Application of community-based and integrated strategy to reduce malaria disease burden in southern Tanzania: the study protocol of China-UK-Tanzania pilot project on malaria control

Wang, Duoquan; Chaki, Prosper; Mlacha, Yeromin P.; Gavana, Tegemeo; Michael, Mihayo Gabriel; Khatibu, Rashid; Feng, Jun; Zhou, Zhengbin; Lin, Kangming; Shang, Xianwen; He, Yao; Ishengoma, Deus S.; Rumisha, Susan F.; Mkude, Sigbert; Mandike, Renata; Chacky, Frank; Dismasi, Charles; Abdulla, Salim; Masanja, Honorati; Xiao, Ning; Zhou, Xiao‐Nong

doi:10.1186/s40249-018-0507-3

Cited by 40 publications

(36 citation statements)

References 7 publications

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“…China reported the successful combination of targeted schistosomiasis screening and selective/targeted treatment with the aim to avoid the treatment of non-infected individuals and to increase compliance for treatment against Schistosoma infections in endemic areas [ 20 – 29 ]. The value for decision-making of tailored interventions to target asymptomatic carriers contributing to transmission through community-wide mass drug treatment and active case finding, in addition to mapping spatial and temporal transmission dynamics, has been established for malaria [ 30 – 34 ].…”

Section: Resultsmentioning

confidence: 99%

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

et al. 2020

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Efforts to control and eliminate human schistosomiasis have accelerated over the past decade. In a number of endemic countries and settings, interruption of schistosome transmission has been achieved. In others, Schistosoma infections continue to challenge program managers at different levels, from the complexity of the transmission cycle, over limited treatment options and lack of field-friendly accurate diagnostics, to controversy around adequate intervention strategies. We conducted a landscape analysis on parasitic and vector-borne disease elimination approaches with the aim to identify evidence-based strategies, core components and key concepts for achieving and sustaining schistosomiasis control and for progressing elimination efforts towards interruption of transmission in sub-Saharan Africa. A total of 118 relevant publications were identified from Web of Science, Pubmed and the grey literature and reviewed for their content. In addition, we conducted in-depth interviews with 23 epidemiologists, program managers, policymakers, donors and field researchers. Available evidence emphasizes the need for comprehensive, multipronged and long-term strategies consisting of multiple complementary interventions that must be sustained over time by political commitment and adequate funding in order to reach interruption of transmission. Based on the findings of this landscape analysis, we propose a comprehensive set of intervention strategies for schistosomiasis control and elimination. Before deployment, the proposed interventions will require review, evaluation and validation in the frame of an expert consultation as a step towards adaptation to specific contexts, conditions and settings. Field testing to ensure local relevance and effectiveness is paramount given the diversity of socio-ecological and epidemiological contexts.

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Section: Resultsmentioning

confidence: 99%

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

et al. 2020

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“…A random sample of 2,000 households was selected based on community census data for each of the baseline and endline surveys. The sample size and power calculation for this evaluation can be found in the previously published protocol [33]. A structured questionnaire was designed based on the standard RBM-MERG guidelines with modi cation to t the study area [38].…”

Section: Discussionmentioning

confidence: 99%

“…The study area was the Ru ji District, located in southern Tanzania, which has been described previously [32,33]. A pilot project was implemented from September 2015 to June 2018.…”

Section: Study Design and Settingmentioning

confidence: 99%

“…Monday-Friday of the following week teams of community-based health care workers (CHCWs) set up community-based mobile test stations (cMTS) in different hamlets (sub-villages) of the 'hot spot' village, starting with those presumed to have the highest case ratio, but moving around to ensure the village-wide coverage of community members. The detailed activities for the 1,7-mRCTR implementation are provided in the Additional le 1 and study protocol which has been published elsewhere [33].…”

Section: The Interventionmentioning

confidence: 99%

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

Mlacha

Wang²,

Chaki

et al. 2020

Preprint

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BackgroundIn 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.MethodsThe 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.ResultsOverall 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.ConclusionThe 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.

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“…1). The 1-3-7 strategy was initially developed and implemented in China in 2012 [5][6][7] and has since been adapted to the local contexts in several country settings in Southern Africa and Southeast Asia [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Malaria elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia

Kheang¹,

Sovannaroth

Barat

et al. 2020

BMC Public Health

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Background: Cambodia has targeted malaria elimination within its territory by 2025 and is developing a model elimination package of strategies and interventions designed to achieve this goal. Methods: Cambodia adopted a simplified 1-3-7 surveillance model in the Sampov Loun operational health district in western Cambodia beginning in July 2015. The 1-3-7 approach targets reporting of confirmed cases within one day, investigation of specific cases within three days, and targeted control measures to prevent further transmission within seven days. In Sampov Loun, response measures included reactive case detection (testing of co-travelers, household contacts and family members, and surrounding households with suspected malaria cases), and provision of health education, and insecticide-treated nets. Day 28 follow up microscopy was conducted for all confirmed P. falciparum and P. falciparum-mixed-species malaria cases to assess treatment efficacy.

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Application of community-based and integrated strategy to reduce malaria disease burden in southern Tanzania: the study protocol of China-UK-Tanzania pilot project on malaria control

Cited by 40 publications

References 7 publications

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

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 elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia

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