Effectiveness of the innovative 1,7-malaria reactive community-based testing and response (1, 7-mRCTR) approach on malaria burden reduction in Southeastern Tanzania

Malaria Journal

Ellen Hertzmark¹  Kangming Lin²  Ernest Tambo³  Mihayo G. Michael⁴  Sigsbert Mkude⁴  Hajirani M. Msuya⁴  Christina Makungu⁴  Muhidin K. Mahende⁴  Exavery Chaki⁴  Yeromin P. Mlacha⁴  Prosper P. Chaki⁴  Tegemeo Gavana⁴  Honorati Masanja⁴  Rashid Khatib⁴  Salim Abdulla⁴  Godlove Chila⁴  Susan F. Rumisha⁵  Zhengbin Zhou⁶  Duoquan Wang⁶  Ning Xiao⁶  Xiao-Nong Zhou⁶  Frank Chacky⁷  Penelope Vounatsou⁸  Marcel Tanner⁸  Maru Aregawi⁹ 

[1] Department of Global Health and Population, Harvard T.H. Chan School of Public Health;Guangxi Center for Disease Control and Prevention;Higher Institute of Health Sciences, Université des Montagnes;Ifakara Health Institute;National Institute for Medical Research (NIMR);National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention;National Malaria Control, Ministry of Health, Community Development, Gender, Elderly and Children;Swiss Tropical and Public Health Institute;The Global Malaria Programme (GMP), World Health Organization;

关键词: Malaria;    1,7-mRCTR approach;    Community-based;    Testing;    Treatment;    Response;   

DOI  :  10.1186/s12936-020-03363-w

来源: DOAJ

【 摘 要 】

Abstract Background In 2015, a China-UK-Tanzania tripartite pilot project was implemented in southeastern Tanzania to explore a new model for reducing malaria burden and possibly scaling-out the approach into other malaria-endemic countries. The 1,7-malaria Reactive Community-based Testing and Response (1,7-mRCTR) which is a locally-tailored approach for reporting febrile malaria cases in endemic villages was developed to stop transmission and Plasmodium life-cycle. The (1,7-mRCTR) utilizes existing health facility data and locally trained community health workers to conduct community-level testing and treatment. Methods The pilot project was implemented from September 2015 to June 2018 in Rufiji District, southern Tanzania. The study took place in four wards, two with low incidence and two with a higher incidence. One ward of each type was selected for each of the control and intervention arms. The control wards implemented the existing Ministry of Health programmes. The 1,7-mRCTR activities implemented in the intervention arm included community testing and treatment of malaria infection. Malaria case-to-suspect ratios at health facilities (HF) were aggregated by villages, weekly to identify the village with the highest ratio. Community-based mobile test stations (cMTS) were used for conducting mass testing and treatment. Baseline (pre) and endline (post) household surveys were done in the control and intervention wards to assess the change in malaria prevalence measured by the interaction term of ‘time’ (post vs pre) and arm in a logistic model. A secondary analysis also studied the malaria incidence reported at the HFs during the intervention. Results Overall the 85 rounds of 1,7-mRCTR conducted in the intervention wards significantly reduced the odds of malaria infection by 66% (adjusted OR 0.34, 95% CI 0.26,0.44, p < 0001) beyond the effect of the standard programmes. Malaria prevalence in the intervention wards declined by 81% (from 26% (95% CI 23.7, 7.8), at baseline to 4.9% (95% CI 4.0, 5.9) at endline). In villages receiving the 1,7-mRCTR, the short-term case ratio decreased by over 15.7% (95% CI − 33, 6) compared to baseline. Conclusion The 1,7-mRCTR approach significantly reduced the malaria burden in the areas of high transmission in rural southern Tanzania. This locally tailored approach could accelerate malaria control and elimination efforts. The results provide the impetus for further evaluation of the effectiveness and scaling up of this approach in other high malaria burden countries in Africa, including Tanzania.

【 授权许可】

Unknown