Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia.
Division of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.
Malar J. 2018 Nov 16;17(1):430. doi: 10.1186/s12936-018-2562-4.
Malaria cases among mobile and migrant populations (MMPs) represent a large and important reservoir for transmission, if undetected or untreated. The objectives of this review were to identify which intersectoral actions have been taken and how they are applied to interventions targeted at the MMPs and also to assess the effect of interventions targeted to these special groups of population.
A total of 36 studies met the inclusion criteria for this review. Numerous stakeholders were identified as involved in the intersectoral actions to defeat malaria amongst MMPs. Almost all studies discussed the involvement of Ministry of Health/Public Health (MOH/MOPH). The most frequently assessed intervention among the studies that were included was the coverage and utilization of insecticide-treated nets as personal protective measures (40.5%), followed by the intervention of early diagnoses and treatment of malaria (33.3%), the surveillance and response activities (13.9%) and the behaviour change communication (8.3%). There is a dearth of information on how these stakeholders shared roles and responsibilities for implementation, and about the channels of communication between-and-within the partners and with the MOH/MOPH. Despite limited details in the studies, the intermediate outcomes showed some evidence that the intersectoral collaborations contributed to improvement in knowledge about malaria, initiation and promotion of bed nets utilization, increased access to diagnosis and treatment in a surveillance context and contributed towards a reduction in malaria transmission. Overall, a high proportion of the targeted MMPs was equipped with correct knowledge about malaria transmission (70%, 95% CI 57-83%). Interventions targeting the use of bed nets utilization were two times more likely to reduce malaria incidence amongst the targeted MMPs (summary OR 2.01, 95% CI 1.43-2.6) than the non-users. The various intersectoral actions were often more vertically organized and not fully integrated in a systemic way within a given country or sub-national administrative setting.
Findings suggest that interventions supported by the multiple stakeholders had a significant impact on the reduction of malaria transmission amongst the targeted MMPs. Well-designed studies from different countries are recommended to robustly assess the role of intersectoral interventions targeted to MMPs and their impact on the reduction of transmission.
流动人口中的疟疾病例代表了一个重要的、大量的传播源，如果这些病例没有被发现或没有得到治疗。本综述的目的是确定已经采取了哪些跨部门行动，以及它们如何应用于针对流动人口的干预措施，同时评估针对这些特殊人群的干预措施的效果。
共有 36 项研究符合本综述的纳入标准。确定了许多利益攸关方参与了针对流动人口的疟疾跨部门行动。几乎所有研究都讨论了卫生部/公共卫生部（MOH/MOPH）的参与。纳入研究中最常评估的干预措施是使用驱虫蚊帐作为个人保护措施的覆盖率和利用率（40.5%），其次是疟疾的早期诊断和治疗（33.3%）、监测和应对活动（13.9%）以及行为改变沟通（8.3%）。关于这些利益攸关方如何分担实施的角色和责任，以及关于合作伙伴之间以及与 MOH/MOPH 之间的沟通渠道，信息匮乏。尽管研究中的细节有限，但中期结果表明，跨部门合作有助于提高对疟疾的认识，启动和促进蚊帐的使用，在监测背景下增加获得诊断和治疗的机会，并有助于减少疟疾的传播。总体而言，很大一部分目标流动人口都具备了正确的疟疾传播知识（70%，95%置信区间 57-83%）。针对蚊帐使用的干预措施使目标流动人口中的疟疾发病率降低了两倍（汇总 OR 2.01，95%置信区间 1.43-2.6），比非使用者降低了两倍。各种跨部门行动通常更多地是垂直组织的，而不是在一个特定国家或国家以下行政单位内以系统的方式完全整合。
研究结果表明，得到多方利益攸关方支持的干预措施对减少目标流动人口中的疟疾传播产生了重大影响。建议来自不同国家的精心设计的研究，以稳健地评估针对流动人口的跨部门干预措施的作用及其对减少传播的影响。
