilities. We used a difference-in-differences quasi-experimental design with linear probability models and two waves of cross-sectional household surveys to assess the impact of 1,7-mRCTR on malaria prevalence. We conducted sensitivity analyses to assess the robustness of our results, examined how intervention effects varied in subgroups, and explored alternative explanations for the observed results. Between October 2019 and September 2021, 244,771 community-based malaria rapid tests were completed in intervention areas, and each intervention village received an average of 3.85 rounds of 1-7mRCTR. Malaria prevalence declined from 27.4% at baseline to 11.7% at endline in the intervention areas and from 26.0% to 16.0% in the control areas. 1,7-mRCTR was associated with a 4.5-percentage-point decrease in malaria prevalence (95% confidence interval: − 0.067, − 0.023), equivalent to a 17% reduction from the baseline. In Rufiji, a district characterized by lower prevalence and where larviciding was additionally provided, 1,7-mRCTR was associated with a 63.9% decline in malaria prevalence. The 1,7-mRCTR approach reduced malaria prevalence. Despite implementation interruptions due to the COVID-19 pandemic and supply chain challenges, the study provided novel evidence on the effectiveness of community-based reactive approaches in moderate- to high-endemicity areas and demonstrated the potential of South-South cooperation in tackling global health challenges.
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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health
CiteScore
16.70
自引率
1.20%
发文量
368
审稿时长
13 weeks
期刊介绍: Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.
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