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‑i...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 demonstrated the potential of South-South cooperation in tackling global health challenges.展开更多
基金supported by Bill&Melinda Gates Foundation(OPP1198779 and OPP1213975).
文摘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 demonstrated the potential of South-South cooperation in tackling global health challenges.
