Towards malaria elimination in Savannakhet, Lao PDR: mathematical modelling driven strategy design

Malaria Journal

Research

Mayfong Mayxay¹  Maciej F. Boni²  Phetsavanh Chanthavilay³  Sai Thein Than Tun⁴  Olivier Celhay⁴  Shwe Sin Kyaw⁴  Sompob Saralamba⁴  Lorenz von Seidlein⁵  Arjen M. Dondorp⁵  Lisa J. White⁵  Thu Nguyen-Anh Tran⁶  Tran Dang Nguyen⁶  Tiengkham Pongvongsa⁷  Daniel M. Parker⁸ 

[1] Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Churchill Hospital, Oxford, UK;Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao People’s Democratic Republic;Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao People’s Democratic Republic;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Churchill Hospital, Oxford, UK;Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam;Department of Biology, Pennsylvania State University, University Park, PA, USA;Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao People’s Democratic Republic;Institute of Francophonie for Tropical Medicine, Vientiane, Lao People’s Democratic Republic;Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Churchill Hospital, Oxford, UK;Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam;Savannakhet Provincial Health Department, Phonsavangnuea Village, Kaysone-Phomvihan District, Savannakhet, Lao People’s Democratic Republic;Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand;

关键词: Malaria elimination;    Plasmodium falciparum;    Mathematical model;    Savannakhet;    Laos;    Mass Vaccination and Drug Administration (MVDA);    Malaria surveillance;   

DOI  :  10.1186/s12936-017-2130-3

 received in 2017-06-19, accepted in 2017-11-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe number of Plasmodium falciparum malaria cases around the world has decreased substantially over the last 15 years, but with the spread of resistance against anti-malarial drugs and insecticides, this decline may not continue. There is an urgent need to consider alternative, accelerated strategies to eliminate malaria in countries like Lao PDR, where there are a few remaining endemic areas. A deterministic compartmental modelling tool was used to develop an integrated strategy for P. falciparum elimination in the Savannakhet province of Lao PDR. The model was designed to include key aspects of malaria transmission and integrated control measures, along with a user-friendly interface.ResultsUniversal coverage was the foundation of the integrated strategy, which took the form of the deployment of community health workers who provided universal access to early diagnosis, treatment and long-lasting insecticidal nets. Acceleration was included as the deployment of three monthly rounds of mass drug administration targeted towards high prevalence villages, with the addition of three monthly doses of the RTS,S vaccine delivered en masse to the same high prevalence sub-population. A booster dose of vaccine was added 1 year later. The surveillance-as-intervention component of the package involved the screening and treatment of individuals entering the simulated population.ConclusionsIn this modelling approach, the sequential introduction of a series of five available interventions in an integrated strategy was predicted to be sufficient to stop malaria transmission within a 3-year period. These interventions comprised universal access to early diagnosis and adequate treatment, improved access to long-lasting insecticidal nets, three monthly rounds of mass drug administration together with RTS,S vaccination followed by a booster dose of vaccine, and screening and treatment of imported cases.

【 授权许可】

CC BY   
© The Author(s) 2017