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Impact of 1,7-malaria reactive community-based testing and response(1,7-mRCTR)approach on malaria prevalence inTanzania

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Infectious Diseases of Poverty 2023年第6期12卷 103-104页

作者： Wei Chang Jessica Cohen Duo‑Quan Wang Salim Abdulla Muhidin Kassim Mahende Tegemeo Gavana Valerie Scott Hajirani M.Msuya Mary Mwanyika‑Sando Ritha John ANjau 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 AMenzies Sein Kim Xiao Ning Xiao‑Nong Zhou Prosper Chaki Yeromin P.Mlacha Department of Global health and Population Harvard T.H. Chan School of Public Health Boston USA Chinese Center for Disease Control and Prevention National Institute of Parasitic Diseases Shanghai People’s Republic of China School of Global health Chinese Center for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine Shanghai People’s Republic of China Chinese Center for Tropical Diseases Research Shanghai People’s Republic of China WHO Collaborating Centre for Tropical Diseases Shanghai People’s Republic of China Ifakara health Institute Dar es Salaam United Republic of Tanzania Africa Academy for Public health Dar es Salaam Tanzania Muhimbili University of health and Allied Sciences Dar es Salaam Tanzania National Center for International Research on Tropical Diseases Ministry of Science and Technology Shanghai People’s Republic of China Global Malaria Programme World Health Organization Geneva Switzerland Bentley University Waltham USA Vanke School of Public health Tsinghua University Beijing People’s Republic of China School of Public health University of Alabama at Birmingham Birmingham USA The Pan-African Mosquito Control Association (PAMCA) KEMRI Headquarters Nairobi Kenya

Background Progress in malaria control has stalled in recent years and innovative surveillance and response approaches are needed to accelerate malaria control and elimination eforts in endemic areas of Africa.Build‑ing 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.Methods The 1,7-mRCTR approach provides community-based malaria testing via rapid diagnostic tests and treat‑ment in villages with the highest burden of malaria incidence based on surveillance data from health facilities.We used a diference-in-diferences quasi-experimental design with linear probability models and two waves of crosssectional 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 efects varied in subgroups,and explored alternative explanations for the observed results.Results Between October 2019 and September 2021,244,771 community-based malaria rapid tests were com‑pleted 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%confdence interval:−0.067,−0.023),equivalent to a 17%reduction from the baseline.In Rufji,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.Conclusions 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 efectiveness of community-based reactive approaches in moderate-to high-endemicity areas and demon

关键词： Malaria Surveillance and response Incidence rate community-health worker health facility communitybased testing and treatment 1,7-mRCTR Tanzania

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